针刺对变应性鼻炎患者血浆内皮素及鼻粘膜微血管的影响

目的对３３例常年性变应性鼻炎患者进行针刺治疗,以观察其对血浆内皮素（ｅｎｄｏｔｈｅｌｉｎ,ＥＴ）及鼻粘膜微血管的影响。方法①血浆ＥＴ测定：采用特异性放射免疫法（均相竞争法）直接测定血浆ＥＴ含量。②鼻粘膜微血管的观察：主要观察鼻粘膜微血管管径、管袢数及鼻粘膜微血管的形态。③针刺治疗：选择曲池、血海两穴进行针刺。结果变应性鼻炎患者鼻粘膜微血管管径针刺后较针刺前增粗;针刺后变应性鼻炎患者鼻粘膜微血管形态变化以灯丝状微血管增多、网络状微血管减少为特征;变应性鼻炎患者鼻粘膜微血管管袢数针刺后较针刺前增多;变应性鼻炎患者针刺后血浆ＥＴ含量明显降低。结论变应性鼻炎针刺后鼻粘膜微循环明显改善,表现为鼻粘膜微血管管径增粗,灯丝状微血管增多、网络状微血管减少,管拌数增加,并与血浆ＥＴ存在密切关系,其机理可能是通过降低血浆ＥＴ的水平而起作用的。     

Impaired norepinephrine-mediated contraction of isolated nasal mucosa in guinea pigs with allergic rhinitis

BACKGROUND: One of the causes of nasal obstruction associated with allergic rhinitis probably is caused by the dilatation of plexus cavernosum in nasal mucosa. In this study, the change in vascular responsiveness of nasal mucosa was investigated in the septal mucosae isolated from guinea pigs with allergic rhinitis. METHODS: An allergic rhinitis model was prepared in guinea pigs by repeated challenge with aerosolized dinitrophenylated-ovalbumin antigen. Twenty-four hours after the last antigen challenge, the changes in the isometrical tension of isolated nasal septal mucosa were measured. RESULTS: In isolated nasal mucosal tissues, both norepinephrine (NE) and leukotriene D4 caused concentration-dependent contractile and relaxant responses, respectively. The NE-induced contractile response was significantly attenuated in nasal mucosae of the repeatedly antigen challenged guinea pigs. The mucosal relaxation induced by leukotriene D4 was slightly attenuated in this animal model of allergic rhinitis. CONCLUSION: This study shows an attenuation of NE-induced contraction of isolated nasal mucosa in the antigen-exposed guinea pigs. The impaired contractile response mediated by sympathetic alpha-adrenoceptors of nasal blood vessels might be involved in the development of nasal obstruction in allergic rhinitis.     

Nasal histamine reactivity; relationships to skin-test responses, allergen provocation and symptom severity in patients with long-continuing allergic rhinitis

It has been reported that skin-test reactivity and rhinitis symptom severity weaken in the course of time. A corresponding weakening might also be seen in non-specific nasal hyper-reactivity, but the relationships of these responses are poorly understood. Our aim was to measure nasal responsiveness to histamine in a series of patients with long-continuing allergic rhinitis and to compare these measurements with skin test responses, allergen provocation and changes in severity of allergic rhinitis symptoms. A total of 73 patients in whom allergic rhinitis had been verified over 20 years earlier were re-interviewed and re-investigated. Skin prick tests with common allergens were performed and the presence of nasal allergy was confirmed by allergen provocation. Non-specific nasal hyper-reactivity was determined with nasal histamine challenge using four concentrations of histamine phosphate. The response was registered by counting sneezes, recording changes in nasal discharge and mucosal swelling and measuring nasal airway resistance. Sneezing and discharge scores showed that milder non-specific nasal hyper-reactivity was associated with lack of reactivity in skin prick tests and nasal allergen challenge. No association was observed between allergy test results and changes in nasal airway resistance during the histamine provocation. In most patients the symptoms of rhinitis had become milder or disappeared during the follow-up, but the results of the histamine challenge showed no relationship with the changes in symptom severity. In patients with allergic rhinitis, reactivity to histamine is associated with a concomitant change in skin and nasal mucosal reactivity to allergens.     

