Aubier M, Neukirch C, Maachi M, Boucara D, Engelstätter R, Steinijans V, Samoyeau R, Dehoux M
Unité de Pneumologie, Hôpital BICHAT, Paris, France.
Eur Respir J. 1998 May;11(5):1105-10. doi: 10.1183/09031936.98.11051105.
It has been recognized recently that theophylline possesses anti-inflammatory effects that could be of clinical interest in patients with airway inflammatory diseases such as asthma and allergic rhinitis (AR). The aim of the present study was to explore the effect of theophylline on the nasal eosinophilic inflammatory response following allergen challenge in patients with AR. Fourteen subjects suffering from seasonal rhinitis with an early reaction after nasal allergen provocation were challenged outside the pollen season after pretreatment for 3 weeks with placebo or slow-release theophylline (Euphylong in a randomized double-blind, cross-over study. Nasal blocking index (NBI), nasal airway resistance and symptoms were recorded before, and 1 and 5 h after challenge; additionally, nasal lavage fluid was collected before, as well as 1 and 5 h after challenge. Eosinophil cationic protein (ECP) was measured in the lavage as well as the number of eosinophils before, and 1 h and 5 h after allergen challenge. After 3 weeks of treatment, baseline concentrations of ECP in nasal lavage amounted to 826+/-329 ng x L(-1) (placebo) and 936+/-351 ng x L(-1) (theophylline). The ECP levels did not increase during the early phase response. Five hours after challenge, ECP in the placebo group increased markedly (p<0.01), whereas no significant increase was observed during theophylline treatment. In parallel, the number of eosinophils in the nasal lavage fluid was lower during theophylline treatment. Additionally, theophylline therapy also significantly reduced the nasal symptoms and had some protective effect against nasal obstruction following allergen challenge. These results confirm the anti-inflammatory effects of theophylline and suggest that these effects may be of clinical benefit in patients with allergic rhinitis.
最近人们认识到，茶碱具有抗炎作用，这可能对患有气道炎性疾病（如哮喘和变应性鼻炎（AR））的患者具有临床意义。本研究的目的是探讨茶碱对AR患者变应原激发后鼻嗜酸性粒细胞炎症反应的影响。在花粉季节之外，对14名患有季节性鼻炎且鼻变应原激发后有早期反应的受试者进行了研究，在随机双盲交叉研究中，他们接受了3周的安慰剂或缓释茶碱（优菲龙）预处理。在激发前、激发后1小时和5小时记录鼻阻塞指数（NBI）、鼻气道阻力和症状；此外，在激发前以及激发后1小时和5小时收集鼻灌洗液。测定灌洗液中的嗜酸性粒细胞阳离子蛋白（ECP）以及变应原激发前、激发后1小时和5小时的嗜酸性粒细胞数量。治疗3周后，鼻灌洗液中ECP的基线浓度在安慰剂组为826±329 ng·L⁻¹，在茶碱组为936±351 ng·L⁻¹。在早期反应阶段，ECP水平未升高。激发后5小时，安慰剂组的ECP显著升高（p<0.01），而在茶碱治疗期间未观察到显著升高。同时，在茶碱治疗期间，鼻灌洗液中的嗜酸性粒细胞数量较低。此外，茶碱治疗还显著减轻了鼻部症状，并对变应原激发后的鼻阻塞有一定的保护作用。这些结果证实了茶碱的抗炎作用，并表明这些作用可能对变应性鼻炎患者具有临床益处。
