炎性细胞在变应性鼻炎患者鼻黏膜中的观察

目的 探讨变应性鼻炎患者鼻黏膜组织中炎性细胞的变化及与变应性鼻炎的关系。方法 选择55例发作期变应性鼻炎患者及123例健康者，采用刮匙在下鼻甲黏膜处刮拭涂片，用Wright染色，进行细胞学检测，并进行统行学分析。结果变应性鼻炎发作期患者黏膜细胞发生了显著变化，中性粒细胞及嗜酸粒细胞的数量显著增加（P〈0．001），淋巴细胞明显增加（P〈0.05），而脱落上皮细胞显著减少（P〈0．001）。结论 炎性细胞是变应性鼻炎发病机制中诸多因素之一，深入了解这一作用对于指导临床治疗有重要的意义。     

变应性鼻炎鼻分泌物中上皮细胞集落和嗜酸粒细胞的检测

为了观察变应性鼻炎（allesgicrhinitis，AR）患者鼻分泌物中的上皮细胞集落和嗜酸粒细胞，对20例AR患者（AR组）和15例鼻窦炎患者（感染组）鼻分泌物中细胞成分进行了电镜观察，发现AR组鼻分泌物中有大量上皮细胞集落，其特征是数个至数十个上皮细胞成片状脱落，上皮细胞集落的数量和嗜酸粒细胞的数量、嗜酸粒细胞阳离子蛋白（eosinophiliccationicprotein，ECP）的含量呈正相关。感染组中上皮细胞集落和嗜酸粒细胞极少，ECP含量甚微。结果提示嗜酸粒细胞的ECP可能导致AR患者的鼻粘膜上皮呈片状脱落，对上皮结构造成损害。     

免疫疗法合并鼻炎冲剂治疗常所性变应性鼻炎疗…

常年性变应性鼻炎９０例分单纯中药组（鼻炎冲剂），单纯免疫疗法组和中西医结合（鼻炎冲剂结合免疫疗法）进行治疗，治疗前及治疗４月时测定血清ＩｇＥ，ＩｇＧ血浆ｃＡＭＰ，ｃＧＭＰ及鼻分泌物嗜酸细胞，结果表明，单纯中药组，单纯免疫法组和中西医结合治疗组有效率分别为７１％，７５％和９７％。中西医结合组疗效优于其它两组（Ｐ〈０．０５）。三组患者治疗后，ＩｇＧ升高，而ＩｇＥ趋于正常，血浆ｃＡＭＰ有不同程度的上升，     

嗜酸粒细胞主体碱性蛋白对鼻粘膜上皮肥大细胞组胺释放的影响

为探讨变应性鼻炎患者鼻粘膜上皮肥大细胞和嗜酸粒细胞主体碱性蛋白的相互作用，将取自５９例变应性鼻炎患者的含有肥大细胞的鼻粘膜上皮在体外与嗜酸粒细胞主体碱性蛋白（ＭＢＰ）进行反应，测定反应前后肥大细胞组胺的释放量。结果显示１０－５ｍｏｌ／Ｌ浓度ＭＢＰ可促使肥大细胞释放组胺，１．５７×１０－５ｍｏｌ／ＬＭＢＰ处理肥大细胞可使变应原诱发的组胺释放受到抑制。提示嗜酸粒细胞在鼻粘膜上皮层内的聚集、活化、脱颗粒等可通过与肥大细胞的相互作用而对变应性鼻炎症状的发生、发展产生影响。     

变应性鼻炎舌下含服粉尘螨滴剂免疫治疗早期鼻分泌物嗜酸细胞检测与临床分析

目的 探讨变应性鼻炎舌下含服粉尘螨滴剂免疫治疗早期鼻分泌物嗜酸细胞计数及与临床症状的关系。方法 对43例行舌下含服粉尘螨滴剂免疫治疗的变应性鼻炎患者,在免疫治疗前及治疗后2、4、8周采集鼻腔分泌物,经涂片染色后计数鼻分泌物嗜酸细胞,并分析其与临床症状的可能相关性。结果 舌下含服粉尘螨滴剂免疫治疗后4、8周鼻分泌物嗜酸细胞计数较免疫治疗前下降,差异有统计学意义（P<0.05）;免疫治疗后4周及8周主观症状有明显改善的患者鼻分泌物嗜酸细胞计数较免疫治疗前下降,差异有统计学意义（P<0.05）。结论 舌下含服粉尘螨滴剂治疗变应性鼻炎时,鼻黏膜局部免疫状态的改变在免疫治疗后4周或更早的时间已经发生。     

