Hayashi M, Ohashi Y, Tanaka A, Kakinoki Y, Nakai Y
Department of Otolaryngology, Osaka City University Medical School, Japan.
Acta Otolaryngol Suppl. 1998;538:133-42. doi: 10.1080/00016489850182855.
Although immunotherapy is recognized as a highly effective form of treatment for allergic rhinitis, especially pollen-induced seasonal allergic rhinitis, the mechanisms have not been fully established. In the present study, we investigated whether immunotherapy could affect the seasonal increase in interleukin-5 (IL-5) in the serum of patients with seasonal allergic rhinitis and whether the effect on IL-5 in serum is related to the clinical efficacy of immunotherapy. Venous blood was collected twice from each patient with seasonal allergic rhinitis due to Japanese cedar pollens, before and during the cedar pollen season in 1997, to determine the cedar pollen-specific IgE and IL-5 in serum. Both specific IgE and IL-5 in serum were significantly increased during the pollen season, not only in the poor responders to antihistamines but also in the good responders. Neither the rate of seasonal increase in specific IgE nor the rate of seasonal increase in IL-5 differed significantly between the good responders and the poor responders to antihistamines. Both specific IgE and IL-5 were significantly increased during the pollen season in the poor responders to immunotherapy, whereas neither specific IgE nor IL-5 was increased during the pollen season in the good responders to immunotherapy. The rate of seasonal increase in specific IgE as well as IL-5 was significantly smaller in the good responders than in the poor responders to immunotherapy. The rates of seasonal increase in specific IgE and in IL-5 were inversely correlated with the length of time on immunotherapy. However, the rate of seasonal increase in specific IgE was not significantly correlated with the rate of seasonal increase in IL-5. In conclusion, the suppression of the seasonal increase in IL-5 in serum is a working mechanism of immunotherapy related to the clinical efficacy of the treatment.
尽管免疫疗法被认为是治疗过敏性鼻炎，尤其是花粉诱发的季节性过敏性鼻炎的一种高效治疗方式，但其作用机制尚未完全明确。在本研究中，我们调查了免疫疗法是否会影响季节性过敏性鼻炎患者血清中白细胞介素-5（IL-5）的季节性升高，以及血清中IL-5的变化是否与免疫疗法的临床疗效相关。1997年，在日本柳杉花粉季节之前和期间，从每位因日本柳杉花粉导致季节性过敏性鼻炎的患者身上采集两次静脉血，以测定血清中柳杉花粉特异性IgE和IL-5。在花粉季节，血清中的特异性IgE和IL-5均显著升高，不仅在抗组胺药治疗效果不佳的患者中如此，在治疗效果良好的患者中也是如此。抗组胺药治疗效果良好的患者和效果不佳的患者之间，特异性IgE的季节性升高率和IL-5的季节性升高率均无显著差异。免疫疗法效果不佳的患者在花粉季节特异性IgE和IL-5均显著升高，而免疫疗法效果良好的患者在花粉季节特异性IgE和IL-5均未升高。免疫疗法效果良好的患者特异性IgE和IL-5的季节性升高率均显著低于效果不佳的患者。特异性IgE和IL-5的季节性升高率与免疫治疗的时长呈负相关。然而，特异性IgE的季节性升高率与IL-5的季节性升高率无显著相关性。总之，血清中IL-5季节性升高的抑制是免疫疗法的一种作用机制，与治疗的临床疗效相关。
