不同类型鼻息肉患者外周血Th17细胞含量的变化及意义

目的：研究不同类型鼻息肉患者外周血Th17细胞含量及其与炎性细胞浸润的关系;探讨其与预后的关系。方法对81例鼻息肉和20例鼻中隔偏曲患者进行研究。外周血Th17细胞含量采用流式细胞仪检测;鼻息肉组织嗜酸性粒细胞、中性粒细胞、淋巴细胞、浆细胞浸润程度以每高倍视野每104μm2面积所含有的数量表示;内镜表现采用Lund-Kennedy评分;主观症状采用VAS评分;影像学CT表现采用Lund-Mackay评分。结果嗜酸性鼻息肉组和非嗜酸性鼻息肉组患者外周血Th17细胞百分比分别为2.10%（3.75%,1.40%）和1.10%（1.70%,0.73%）,两组差异有统计学意义（Mann-Whitney U=358.0,Z=-2.965,P=0.001）;外周血Th17细胞百分比与鼻息肉组织中嗜酸性粒细胞呈正相关（r=0.408,P＜0.001）,与术后3个月内镜评分有中等程度相关性（r=0.458,P＜0.001）。结论 Thl7细胞表达可能与噬酸性鼻息肉发病及预后有关。     

慢性鼻窦炎骨炎患者病情程度的危险因素

目的 探讨慢性鼻窦炎骨炎患者病情程度的危险因素及预防对策.方法 对2011年4月～2014年4月期间本院收治的120例慢性鼻窦炎患者的手术治疗及临床资料进行回顾性分析,对影响患者病情程度的危险因素进行Logistic回归分析.结果 本组慢性鼻窦炎病例中,有65例（54.17％）合并骨炎,与未合并骨炎患者比较,其慢性鼻窦炎病程、合并哮喘比例、伴发鼻息肉比例、手术次数、Lund Kennedy评分、Lund Mackay评分、GOSS评分等指标差异有统计学意义（P＜0.05）,尤其慢性鼻窦炎病程、Lund Kennedy评分、LundMackay评分及手术次数等,均是影响慢性鼻窦炎骨炎患者全球骨炎评分（GOSS）的独立危险因素（P＜0.05）.结论 慢性鼻窦炎患者骨炎的发生与手术次数、慢性鼻窦炎病程、Lund-Kennedy评分、Lund-Mackay评分等因素密切相关,应规范鼻窦手术操作,预防骨炎的发生。     

不同年龄段慢性鼻-鼻窦炎患者外周血白细胞和嗜酸细胞与鼻窦CT的相关分析

目的　分析不同年龄段慢性鼻-鼻窦炎（CRS）患者外周血中白细胞（WBC）、中性粒细胞/淋巴细胞比值（NLR）、嗜酸细胞（Eos）与鼻窦CT的相关性。方法　通过分析2016年1月～2019年6月就诊于宁波市医疗中心李惠利医院东部院区的225例CRS患者的临床资料,对所有患者进行年龄分组,并对病例进行Lund-Mackay鼻窦CT评分,同时统计所有患者的外周血中白细胞（WBC）计数、中性粒细胞（NEU）计数、淋巴细胞（LYM）计数、Eos计数和嗜酸细胞占白细胞总数的百分比（Eos%）。对不同年龄段组间的Lund-Mackay鼻窦CT评分结果、WBC计数、NLR、Eos计数和Eos%进行对比分析,从而评判组间是否存在统计学差异。并探讨分析各组内Lund-Mackay鼻窦CT评分结果和WBC计数、NLR、Eos计数、Eos%是否存在相关性。结果　不同年龄段组间的Eos计数和Eos%均存在统计学差异（P 均<0.05）。青年组、成年组、老年组及总体的Lund-Mackay鼻窦CT评分与外周血WBC计数均存在正相关（r 分 别为0.661、0.158、0.332、0.219,P 均<0.05）,而与NLR、Eos计数、Eos%无相关性（P >0.05）。结论　①不同年龄段的 CRS患者外周血Eos计数、Eos%存在差异;②外周血中Eos计数、Eos%、NLR与Lund-Mackay鼻窦CT评分无相关性;③外周血中的WBC计数可作为预测CRS炎症严重的实验室指标,但相关强度不高,临床实用较受限。     