VCAM-1表达在上下呼吸道一致性的研究

目的：探讨血管内皮细胞黏附分子（VCAM-1）在呼吸道变应性炎症患者中的表达和意义。方法：将39名患有变应性鼻炎并哮喘的患者和21例仅患有变应性鼻炎的患者分成两组,取鼻腔黏膜和支气管黏膜进行活组织病理检查,并用免疫组织化学的方法对VCAM-1的表达进行检测。结果：变应性鼻炎并哮喘组支气管黏膜中嗜酸粒细胞数显著高于变应性鼻炎组（t=12．81,P〈0．01）,变应性鼻炎组鼻腔黏膜中VCAM-1阳性细胞比例与变应性鼻炎并哮喘组相比差异无统计学意义。变应性鼻炎并哮喘组支气管黏膜中VCAM-1阳性细胞比例显著高于变应性鼻炎组（t=9．43,P〈0．01）,变应性鼻炎并哮喘组支气管黏膜中VCAM-1阳性细胞比例和支气管黏膜嗜酸粒细胞数呈显著正相关（r=0．788,P〈0．01）。结论：VCAM-1表达的上调,导致呼吸道变应性炎症的蔓延。     

免疫疗法合并鼻炎冲剂治疗常年性变应性鼻炎疗效观察

常年性变应性鼻炎90例分单纯中药组（鼻炎冲剂）、单纯免疫疗法组和中西医结合组（鼻炎冲剂结合免疫疗法）进行治疗，治疗前及治疗4月时测定血清IgE、IgG、血浆cAMP、cGMP及鼻分泌物嗜酸细胞。结果表明：单纯中药组、单纯免疫疗法组和中西医结合疗法组有效率分别为71％、75％和97％。中西医结合组疗效优于其它两组（P＜0．05）。三组患者治疗后，IgG升高，而IgE趋于正常。血浆cAMP有不同程度的上升，cGMP下降，中西医结合组尤为明显。本文资料表明：中西医结合免疫疗法是疗效好且巩固的治疗常年性变应性鼻炎的方法。     

黏附分子在实验性变应性鼻炎鼻黏膜中的表达

变应性鼻炎迟发相反应阶段是以嗜酸粒细胞为代表的大量的炎性细胞的浸润而导致的慢性炎症，血管细胞黏附分子-1(vascular cell adhesion molecule-1，VCAM-1)、细胞间黏附分子-1(intercellular adhesion molecule-1，ICAM-1)在嗜酸粒细胞等炎性细胞的黏附、浸润到黏膜炎症区域起着重要作用。本研究观察实验性变应性鼻炎鼻黏膜中黏附分子的表达。     

变应性鼻炎患者鼻腔分泌物中嗜酸性粒细胞的检测

目的探讨变应性鼻炎患者鼻腔分泌物中嗜酸性粒细胞的检测及其对变应性鼻炎诊断的意义。方法随机选取变应性鼻炎、正常人和非变应性鼻炎患者鼻腔分泌物各100例行薄层涂片和瑞-姬染色,观察嗜酸性粒细胞的数量、形态及分布程度和阳性率。结果 100例变应性鼻炎患者鼻腔分泌物中嗜酸性粒细胞数量显著高于正常人及非变应性鼻炎患者(P<0.01),变应性鼻炎患者鼻腔分泌物中嗜酸性粒细胞阳性率也明显高于正常人和非变应性鼻炎患者(P<0.01)。结论嗜酸性粒细胞在变应性鼻炎的发病过程中具有十分重要的作用,鼻腔分泌物涂片检查嗜酸性粒细胞,对变应性鼻炎的诊断有重要参考价值。     

区别变应性和非变应性鼻炎的一种特异性蛋白

尽管变应性鼻炎(AR)和非变应性鼻炎(NACR)的病因不同,但二者却有着相似的症状,如打喷嚏、水样涕、鼻阻等,有时临床上鉴别较困难。随机选择10例AR和10例NACR进行研究,诊断标准:AR具有典型症状,鼻窦X线检查正常,屋尘皮试(+),放射免疫吸附实验螨(+);NACR具有上述症状,鼻分泌物嗜酸细     

The effect of immunotherapy on the serum levels of eosinophil cationic protein in seasonal allergic rhinitis

The role of serum eosinophil cationic protein levels in allergic rhinitis is controversial. It is also unclear whether with immunotherapy it is possible to reduce these serum levels in allergic diseases. We studied serum eosinophil cationic protein levels in patients with cedar-induced allergic rhinitis and compared them with non-atopic controls. The second aim of this study was to elucidate whether immunotherapy is capable of decreasing the seasonal elevation in serum eosinophil cationic protein levels in seasonal allergic rhinitis. The serum eosinophil cationic protein levels of the untreated patient group were significantly higher than those of the non-atopic controls. The levels in patients who received immunotherapy for 2 yr were also significantly higher than those of the non-atopic controls. However, the levels were not different between the patients undergoing immunotherapy for over 3 yr and the non-atopic controls. The serum levels of the 31 patients treated with immunotherapy correlated with the duration of immunotherapy. In conclusion, the serum eosinophil cationic protein levels are higher in untreated patients with seasonal allergic rhinitis and this seasonal activation in circulating eosinophils decreases gradually during immunotherapy, but this inhibitory effect becomes apparent only after a number of years of immunotherapy. This prevention of seasonal eosinophil activation is one of the mechanisms responsible for the clinical effect of immunotherapy.     

