变应性鼻炎发病期和稳定期人群血清中重要参与因子的动态变化的观察

目的采用组合监测方案,了解各指标在变应性鼻炎发敏过程中的动态变化;分析相互之间的调控机理,拟释放过敏性鼻炎的区域性、季节性、个体性的内在原因。方法应用放射免疫和酶联技术对变应性鼻炎发病期(30例)稳定期(30例)血样IL-4,IL-8,TNF-,αLgE水平进行检测和嗜酸性粒细胞计数。结果过敏性鼻炎发病期IL-4,IL-8,IgE水平高于稳定期(P<0.01),并且过敏性鼻炎发病期测量水平与稳定期相比具有统计意义(P<0.01)。结论过敏性鼻炎患者不同时期多种重要参与因子有意义的变化,提示患者发病期与稳定期测定指标(IL-4,IL-8,LgE)的明显差异为临床诊断和预后判断提供辅助诊断的科学依据,并且依据发病期和稳定期各测量值的差异,可作为发病前预测指标。     

变应性鼻炎、哮喘患者T细胞亚群、白介素水平及肺功能测定

目的评价变应性鼻炎、哮喘患者血清中白细胞介素IL-4、IL-5、IL-6检测指标的方法。方法变应性鼻炎、哮喘及鼻炎并哮喘患者外周血CD3、CD4、CD8较正常对照组均有明显下降,经t检验有显著性差异(P<0.01),鼻炎组、哮喘组及鼻炎并哮喘组血清IL-4、IL-5、IL-6水平明显高于对照组。其气道反应性明显高于对照组。结论IL-4、IL-5、IL-6参与了变应性鼻炎、哮喘的发生和促进了变态反应性疾病的发展,有必要开展更广泛研究和更深层的原因探索。     

过敏性鼻炎口服液对变应性鼻炎动物模型骨髓IL-5的影响

目的观察过敏性鼻炎口服液对变应性鼻炎大鼠骨髓中白细胞介素-5(IL-5)表达的影响,以探讨该药治疗变应性鼻炎的作用机理。方法 40只大鼠随机分为过敏性鼻炎口服液实验组、扑尔敏对照组、盐水对照组、正常对照组;造模完成后第2天,前3组分别予过敏性鼻炎口服液、扑尔敏、生理盐水灌胃7d;最后处死动物,取骨干髓腔将骨髓细胞冲洗出,离心沉渣涂片。采用免疫组化方法检测骨髓中IL-5的表达。结果过敏性鼻炎口服液实验组的骨髓IL-5与扑尔敏对照组、盐水对照组相比差异均有统计学意义(P0.01),与正常对照组比较差异无统计学意义(P0.05)。结论过敏性鼻炎口服液能降低骨髓IL-5,抑制AR的发生,这可能是过敏性鼻炎口服液治疗变应性鼻炎患者的作用机理之一。     

变应性鼻炎患者血清Th细胞亚群及相关细胞因子水平变化

目的 观察变应性鼻炎患者血清辅助性T细胞(Th细胞)亚群及其相关因子(IL-12、IL-2、INF-γ)水平变化。方法 选取40例变应性鼻炎患者(观察组)、36例健康体检者(对照组),检测两组血清IL-4、IL-27、INF-γ、CRP、ESR、TNF-α水平,计算Th1/Th2。结果 与对照组比较,观察组IL-27、INF-γ水平及Th1/Th2降低,而IL-4、CRP、TNF-α水平及ESR升高,两组比较差异有统计学意义(P均<0.05)。结论 变应性鼻炎患者IL-27、INF-γ水平降低,IL-4水平上升,Th1/Th2值下降,此变化可能与变应性鼻炎发病有关。     