慢性鼻窦炎伴鼻息肉患者组织嗜酸性粒细胞与血清特异性IgE的相关性

目的 分析慢性鼻窦炎伴鼻息肉(CRSwNP)患者组织嗜酸性粒细胞与血清特异性免疫球蛋白E(sIgE)的关系及其临床特征。方法 选取2019年6月—2021年6月行功能性鼻窦内镜手术的192例CRSwNP患者，根据血清sIgE检测结果分为sIgE阳性组和sIgE阴性组，比较两组患者组织嗜酸性粒细胞计数、术前VAS评分、Lund-Mackay评分及Lund-Kennedy评分。结果 两组在性别、年龄比较无统计学意义(P>0.05);sIgE阳性与否和嗜酸性粒细胞是否浸润在例数上比较差异无统计学意义(P>0.05);在临床学特征方面，sIgE阳性嗜酸性粒细胞浸润组和其他3组比较在术前VAS评分(P<0.05),Lund-Mackay评分及Lund-Kennedy评分差异具有统计学意义(P<0.05)。结论 CRSwNP患者组织嗜酸性粒细胞浸润程度与过敏反应关系并不确定。患者嗜酸性粒细胞浸润同时合并sIgE阳性主客观症状加重。     

变应性因素对慢性鼻-鼻窦炎影响的研究

目的:探讨变应性因素与慢性鼻-鼻窦炎(CRS)疾病严重程度之间的相关性以及其对CRS的病情发展和转归的影响.方法:101例CRS患者进行变应性因素血清相关指标检测:血清总IgE浓度、血清特异性变应原IgE半定量检测、血清嗜酸粒细胞阳离子蛋白(ECP)浓度及病史询问、Lund-Mackay CT系统评分.结果:CRS组血清总IgE浓度及血清ECP浓度均高于正常对照组(P＜0.01);CRS组血清总IgE浓度增高发生率及血清ECP浓度增高发生率随着临床分型的加重而显著增加,并且在有既往相关手术史的患者中较无相关手术史患者中亦有显著增高(P＜0.05);血清总IgE浓度及血清ECP浓度增高患者的平均Lund-Mackay CT评分较浓度正常患者CT评分有显著性增高.CRS组血清特异性变应原IgE半定量检测阳性率为67.32%,强阳性率27.72%;各分型之间特异性变应原强阳性率差异有统计学意义(P＜0.05);有既往相关手术史的患者变应原强阳性率较无手术史患者的强阳性率显著性增高(P＜0.05);变应原强阳性患者CT评分较阴性患者CT评分有显著性增高(P＜0.05).结论:变应性因素对CRS的病变程度有一定负面作用,是影响疾病严重度及手术预后的不良因素.     

不同分型慢性鼻-鼻窦炎患者外周血嗜酸性粒细胞与中性粒细胞百分比及变态反应临床差异性分析

目的 分析不同分型慢性鼻-鼻窦炎(CRS)患者外周血嗜酸性粒细胞与中性粒细胞百分比及变态反应临床差异性。 方法 前瞻性选取2015年5月至2017年5月间在上海市宝山区大场医院和上海中医药大学附属曙光医院宝山分院接受治疗的150例CRS患者,收集患者临床资料,皮肤点刺试验的结果及外周血内中性粒细胞和嗜酸性粒细胞所占比率,分析其与CRS起病联系情况。 结果 150例患者手术后病理诊断显示45例为中性粒细胞型,105例为嗜酸性粒细胞型;嗜酸性粒细胞的浸润型患者外周血内嗜酸性粒细胞所占比率高于中性粒细胞的浸润型患者,差异有统计学意义(P<0.05);慢性鼻-鼻窦炎不伴鼻息肉(CRSsNP)、慢性鼻-鼻窦炎伴息肉(CRSwNP)分型和免疫病理的分型在两种不同浸润型患者内分布对比差异无统计学意义(P>0.05)。 结论 CRS病理组织内中性粒细胞和嗜酸性粒细胞的浸润程度与其外周血内嗜酸性粒细胞所占比率有关,局部嗜酸性粒细胞和外周血内嗜酸性粒细胞的浸润程度呈现为一致性。     