抗变态反应药物对季节性变应性鼻炎患者血清特异性IgE及嗜酸粒细胞的影响

目的:探讨炎性递质白三烯和组胺在变应性鼻炎发病机制中的作用,比较白三烯受体拮抗剂和抗组胺药治疗变应性鼻炎的疗效及其机制。方法:将符合入选标准的40例变应性鼻炎患者随机分为两组,分别给予孟鲁司特钠和氯雷他定治疗2周。治疗前、后分别检测患者血清特异性IgE、外周血及鼻腔分泌物中嗜酸粒细胞(EOS),并记录用药后医生和患者对疾病整体状况的评价。结果:治疗后两组患者血清特异性IgE、外周血及鼻腔分泌物中EOS计数均明显下降,与治疗前比较差异有统计学意义(均P<0.05);治疗后两组患者血清特异性IgE、外周血及鼻腔分泌物中EOS计数差异无统计学意义(均P>0.05)。结论:孟鲁司特钠和氯雷他定治疗变应性鼻炎效果相近;组胺和白三烯在病理生理学上均是引起变应性鼻炎的重要炎症递质,两者均是通过影响EOS聚集、活化和减少特异性IgE的形成而发挥作用;白三烯受体拮抗剂是治疗变应性鼻炎的一种新的有效药物。     

Perennial rhinitis: an analysis of skin testing, serum IgE, and blood and smear eosinophilia in 201 patients

Allergen skin testing, eosinophil counting in blood and nasal smear and serum IgE determination were performed in patients with simple perennial rhinitis, and in patients with rhinitis and asthma. The results were compared with those obtained in normal controls. As a positive skin test was demonstrated in 40% of patients with simple rhinitis and in 88% of patients with rhinitis and asthma, skin testing is considered relevant in all patients with perennial rhinitis. While blood eosinophil count and serum IgE level were elevated in a fair proportion of asthmatic patients, only a few subjects with simple perennial rhinitis had an elevated level, and the diagnostic values of these tests is questionable. On the other hand, examination of a nasal smear for eosinophils could usually separate the patients from the controls. The study emphasizes the importance of making a distinction between simple perennial rhinitis and perennial rhinitis associated with other symptoms and diseases.     

Effect of platelet-activating factor on nasal vascular permeability and eosinophil accumulation in guinea pigs

Both the increased nasal vascular permeability and eosinophil accumulation were commonly observed in nasal mucosa with allergic rhinitis. Topical administration of platelet-activating factor (PAF) produced dose-dependent increases in nasal vascular permeability concomitant with the increase in both the histamine and leukotriene C4 (LOC4) concentrations of nasal lavage fluid, in non-sensitized guinea pigs. The selective PAF antagonist CV-3988 inhibited these responses. The PAF-induced nasal vascular permeability was also inhibited by a H1 antagonist (diphenhydramine) and a peptido-LTs antagonist (FPL-55712). However, in ovalbumine (OA)-sensitized guinea pigs, CV-3988 did not affect antigen-induced increase in nasal vascular permeability. Four hours after topical administration of antigen or PAF to OA-sensitized guinea pigs, a marked eosinophil infiltration in the nasal mucosa was noted. This antigen-induced eosinophil infiltration was inhibited by CV-3988. These results suggests that PAF plays a major role in the antigen-induced eosinophil accumulation rather than in the antigen-induced vascular permeability.     

布地奈德对变应性鼻炎大鼠鼻腔灌洗液中嗜酸粒细胞凋亡的影响

目的 建立大鼠变应性鼻炎( allergic rhinitis,AR)模型,观察布地奈德对AR大鼠鼻腔灌洗液中嗜酸粒细胞( eosinophil,EOS)凋亡的影响。方法 采用卵清蛋白、氢氧化铝建立大鼠AR模型,分为AR组(B组)、布地奈德组(C组),每组10只大鼠,分别于模型建立后第31～38天,每只每日每侧鼻腔滴入磷酸盐缓冲液50μL、布地奈德50μL(1.28μg/μL),另设对照组(A组)大鼠10只。第39天取各组大鼠鼻腔灌洗液测定EOS百分比,流式细胞术检测EOS凋亡率。 结果 C组大鼠鼻腔灌洗液中EOS为(5.10±0.51)%,明显低于B组的(29.37±4.33)%(P<0.01);C组鼻腔灌洗液中EOS凋亡率为(18.48±2.84)%,明显高于B组的(3.36±0.50)%(P<0.01);且B组、C组大鼠鼻腔灌洗液中EOS百分比与其凋亡率呈显著负相关(r=-0.892, P<0.05)。结论 布地奈德可明显减少AR大鼠鼻腔内EOS浸润,并能显著增加EOS凋亡,进而减轻AR的炎症反应,从而达到治疗AR的目的。     