孟鲁司特钠辅助治疗老年变应性鼻炎的疗效及对IL-6、IL-8、IL-10的影响

目的探讨孟鲁司特钠辅助治疗老年变应性鼻炎的疗效及对白细胞介素(IL)-6、IL-8、IL-10的影响。方法将86例老年变应性鼻炎患者随机分为单药组和联合组,各43例。另选40例健康者作为对照组。单药组给予布地奈德鼻喷雾剂,联合组在单药组的基础上加用孟鲁司特钠进行辅助治疗。比较两组疗效及IL-6、IL-8、IL-10变化。结果与对照组比较,治疗前、后单药组与联合组患者血清IL-6、IL-8水平均明显升高(P0.05),IL-10水平明显降低(P0.05)。与治疗前比较,治疗后单药组与联合组患者血清IL-6、IL-8水平均显著降低(P0.05),IL-10水平明显升高(P0.05),但联合组IL-6、IL-8、IL-10水平改善更明显(P0.05);联合组患者治疗后总有效率为90.70%,显著高于单药组的69.77%(P0.05)。结论孟鲁司特钠辅助治疗老年变应性鼻炎疗效显著,可有效改善患者IL-6、IL-8、IL-10水平。     

苯那普利对中老年慢性心衰患者血清促炎症细胞因子水平的影响

目的观察中老年慢性心衰(CHF)患者血清促炎症细胞因子水平及使用苯那普利治疗后的水平变化。方法选择60例诊断为CHF的患者分为两组,常规治疗组30例,苯那普利治疗组30例。另随机选取正常人30例作为正常对照组。于治疗前和治疗4w后分别检测血清IL-1β、IL-6、TNF-α水平。结果治疗前CHF患者的血清IL-1β、IL-6、TNF-α水平均较正常对照组显著升高(P<0.01)。治疗4w后两个CHF治疗组血清IL-1β、IL-6、TNF-α水平均有降低(P<0.01),常规治疗组患者仅有血清TNF-α水平与治疗前差异具有统计学意义(P<0.01),而苯那普利治疗组患者血清IL-1β、IL-6、TNF-α水平与治疗前相比均有统计学意义(P<0.01)。结论应用苯那普利治疗后,血清3种促炎症细胞因子水平均显著下降,可能与苯那普利的抗炎作用有关。     

哮喘合并过敏性鼻炎患者TH2类细胞因子水平研究

目的 探讨哮喘合并过敏性鼻炎患者血清中TH2类细胞因子水平同单纯哮喘患者是否存在差异.方法 采用双抗体夹心酶联免疫吸附法检测哮喘、过敏性鼻炎合并哮喘患者及健康查体者血清中IL-4、IL-5、IL-10水平.结果 哮喘、哮喘合并过敏性鼻炎患者患者血清IL-4、IL-5、IL-10水平均较健康查体者高,以哮喘合并过敏性鼻炎患者升高为著(P<0.05、<0.01).结论 哮喘合并过敏性鼻炎患者与单纯哮喘患者TH2类细胞因子水平存在差异.     

健脾清肠法治疗溃疡性结肠炎的临床疗效及对血清白细胞介素4和白细胞介素8的影响

[目的]探讨健脾清肠法治疗溃疡性结肠炎(UC)患者的临床疗效及对血清白细胞介素4(IL-4)I、L-8的影响。[方法]72例UC患者随机分为2组,治疗组和对照组各36例,治疗组口服中药健脾灵片加苦参槐花合剂保留灌肠治疗,对照组单纯口服艾迪莎治疗。采用双抗体夹心ELISA法测定2组患者治疗前后血清IL-4I、L-8水平,並与30例健康志愿者(志愿组)对照。[结果]治疗组临床治愈率为66.7%,显效率为91.7%,对照组分别为38.9%、69.4%,2组治愈率和显效率比较差异有统计学意义(P<0.05)。治疗前2组IL-4水平均明显低于志愿组(P<0.01),IL-8明显高于志愿组(P<0.01)。治疗组治疗后IL-4水平明显上升,IL-8水平明显下降,与治疗前比较差异有统计学意义(P<0.01),2者水平与志愿组比较差异无统计学意义(P>0.05)。对照组治疗后IL-4水平有所上升,但与治疗前比较P>0.05,IL-8水平有明显下降,与治疗前比较P<0.01,IL-4上升幅度和IL-8下降幅度均不如治疗组显著(P<0.01)。[结论]健脾清肠法(中药健脾灵片加苦参槐花合剂)治疗UC的疗效明显优于西药艾迪莎,其机制可能与上调IL-4和下调IL-8水平,使机体免疫功能重新恢复平衡有关。     