难治性鼻-鼻窦炎黏膜胶原纤维沉积的研究

目的本研究观察难治性鼻-鼻窦炎（difficult-to-treat rhinosinusitis,DTRS）的鼻窦黏膜胶原纤维沉积程度,同时还探讨其与TGF-β1、嗜酸性粒细胞及影像学表现的关系。方法根据患者就诊时临床特点和纳入标准将51例慢性鼻-鼻窦炎患者分为难治组（12例）、复发组（14例）、初治组（15例）和对照组（10例）。术前对所有研究对象行血常规和鼻内镜检查,同时对术前鼻窦CT行LundMackay评分;术中取黏膜组织进行Masson染色、HE染色和ELISA检测。结果①难治组的黏膜胶原纤维面积百分比高于复发组、初治组和对照组;②胶原纤维面积百分比与TGF-β1浓度、黏膜嗜酸性粒细胞计数和Lund-Mackay评分均有相关性;而与全血嗜酸性粒细胞计数无相关性。结论①鼻窦黏膜纤维组织增生可能是DTRS病理特征之一,可能与发病有关;②TGF-β1高表达、黏膜嗜酸性粒细胞浸润丰富和高Lund-Mackay评分可能是胶原纤维沉积的危险因素。     

外周血嗜酸粒细胞比例在慢性鼻-鼻窦炎伴鼻息肉分类中的作用

目的 探讨伴或不伴嗜酸粒细胞增多的慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)患者的临床特点以及外周血嗜酸粒细胞比例在分类中的作用.方法 回顾性分析119例确诊为CRSwNP患者的临床资料.根据术后鼻息肉组织病理检测结果,分为嗜酸粒细胞浸润组(ECRSwNP)与非嗜酸粒细胞浸润组(non-ECRSwNP).将两组患者血嗜酸粒细胞比例、血清总IgE水平、嗅觉评分、鼻窦CT Lund-Mackay评分以及皮肤点刺试验结果分别进行统计学分析,比较两组的差异.同时,将各指标与病理结果进行相关性分析,筛选与病理结果相关性较强的临床指标,采用ROC曲线方法计算曲线下面积及ECRSwNP的诊断截断值.以SPSS 17.0软件进行数据统计分析.结果 ECRSwNP患者组63例,non-ECRSwNP患者组56例.两组患者术前外周血嗜酸粒细胞比例(7.31％:3.90％)、血清总IgE水平(60.9 IU/L∶28.9 IU/L)、嗅觉评分分别为(5.8∶0.4),差异均有统计学意义(U值分别为620.01、1020.53、1092.52,P值均＜0.05).两组上颌窦Lund-Mackay 评分分别为2.0、2.5,差异有统计学意义(U=12.01,P＜0.05)；两组额窦、前筛、后筛、蝶窦及窦口鼻道复合体区的Lund-Mackay评分差异均无统计学意义(U值分别为27.5、23.5、22.5、31.5、28.5,P值均＞0.05).两组皮肤点刺试验结果差异无统计学意义(x2=1.96,P=0.19).外周血嗜酸粒细胞比例与血清总IgE均与病理结果中嗜酸粒细胞浸润程度呈正相关趋势(r值分别为0.55、0.24,P值分别为0.001、0.01).ROC曲线下面积为0.818,外周血嗜酸粒细胞比例5.65％为ECRSwNP的诊断截断值.结论 伴或不伴嗜酸粒细胞增多的两组CRSwNP患者在临床特点上有显著差异；可根据患者术前外周血嗜酸粒细胞的比例是否大于5.65％进行初步分类.     