Vasomotor rhinitis

The term VMR is used to describe a nonimmunologic, noninfectious, chronic type of rhinitis without nasal eosinophilia. The causes are diverse and, in many cases, never identified. Before the diagnosis of VMR can be made, AR and ENR must be ruled out. A thorough history and physical examination in association with appropriate laboratory testing can be used to distinguish these types of rhinitis. Surgical procedures tend to provide the most relief, but should only be used after more conservative measures have failed.     

Nasal provocation test with lysine-aspirin in diagnosis of nonallergic rhinitis with eosinophilia

Nonallergic rhinitis with eosinophilia is characterized by persistent nasal symptoms without allergy and by a marked eosinophil recruitment in the nasal cavities. The incidence of it is more than 15% among all types of rhinitis. A part of them is caused by nonsteroidal anti-inflammatory drugs hypersensivity. For this study 114 patients were selected on the basis of perennial rhinitis, the absence of allergy and with an eosinophil count higher than 10% of total leukocytes in nasal cytology. In all of them the nasal provocation test with lysine-aspirin was made. The clinical response was evaluated based on nasal symptoms (sneezes, itching, secretion and blockage). The nasal response was measured by acoustic rhinometry. The results of the test was positive in 19 cases, mostly in patients with nasal polyps, bronchial asthma and higher level of nasal eosinophilia (differences statistically significant). The count of nasal eosinophilia corresponded better with the decrease of nasal volume in acoustic rhinometry (r = 0,84) then with the clinical score (r = 0,52). The nasal challenge was well tolerated by almost all subjects. We conclude that the nasal challenge with lysine-aspirin is safe and can be helpful as a diagnostic test in patients with nonallergic rhinitis with eosinophilia.     

Quantitative cytology of nasal secretions under various conditions

Quantitative cytology was performed in nasal secretions of normal control (NC), seasonal allergic rhinitis in season (SAR), perennial allergic rhinitis (PAR), chronic sinusitis with mucoid secretion (MS), and chronic sinusitis with mucopurulent secretion (MPS). The majority of inflammatory cells were neutrophils in NC, MS, and MPS; the majority were eosinophils in SAR and PAR. The concomitant appearance of inflammatory cells in nasal secretions was found, i.e., there were significant correlations between neutrophil and eosinophil counts in MPS, and between eosionophil and basophil counts in SAR. The eosinophil/neutrophil ratio was more than 0.1 in SAR and PAR, but the ratio was less than 0.1 in all NC, all MPS, and in 93% of MS; this indicates that 0.1 in eosinophil/neutrophil ratio is the critical value between allergic and nonallergic nasal diseases.     

Distribution of eosinophils in the nose in patients with perennial rhinitis.

The traditional method of classifying perennial rhinitis into eosinophilic and non-eosinophilic is by taking a single nasal smear from one nostril. In the light of personal experience it was felt that this method of sampling may be inadequate. The present study included 20 patients with perennial rhinitis undergoing nasal surgery. Serum total IgE levels were taken and those above 40 IU/ml had allergen specific IgE measured. Nasal smears and biopsies were taken from 5 sites on each side of the nose; middle and inferior turbinates and post nasal space. The smears significantly correlated with the biopsies (rs = 0.446, P < 0.001). The distribution of eosinophils between and within nasal cavities was found to differ. Representative sampling of the nose is important for accurate eosinophil expression. The definition of an eosinophil rich and poor nose requires greater clarification as it has great clinical relevance regarding management.     

变应性鼻炎鼻腔灌洗液和血清中嗜酸粒细胞阳离子蛋白和E-选择素的检测

OBJECTIVE: To evaluate the role of eosinophil cationic protein (ECP) and serum soluble E-selectin (sE-selectin) in patients with allergic rhinitis. METHODS: The sE-selectin were detected from 30 allergic patients and 20 normal individuals by enzyme-linked immunosorbent assay (ELISA). The ECP in serum and nasal lavage fluid was assayed with pharmacia CAP system. RESULTS: The level of sE-selectin in patients with allergic rhinitis was(41.846 +/- 12.21) ng/ml, higher than that in control (10.678 +/- 2.458) ng/ml. The level of ECP in serum and nasal lavage fluid from patients with allergic rhinitis was significantly higher than that from normal controls. The level of ECP in nasal lavage fluid was much higher than that in serum. CONCLUSION: ECP and sE-selectin play a role in pathogenesis of allergic rhinitis.