扁桃体摘除术对IgA肾病患者免疫功能的影响

对60例伴扁桃体炎的IgA肾病(IgAN)患者(观察组)行扁桃体摘除术,流式细胞术检测其手术前后T细胞亚群水平,ELISA方法检测尿IL-6水平,并与60例健康人(对照组)比较。结果观察组术前尿IL-6水平明显高于对照组(P<0.01),CD4/CD8明显低于对照组(P<0.01);术后尿IL-6水平明显降低,CD4/CD8升高,与术前比较有显著性差异(P<0.05)。认为扁桃体摘除术可改善IgAN患者的免疫功能,有助于IgAN患者的恢复。尿IL-6和血CD4/CD8可作为判断IgAN扁桃体摘除术疗效的指标。     

冠心病患者炎性标志物的检测水平及意义

目的:探讨血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)和可溶性细胞间黏附分子-1(sICAM-1)在冠心病(CHD)发病机制中的意义。方法:采用酶联免疫吸附法(ELISA),检测86例CHD患者TNF-α、IL-8和sICAM-1水平,并与30例正常对照者进行比较。结果:CHD患者TNF-α、IL-8和sICAM-1水平显著高于正常对照组(P<0.01),急性心肌梗死患者和不稳定型心绞痛患者TNF-α、IL-8和sICAM-1水平显著高于稳定型心绞痛患者(P<0.01)。结论:TNF-α、IL-8和sICAM-1可能参与了CHD的发病过程,且与病变稳定性有关。     

低亲和力IgE受体与外源性支气管哮喘

本文对３０例外源性哮喘患者及３０例正常人的外周血单个核细胞（ＭＮＣ）低亲和力ＩｇＥ受体（即ＣＤ２３）表达、白细胞介素－４（ＩＬ－４）及血清ＩｇＥ水平进行测定。结果显示：发作组哮喘患者ＩｇＥ、ＩＬ－４、ＣＤ２３与缓解组及正常对照组之间有显著性差异（Ｐ＜０．０１）。且ＩｇＥ升高与ＣＤ２３呈正相关（ｒ＝０．８２７；Ｐ＜０．０１）。缓解组ＩｇＥ抗体、ＩＬ－４与正常对照组之间无显著性差异（Ｐ＞０．０５）；ＣＤ２３与正常对照组之间有显著性差异（Ｐ＜０．０ｌ）。以上结果表明了这一细胞因子的失衡与外源性哮喘的关系。     

Increase of the soluble IL-4 receptor (IL-4sR) and positive correlation between IL-4sR and IgE in nasal fluids from school children with allergic rhinitis.

Soluble cytokine receptors (SCR) can either act as inhibitors, by competitively inhibiting cytokines from binding to their membrane-bound receptors, or as enhancers, by serving as cytokine carriers. We have previously found that the levels of the Th2 cytokines interleukin (IL)-4, IL-5, IL-6, and IL-10 were positively correlated to eosinophils and IgE in nasal fluids from 60 children with seasonal allergic rhinitis. In this study, nasal fluids were reexamined to analyze IL-4sR, IL-6sR, IL-1 beta, TNF-alpha, IL-1sR2, TNF-sR1, and TNFsR2 in relation to eosinophils, neutrophils, ECP, and IgE. In allergic patients IL-4sR increased significantly during the pollen season, and weak, but positive correlations with IgE and eosinophils were found (r = 0.45, P < 0.001 and r = 0.4, P < 0.001 respectively). By contrast, none of the other SCR showed increases or correlations with IgE. However, positive correlations between IL1 beta, TNF-alpha, IL-6sR, IL-1sR2, TNF-sR1, TNF-sR2, and either neutrophils or ECP were found. Also, in healthy controls, these cytokines and their receptors were positively correlated to neutrophils or ECP. Thus, increased levels of the soluble IL-4 receptor, as well as IgE, were specifically associated with allergic rhinitis, whereas all other SCR correlated with either inflammatory cells or their products, in both allergic and healthy subjects. These results may suggest that SCR in vivo act as cytokine enhancers, rather than inhibitors.     