IL-5及其受体IL-5Rα在慢性鼻-鼻窦炎伴息肉 患者息肉组织中的表达及意义

目的探讨IL 5及其受体IL 5Rα在慢性鼻-鼻窦炎伴息肉（CRSwNP）患者息肉组织中的表达及意义。方法89例CRSwNP患者根据嗜酸性粒细胞在摘除的鼻息肉组织中的浸润程度将患者分为ECRSwNP组（n=41）和对照组（n=48）,收集患者一般临床资料,利用HE染色计数鼻息肉组织中嗜酸性粒细胞表达,利用RT PCR技术检测IL 5和IL 5Rα在鼻息肉组织中表达。结果ECRSwNP组患者变应性鼻炎史比例、双侧鼻息肉比例、鼻窦累及数、鼻息肉病变程度评分和Lund Mackay评分均高于对照组,差异均有统计学意义（P<0.05）,ECRSwNP组患者嗜酸性粒细胞计数、嗜酸性粒细胞百分比和总IgE均大于对照组,差异均有统计学意义（P<0.05）;ECRSwNP组患者鼻息肉组织中每个高倍视野嗜酸性粒细胞平均计数为（36.5±14.2）,远高于对照组患者（1.2±0.6）,差异具有统计学意义（t=17.146,P=0.000）,Pearson相关分析显示,ECRSwNP组患者鼻息肉组织中嗜酸性粒细胞计数与生化指标中血嗜酸性粒细胞计数和百分比均呈正相关（r=0.703和0.652,均P<0.05）;ECRSwNP组患者鼻息肉组织中IL 5 mRNA和IL 5Rα mRNA相对表达量均高于对照组,差异均有统计学意义（P<0.05）,Pearson相关分析显示,ECRSwNP组患者鼻息肉组织中IL 5 mRNA相对表达量与IL 5Rα mRNA相对表达量呈正相关（r=0.454,P=0.003）。结论IL 5和IL 5Rα在ECRSwNP患者鼻息肉组织中表达量显著增加,可能与ECRSwNP发病及进展有关。     

慢性鼻及鼻窦炎中筛骨病理学分析和CT的诊断价值

目的结合术中所见,探讨慢性鼻及鼻窦炎（CRS）患者筛骨病变特点及CT影像诊断价值。方法 44例CRS患者,男25例,女19例,年龄20～58岁,平均42.3岁。采用Biedlingmaier分级标准对筛骨病理改变进行分级,行Lund-Mackay评分。鼻内镜术后1年对患者行视觉模拟评分（visual analogue scale,VAS）和Lund-Kennedy内镜评分,分析其与筛骨病理改变的关系;用同样的统计学方法分析CT值与病变程度及筛骨病理改变的关系。结果根据筛骨病理改变程度,将CRS患者筛骨病理学改变分为I～IV级。术后1年VAS评分随骨质病理等级的增高而增高（r=0.914,P〈0.01）。术后1年Lund-Kennedy评分随骨质病理等级的增高而增高（r=0.871,P〈0.01）。筛骨病理的不同分级之间,其CT值有明显的差异性（P〈0.01）,Spearman相关性分析发现筛骨CT值与病变程度（Lund-Mackay评分）呈显著性相关（r=0.637,P〈0.01）,CT值与筛骨病理学改变呈显著性相关（r=0.839,P〈0.01）。结论 CRS中有一部分患者存在筛骨病变,这种病变包括筛骨黏膜增厚、骨吸收、骨破坏、炎性细胞的浸润以及新骨形成。筛骨病理等级越高,预后越差。CRS患者筛骨CT值与病变范围和筛骨病理分级显著相关,可客观评价CRS患者筛骨病变程度,为预后提供依据。     

不伴有下气道疾病的慢性鼻-鼻窦炎患者肺功能及相关因素分析

目的 探讨不伴有下气道疾病的慢性鼻-鼻窦炎伴息肉患者的肺功能及其影响因素。 方法 选取161例慢性鼻-鼻窦炎伴鼻息肉患者(CRSwNP组),26例慢性鼻-鼻窦炎不伴鼻息肉患者(CRSsNP组)和34例正常人(对照组)进行肺功能检测,比较三组肺功能的各项指标,并分析CRSwNP组肺功能和临床各参数之间的关系,这些参数包括外周血嗜酸粒细胞数、血清特异性IgE、Lund-Mackay评分、呼出一氧化氮水平和视觉模拟量表评分(VAS)。 结果 CRSwNP组患者的肺功能指标FEV₁%pre低于正常组,差异有统计学意义(P=0.045);血清特异性IgE(sIgE)与VC%、FEV₁%pre、FEV₁/FVC呈负相关(P<0.05)。 结论 不伴下气道疾病的CRSwNP患者存在潜在的阻塞性肺功能改变;sIgE与CRSwNP的肺功能异常有关。     

Prognostic factors of chronic rhinosinusitis under long-term low-dose macrolide therapy

