Gutiérrez V, Prieto L, Torres V, Morales C, González E
Sección de Alergología, Hospital Universitario Dr. Peset, Valencia, Spain.
Ann Allergy Asthma Immunol. 1998 Aug;81(2):143-50. doi: 10.1016/s1081-1206(10)62801-3.
Although some non-asthmatic subjects with allergic rhinitis exhibit airway hyperresponsiveness and increased diurnal peak expiratory flow (PEF) variation, little is known about the critical features that determine these physiologic alterations.
In subjects with allergic rhinitis and methacholine hyperresponsiveness but no asthma symptoms, we examined whether there were features of asthmatic airway inflammation.
Forty non-asthmatic adults (11 with allergic rhinitis and methacholine hyperresponsiveness, 20 with allergic rhinitis and normal methacholine responsiveness, and 9 healthy control subjects) were studied. Sputum was induced with inhaled hypertonic saline for 5-minute periods for up to 20 minutes. Plugs from the lower respiratory tract were selected for differential counting in cytocentrifuged preparations. For the next 14 days, subjects measured their PEF two times daily. Peak expiratory flow variation was expressed as amplitude % mean.
Peak expiratory flow variation was significantly higher in subjects with allergic rhinitis and methacholine hyperresponsiveness than in allergic rhinitis patients with normal methacholine responsiveness and healthy controls. Eosinophil counts in the induced sputum were significantly higher in the subjects with allergic rhinitis and methacholine hyperresponsiveness [median (interquartile range), 7.3 (9.0)%] compared with allergic rhinitis patients with normal methacholine responsiveness [2.5 (3.8)%, P = .03] and healthy controls [1.0 (1.0)%, P = .02].
We conclude that eosinophilic inflammation may be present in subjects with allergic rhinitis and airway hyperresponsiveness even when there are no symptoms of asthma. This could indicate that bronchial eosinophilia is insufficient to cause asthmatic symptoms.
尽管一些患有过敏性鼻炎的非哮喘患者表现出气道高反应性和日间呼气峰流速（PEF）变异增加，但对于决定这些生理改变的关键特征知之甚少。
在患有过敏性鼻炎且对乙酰甲胆碱高反应但无哮喘症状的患者中，我们研究是否存在哮喘气道炎症特征。
研究了40名非哮喘成年人（11名患有过敏性鼻炎且对乙酰甲胆碱高反应，20名患有过敏性鼻炎且对乙酰甲胆碱反应正常，9名健康对照者）。通过吸入高渗盐水诱导痰液5分钟，最长可达20分钟。从下呼吸道选取栓子在细胞离心涂片制备物中进行分类计数。在接下来的14天里，受试者每天测量两次PEF。呼气峰流速变异以幅度%均值表示。
患有过敏性鼻炎且对乙酰甲胆碱高反应的患者的呼气峰流速变异显著高于对乙酰甲胆碱反应正常的过敏性鼻炎患者和健康对照者。与对乙酰甲胆碱反应正常的过敏性鼻炎患者[2.5（3.8）%，P = 0.03]和健康对照者[1.0（1.0）%，P = 0.02]相比，患有过敏性鼻炎且对乙酰甲胆碱高反应的患者诱导痰中的嗜酸性粒细胞计数显著更高[中位数（四分位间距），7.3（9.0）%]。
我们得出结论，即使没有哮喘症状，患有过敏性鼻炎和气道高反应性的患者中可能存在嗜酸性粒细胞炎症。这可能表明支气管嗜酸性粒细胞增多不足以引起哮喘症状。