Nasal Histamine Reactivity; Relationships to Skin-test Responses,Allergen Provocation and Symptom Severity in Patients with Long-continuing Allergic Rhinitis

It has been reported that skin-test reactivity and rhinitis symptom severity weaken in the course of time. A corresponding weakening might also be seen in non-specific nasal hyper-reactivity, but the relationships of these responses are poorly understood. Our aim was to measure nasal responsiveness to histamine in a series of patients with long-continuing allergic rhinitis and to compare these measurements with skin test responses, allergen provocation and changes in severity of allergic rhinitis symptoms. A total of 73 patients in whom allergic rhinitis had been verified over 20 years earlier were re-interviewed and re-investigated. Skin prick tests with common allergens were performed and the presence of nasal allergy was confirmed by allergen provocation. Non-specific nasal hyper-reactivity was determined with nasal histamine challenge using four concentrations of histamine phosphate. The response was registered by counting sneezes, recording changes in nasal discharge and mucosal swelling and measuring nasal airway resistance. Sneezing and discharge scores showed that milder non-specific nasal hyper-reactivity was associated with lack of reactivity in skin prick tests and nasal allergen challenge. No association was observed between allergy test results and changes in nasal airway resistance during the histamine provocation. In most patients the symptoms of rhinitis had become milder or disappeared during the follow-up, but the results of the histamine challenge showed no relationship with the changes in symptom severity. In patients with allergic rhinitis, reactivity to histamine is associated with a concomitant change in skin and nasal mucosal reactivity to allergens.     

Eustachian tube obstruction after intranasal challenge with house dust mite

Past studies have shown that provocative intranasal pollen challenge in allergic subjects results in signs and symptoms of allergic rhinitis, nasal obstruction, and eustachian tube obstruction. The study presented herein extends these observations to challenges with a perennial antigen, house dust mite. Twenty-three adult volunteers with confirmed sensitivity to Dermatophagoides farinae were challenged by intranasal inhalation of antigen in doses that were incremented from 0.5 to 10.0 mg. Eustachian tube function by the nine-step pressure-swallow test and nasal airway resistance by anterior rhinomanometry were evaluated before and after challenge. Twenty-two of the 40 ears showing normal tubal function before challenge were abnormal after challenge. Sixteen of the 23 subjects developed a nasal obstruction after challenge. The median specific serum IgE antibody titer for those individuals responding to the challenge was significantly greater than that of the individuals exhibiting no response. These results show that intranasal challenge with D farinae can provoke immune-mediated nasal obstruction and eustachian tube dysfunction in sensitized subjects.     

Vascular endothelial growth factor produced in nasal glands of perennial allergic rhinitis

BACKGROUND: Vascular endothelial growth factor (VEGF), a pleiotropic polypeptide that mediates endothelial cell-specific responses such as induction of angiogenesis and vascular leakage, is hyperproduced in a variety of inflammatory disorders. In asthma, VEGF hyperproduction promotes mucosal edema by enhancing vascular leakage. However, in allergic rhinitis, details of the pathophysiological importance remain unclear. This study was designed to investigate and discuss the pathophysiological significance of VEGF in nasal secretions from perennial allergic rhinitis sufferers. METHODS: Seven allergic rhinitis patients sensitized with house-dust mites and 12 chronic rhinosinusitis patients were enrolled. Nasal secretion VEGF was quantified and compared between groups. In allergic rhinitis cases, nasal lavage VEGF was estimated before and after the antigen provocation. Nasal gland VEGF was immunohistochemically investigated. VEGF messenger RNA (mRNA) levels in serous and mucous acini were analyzed by laser microdissection and light cycler-polymerase chain reaction. RESULTS: VEGF levels in nasal secretions and nasal lavage from allergic rhinitis were higher than in nonallergic rhinosinusitis, after rather than before antigen provocation. VEGF mRNA expression was higher in serous versus mucous acini. These results are consistent with the immunohistochemistry results. CONCLUSION: In allergic rhinitis, there was significant VEGF production in serous acini, which was hypersecreted after antigen provocation. VEGF may play an important role in pathophysiology of allergic rhinitis.     

Nasal hyperreactivity to methacholine measured by acoustic rhinometry in asymptomatic allergic and perennial nonallergic rhinitis