成人期起病支气管哮喘临床及炎症特点分析

目的了解成人期起病支气管哮喘临床特点及相关细胞因子分析。方法根据哮喘起病年龄,分为成人期起病组和儿童期起病组,检测肺功能、外周血总Ig E、IL-1、IL-4、IL-6、IL-8、IL-10以及肿瘤坏死因子-α等炎症因子,诱导痰细胞计数及分类,两组进行比较。结果共入选哮喘患者161例,成人期起病患者103例,儿童期起病患者58例。成人期起病组与儿童期起病组有过敏史者分别为71.8%和94.8%(P0.001);合并过敏性鼻炎者分别为58.3%(60/103)和74.1%(43/58),P0.05;两组平均病程为7.9±8.9年和34.4±14.8年,FEV1%两组无统计学差异。白介素及肿瘤坏死因子两组无统计学差异(P0.05)。结论无论哮喘起病年龄早晚,过敏仍是哮喘起病主要因素。成人期起病哮喘FEV1%与病程无显著相关。血及诱导痰嗜酸性粒细胞、血清白介素、TNF-α等在不同年龄起病哮喘中无差异。     

Cytokines in nasal lavage fluids from acute sinusitis, allergic rhinitis, and chronic fatigue syndrome subjects.

The aim of this study was to compare the degree of inflammation present in acute sinusitis, allergic rhinitis, chronic Fatigue Syndrome (CFS), and non-CFS control subjects by measuring cytokine concentrations in nasal lavage fluids. The concentrations of total protein (TP; Lowry assay), nerve growth factor (NGF), tumor necrosis factor (TNF) alpha, and interleukin (IL)-8 were measured by ELISA in nasal lavage fluids from acute sinusitis (n = 13), active allergic rhinitis (n = 16), CFS (n = 95), and non-CFS (n = 89) subjects. CFS and non-CFS groups were subdivided further using allergy skin test and rhinitis score results. Acute sinusitis subjects had significantly higher TP (p = 0.011, ANOVA), TNF-alpha (p = 0.00071), and IL-8 (p = 0.0000027) concentrations and IL-8/TP ratios (p = 0.0030) than the other three patient groups. There were no differences based on skin test or rhinitis score severity within either the CFS or non-CFS groups. The mucopurulent discharge of acute sinusitis contained significantly higher TNF-alpha and IL-8. Neutrophils were a likely source for these cytokines. There were no differences between CFS and non-CFS subjects, making it unlikely that the rhinitis of CFS has an inflammatory component.     

C-反应蛋白与冠心病关系的研究

目的：探讨高敏C-反应蛋白（hs—CRP）水平与冠状动脉疾病的关系。方法：对经冠状动脉造影确诊或有明确心肌梗塞的冠心病患者82例和同期经冠状动脉造影证实冠状动脉无狭窄的正常对照者43例进行对照研究。所有研究对象在入院初或病情稳定48h后采清晨空腹静脉血，应用微粒子增强透射免疫分析法测定血浆hs—CRP水平。结果：冠心病组的血浆hs—CRP水平显著高于对照组（P〈0．001）；在冠心病组中，急性冠脉综合征（ACS）组（42例）的hs—CRP水平显著高于稳定型心绞痛（SAP）组（40例）（P〈0．001），SAP组的hs—CRP水平也显著高于对照组（P〈0.01）。单支病变（19例）、双支病变（23例）、三支及左主干病变（30例）组的hs—CRP水平均显著高于对照组（P分别〈0.01，〈0.001和〈0.001）。以人群血浆hs—CRP水平的第90分位值3mg／L为截点，将冠心病组中行冠脉造影的对象分为低hs—CRP水平组和高hs—CRP水平组，可见后者多支病变（包括双支病变和三支及左主干病变）的例数（n=36）显著多于前者（n=17）（P〈0．05）。结论：高敏C-反应蛋白水平可反映冠状动脉疾病及其病变的严重程度。     

Gender differences in IgE-mediated allergic asthma in the epidemiology and natural history of asthma: Outcomes and Treatment Regimens (TENOR) study.