We studied the immunological and histopathological factors that affect the prognosis of chronic rhinosinusitis under long-term low-dose macrolide therapy. Sixteen patients with chronic rhinosinusitis were given 200 mg clarithromycin or 150 mg roxithromycin orally once a day without other concurrent treatments for 2-3 months. Measurement of the serum IgE level, blood cell count and differential leukocyte count of the peripheral blood, cytological assessment of the nasal smear and computed tomographic (CT) scans of the paranasal sinuses were performed before treatment. The opacity of the sinuses was estimated and scored by the CT images. After treatment, anterior ethmoidal mucosa samples were collected, an infiltrated inflammatory cells, interferon (IFN)-gamma-positive cells and interleukin (IL)-4-positive cells were examined histologically and immunohistochemically. The severity of nasal symptoms was scored before and after treatment, and the improvement rate of the score (symptomatic improvement rate) was calculated. Patients with normal levels of serum IgE (相似文献   

Allergy accelerates the disease progression of chronic rhinosinusitis

Background: The role of allergy in the development of chronic rhinosinusitis (CRS) in East Asians is not clear.

Aims/objectives: The aim was to investigate the impact of allergies in the clinical characteristics of chronic rhinosinusitis.

Material and methods: A total of 138 CRS patients who underwent endoscopic sinus surgery were included. A brief history of rhinosinusitis symptoms, blood eosinophil count, blood-specific allergen tests, computed tomography (CT) scan findings, Lund-Mackay (LM) CT scores, and Sino-Nasal Outcome Test (SNOT-22) Questionnaire scores, and sinoscopy findings at 3 and 6 months postoperatively.

Results: The ImmunoCAP test was positive in 71(51%) patients and negative in 67(49%) patients. The mean age of those who received endoscopic sinus surgery was 7-years younger in the allergic group compared with the non-allergic group (p?=?.008). The peripheral eosinophil count in the allergic group was higher than that of the non-allergic group (p?=?.008). The LM scores and SNOT-22 scores were not significantly different between the two groups. The recurrence rate of nasal polyps in the allergic group was higher but without statistical significance.

Conclusions and significance: Allergy may accelerate the disease progression of CRS. The presence of the serum-specific IgE was correlated with peripheral eosinophil percentage, especially in the CRSwNP patients.     

Total IgE levels and peripheral eosinophilia: correlation with mucosal disease based on computed tomographic imaging of the paranasal sinus

OBJECTIVE: To evaluate the relationship among peripheral eosinophilia, total IgE, and paranasal sinus mucosal disease based on computed tomography (CT) of the sinus. DESIGN: Retrospective review of a large medical information database from a tertiary referral medical center. SETTING: Tertiary referral medical center specializing in respiratory disorders. PATIENTS: Consecutive patients having total IgE and peripheral eosinophil levels and sinus CT imaging available for review. Patients 18 years or older were included; subjective or objective evidence of chronic rhinosinusitis was not used as selection criteria. A total of 303 patients were found to have peripheral eosinophil levels and CT imaging for review; 288 patients had total IgE levels and CT imaging. MAIN OUTCOME MEASURES: Linear regression analysis was used to evaluate (1) the correlation between peripheral eosinophil level and CT stage of sinus disease and (2) the correlation between total IgE level and CT stage of sinus disease. The CT scans were graded using the Lund-MacKay scoring system. RESULTS: There was a significant positive correlation between sinus CT stage and peripheral eosinophil levels (r=0.60, P<.05). Eighty-nine percent of the abnormal eosinophil counts (>550 cells/microL) were associated with CT scores higher than 12. Total IgE did not correlate with CT stage of disease (r=0.05, P>.05). CONCLUSIONS: The presence of peripheral eosinophilia indicates a high likelihood of mucosal sinus disease based on CT imaging. No correlation was noted between total IgE levels and CT stage of mucosal disease. These data support a link between eosinophilia and the presence of paranasal sinus mucosal inflammation.     