BACKGROUND: The TENOR study consists of a large cohort of subjects with severe or difficult-to-treat asthma. The objective of this analysis was to evaluate demographic and clinical characteristics of subjects 12 years of age or older with immunoglobulin E (IgE)-mediated allergic asthma (skin test positive with an IgE level = 30 to =700 IU/mL), and specifically, to assess gender differences in this cohort. METHODS: A total of 4,756 subjects were enrolled by 283 US study sites between January and October 2001. Of those subjects 12 years or older at baseline with an IgE measure and who were skin tested (n = 2,843), 1,783 (63%) were skin test positive and had an IgE level between = 30 to = 700 IU/mL. RESULTS: Compared to males, females reported significantly greater healthcare utilization (steroid bursts in previous 3 months: 50% vs 42%, p < 0.001; unscheduled office visits in previous 3 months: 50% vs 36%, p < 0.0001; missed 1+ days of work/school in previous 2 weeks: 14% vs 10%, p < 0.01). Females also reported significantly more asthma control problems and lower asthma-related quality of life (4.6 +/- 1.3 vs 5.2 +/- 1.2; p < 0.0001); the difference was clinically meaningful. Asthma triggers and allergic comorbidities, such as allergic rhinitis and atopic dermatitis, were more common in female subjects. Despite their overall worse health outcomes, female subjects demonstrated better lung function, had similar treatment patterns, and showed no differences in physician-assessed asthma severity when compared with males. CONCLUSIONS: The reasons for these gender differences in subjects with IgE-mediated allergic asthma are complex, but results from this analysis suggest that detailed evaluations of asthma patients, including symptom-related questions and asthma-related healthcare utilization, are needed to accurately assess asthma severity and control.     

Allergic rhinitis and onset of bronchial hyperresponsiveness: a population-based study

RATIONALE: Patients with allergic rhinitis have more frequent bronchial hyperresponsiveness (BHR) in cross-sectional studies. OBJECTIVES: To estimate the changes in BHR in nonasthmatic subjects with and without allergic rhinitis during a 9-year period. METHODS: BHR onset was studied in 3,719 subjects without BHR at baseline, who participated in the follow-up of the European Community Respiratory Health Survey. MEASUREMENTS AND MAIN RESULTS: BHR was defined as a >or=20% decrease in FEV(1) for a maximum dose of 1 mg of methacholine. Allergic rhinitis was defined as having a history of nasal allergy and positive specific IgE (>or=0.35 IU/ml) to pollen, cat, mites, or Cladosporium. The cumulative incidence of BHR was 9.7% in subjects with allergic rhinitis and 7.0% in subjects with atopy but no rhinitis, compared with 5.5% in subjects without allergic rhinitis and atopy (respective odds ratios [OR] and their 95% confidence intervals [95% CI] for BHR onset, 2.44 [1.73-3.45]; and 1.35 [0.86-2.11], after adjustment for potential confounders including sex, smoking, body mass index and FEV(1)). Subjects with rhinitis sensitized exclusively to cat or to mites were particularly at increased risk of developing BHR (ORs [95% CI], 7.90 [3.48-17.93] and 2.84 [1.36-5.93], respectively). Conversely, in subjects with BHR at baseline (n = 372), 35.3% of those with allergic rhinitis, compared with 51.8% of those without rhinitis had no more BHR at follow-up (OR [95% CI], 0.51 [0.33-0.78]). BHR "remission" was more frequent in patients with rhinitis treated by nasal steroids than in those not treated (OR [95% CI], 0.33 [0.14-0.75]). CONCLUSIONS: Allergic rhinitis was associated with increased onset of BHR, and less chance for remission except in those treated for rhinitis.     

尘螨变应性鼻炎全血细胞IL-4、IL-13的表达及临床意义

目的探讨IL-4、IL-13在变应性鼻炎发病机制中的作用及IL-4、IL-13拮抗剂治疗变应性鼻炎的临床意义。方法取52例变应性鼻炎（实验组）及25例无过敏性疾病（对照组）患者的外周血，用PMA（phorbol 12-myristate 13-acetate佛波酯）＋inomycin（离子霉素）及标准化尘螨抗原刺激后经细胞内染色，流式细胞仪检测IL-4、IL-13、IFN-γ的表达细胞百分数，ELISA检测血清IL-4、IL-13含量。结果对照组经标准化尘螨变应原刺激后细胞内测出IFN-γ为0．3％-0．4％，但检测不到IL-4与IL-13，经PMA＋inomycin刺激后IFN-γ为5．0％-12．4％、IL-4为0．5％-0．8％、IL-13为0％-0．2％；实验组经标准化尘螨变应原刺激后IFN-γ为0．3％-0．5％、IL-4为0．9％-1．3％、IL-13为0．5％-0．9％，经PMA＋inomycin刺激后IFN-γ为17.3％-24．0％、IL-4为2．1％-3．5％、IL-13为0．8％-2．0％。实验组血清中IL-4含量为（1．768±0．485）pg／ml、IL-13为（5．427±1．263）pg／ml，对照组IL-4与IL-13含量均低于敏感度。结论IL-4、IL-13在变应性鼻炎患者中表达升高，参与了变态反应过程，为临床应用IL-4、IL-13拮抗剂治疗变应性鼻炎提供了依据。     

IL-25 and IL-33 Serum Levels are not Associated with the Type of Allergen Causing Allergic Rhinitis

Background: Fungal aeroallergens might sensitize the airway which in turn produces a specific cytokine profile. Objective: To evaluate the IL-25 and IL-33 profile in patients with fungal allergic rhinitis. Methods: The present study examined patients who were evaluated due to allergic rhinitis (AR) at Emam Reza Hospital of Shiraz, Iran. The allergic patients were categorized based on the skin prick test. Blood samples were collected and allergen-specific IgE and cytokine profiles were analyzed. Results: 184 patients were enrolled in the study and in 35 of whom fungal rhinitis was confirmed. The levels of specific IgE in patients with fungal allergy were statistically significant compared to those in the control group (p<0.000). However, there were no significant differences in IL-25 and IL-33 levels between fungal and none-fungal AR patients. Conclusion: Chronic fungal challenge might regulate innate system cytokines in severe persistent AR.     

Beta-adrenergic receptors of lymphocytes in children with allergic respiratory diseases

The beta-adrenergic receptor binding sites on peripheral lymphocytes in children with bronchial asthma (n = 16) and seasonal allergic rhinitis (n = 8) were examined in comparison with normal controls (n = 18) by means of 124I-cyanopindolol. The number of beta-adrenergic receptors was significantly lower in the asthmatic group (858 +/- 460/lymphocyte) than in the controls (1564 +/- 983/lymphocyte). The value (1891 +/- 1502/lymphocyte in children with allergic rhinitis was slightly higher than that in healthy controls. Of the 24 patients suffering from allergic diseases of the lower or upper airways, the bronchial histamine provocation test was performed in 21; 16 gave positive results, while 5 were negative. No difference in beta-adrenergic receptor count was found between the histamine-positive and negative patients. Neither was there any correlation between the number of beta-adrenergic receptors and the high (16/24) and low (8/24) serum IgE concentrations found in allergic patients. The significant decrease in beta-adrenergic receptor count in asthmatic children lends support to Szentiványi's concept. Further qualitative and quantitative analysis of lymphocyte beta-adrenergic receptors may provide an individual approach to the treatment of bronchial asthma with beta-sympathomimetic drugs.