Global Osteitis Scoring Scale and chronic rhinosinusitis: a marker of revision surgery

Clin. Otolaryngol. 2010, 35 , 455–461 Objectives: Determine the incidence and severity of osteitis in patients with chronic rhinosinusitis using a new Global Osteitis Scoring Scale. Design: Validation and prospective case–control study. Setting: Academic Tertiary Otolaryngology Department (Academic Medical Centre, Amsterdam). Participants: A prospective series of 102 patients undergoing a computed tomography (CT) sinuses as part of their evaluation for chronic rhinosinusitis between January and May 2008 (study group) and an age- and gender-matched control group of 68 non-rhinosinusitis patients. Seventy-eight of the chronic rhinosinusitis patients completed the nasal subset of the RhinoSinusitis Outcome Measure (RSOM-31) and visual analogue scales. Their CT scans were assessed for osteitis using a newly developed Global Osteitis Scoring Scale. A subsample of 35 scans were additionally scored by a second otolaryngologist and a radiologist. Main outcome measures: Global Osteitis Scoring Scale. Results: The interrater variability of Global Osteitis Scoring Scale was low (average intraclass correlation coefficient: 0.94). Forty per cent of the chronic rhinosinusitis group and none of the control group had evidence of clinically significant osteitis. In the chronic rhinosinusitis group (102 patients), the severity of osteitis was correlated with Lund–Mackay (L–M) score (P < 0.001), duration of symptoms (P < 0.01) and previous surgery (P < 0.001), rising in incidence with increasing number of previous operations. There was no association between osteitis and age, gender, smoking, co-existing asthma, allergy or Sumpter’s triad. Additionally, there was no correlation between osteitis and symptom burden including headache, facial pain and nasal subset score of the RhinoSinusitis Outcome Measure. Conclusion: In patients with recalcitrant chronic rhinosinusitis who have undergone multiple surgeries in the past, the incidence of osteitis can be as high as 64%. It does not seem to be associated with more troublesome symptoms; however, it is strongly associated with previous sinus surgery, which may be a manifestation of a shared endpoint (underlying recalcitrant disease).     

慢性鼻-鼻窦炎鼻息肉组织及外周血嗜酸细胞与临床表现的关系

目的 探讨慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)患者组织及外周血中嗜酸细胞(eosinophils,Eos)计数的相关性,并研究Eos与鼻窦影像学表现及术后复发的关系.方法 回顾性分析102例确诊为CRSwNP患者的临床资料,对鼻息肉组织进行Eos计数,比较其与外周血Eos的相关性.根据术后1年随访结果,比较复发组与非复发组之间的组织及外周血Eos计数、鼻窦CT Lund-Mackay评分的统计学差异.结果 复发组外周血Eos计数、外周血Eos百分数以及鼻息肉组织Eos计数显著高于非复发组(P=0.032、0.033、0.017),两组的鼻窦CT评分无统计学差异(P=0.089).鼻息肉组织Eos计数与外周血Eos绝对值具有显著相关性(r=0.637,P=0.000);鼻息肉组织Eos计数与外周血Eos百分比也具有显著相关性(r=0.542,P=0.000);外周血Eos计数、Eos百分数、鼻息肉组织Eos计数与术前鼻窦CT评分无显著相关性(P=0.072、0.065、0.695).结论 外周血及鼻息肉组织Eos计数具有显著相关性,并且鼻息肉组织及外周血Eos计数与鼻息肉术后复发相关.     

Local IgE and inflammation in chronic rhinosinusitis of asthmatics and non-asthmatics

The aim of the study was to show the difference in the pattern of inflammation, and Th1/Th2 polarization between asthmatic and non-asthmatic patients with CRS, specifically eosinophil activation, local IgE levels in the sinus fluid and tissue, and the severity of inflammation were measured. The maxillary sinus lavages, mucosal biopsies and bacteriological swabs were taken in 17 asthmatic and 36 non-asthmatic adult patients with CRS. The concentrations of IgE, eosinophil cationic protein (ECP), myeloperoxidase (MPO), and tryptase were analyzed and IgE+ cells, eosinophils, lymphocytes and plasma cells were counted. The granulocyte activation markers and IgE in sinus lavages, and the inflammatory and IgE+ cells counts were significantly higher in the asthmatics with the greatest difference in ECP and IgE concentrations. The tryptase concentrations did not differ, but only in the asthmatics they correlated significantly with the IgE concentrations and IgE+ cells count. Asthmatic patients present a distinct subgroup among the patients with chronic rhinosinusitis (CRS). The levels of the cellular markers and IgE in the sinus fluid differ from those of non-asthmatic patients with CRS. The activation of granulocytes (especially eosinophils), local IgE concentrations and the inflammatory cells infiltration are significantly higher in the asthmatics.