This study was carried out to assess nasal response to different doses of methacholine and to evaluate the diagnostic possibilities of this test. Thirty-seven patients with allergic rhinitis induced by pollen (out of season), 16 with nonallergic rhinitis, and 25 normal subjects were evaluated. After provocation with saline, increasing doses of methacholine, ranging from 0.5 to 16 mg/mL, were applied. Nasal obstruction was assessed by acoustic rhinometry 10 minutes after each dose, the minimum cross-sectional area and the nasal volume in both fossae were obtained. Ipratropium bromide was applied after the last dose of methacholine to evaluate reversibility. After methacholine challenge with 0.5, 1, 2, and 4 mg/mL there was a statistically significant decrease (p < 0.05) in nasal area and volume in a dose-dependent manner in patients with allergic and nonallergic rhinitis in comparison with controls. A ROC (receiver-operating characteristic) analysis showed that a decrease in nasal volume > or = 20% at methacholine concentration of 2 mg/mL is able to predict the presence of rhinitis (positive predicted value 93%, negative predicted value 79%) in 75% of subjects. The clinical relevance of this finding suggests that patients with symptomatic nonallergic rhinitis or even asymptomatic patients with allergic rhinitis out of pollen season present a nasal hyperreactivity to methacholine, and that a decrease of nasal volume > 20% by acoustic rhinometry after challenge with methacholine at 2 mg/mL is able to discriminate these patients from normal subjects. This method seems to be a suitable tool in the diagnosis of rhinitis.     

Reflex activation in allergen-induced nasal mucosal vascular reactions

Subjects with allergic rhinitis were challenged unilaterally with diluent and increasing doses of allergen. Challenge with the highest dose of allergen was also carried out after topical anesthesia of the nasal cavity using lidocaine. In the contralateral, unprovoked nasal cavity the mucosal blood flow was determined using the 133Xenon wash-out technique and the nasal airway resistance was determined by rhinomanometry before and after challenge. Nasal symptom scores were estimated 15 min after each challenge. Blood flow in the nasal mucosa in the unprovoked right nasal cavity decreased in a dose-dependent manner for th two highest doses of allergen where a reduction of 21% (p less than 0.05) and 26% (p less than 0.01) was obtained. Nasal airway resistance increased somewhat after the highest dose (p greater than 0.05). Topical anesthesia in the provoked nasal cavity inhibited the decrease in blood flow in the unchallenged nasal cavity. These findings suggest that the changes in the tone of the resistance vessels, but not the capacitance vessels, which are induced by allergen, are largely reflex-mediated.     

Humoral mucosal immunity in allergic rhinitis

BACKGROUND: Mucosa-immunologic aspects are gaining an increasing awareness in the pathophysiology of type I allergies. Humoral mucosal immune responses are dominated by secretory IgA, but there is evidence for a relevant role of IgG in nasal mucosa-associated lymphoid tissue. OBJECTIVE: was to measure allergen-specific immunoglobulins (IgA and IgG) in nasal secretions as an expression of a humoral mucosal immune response in allergic rhinitis. For tissue eosinophilia we studied nasal Eosinophilic Cationic Protein (ECP) and for mast cell activation nasal tryptase. METHODS: Nasal secretions of 40 patients suffering from allergic rhinitis were analyzed for allergen-specific IgA, IgG, and IgE, and for ECP and tryptase. Patients were highly sensitized against the major allergens of house dust mites, timothy, and birch pollen. 43 non-atopic individuals served as controls. In order to study possible effects of the actual pollen season on the studied parameter we secondly compared patients allergic to seasonal allergens co- (n = 28) and extra-seasonally (n = 41). In order to determine a possible influence of allergen-specific IgA in eosinophilic degranulation we additionally studied 5 patients after nasal allergen challenge. RESULTS: In allergic rhinitis we found significantly increased levels of allergen-specific immunoglobulins of all studied subclasses and allergens in nasal secretions. Comparison of nasal ECP and tryptase showed significantly increased concentrations in allergic individuals as well. Co-seasonally we found elevated allergen-specific IgE, ECP, and tryptase but lower concentrations of allergen-specific IgA and IgG. There was no association between late phase eosinophilia and IgA concentrations after local allergen challenge. CONCLUSIONS: The occurrence of allergen-specific immunoglobulins in nasal secretions is interpreted as a local humoral mucosal immune response. The physiologic role of local allergen-specific immunoglobulins is not clear to date. Involvement in degranulation of eosinophils or mast cells, like suggested before, seems unlikely.     

Sympathomimetics in nasal allergy

The effect of a topically administered alpha-adrenoceptor agonist (phenylpropanolamine) after allergen challenge was evaluated in a placebo-controlled double-blind crossover study in 10 subjects with allergic rhinitis in an asymptomatic period. The nasal airway resistance was objectively measured by anterior rhinomanometry after nasal allergen challenge. The degree of nasal blockage, secretion and the number of sneezes were registered in a score. Nasal airway resistance and the degree of blockage were found to be significantly reduced. Thus, alpha-adrenoceptor agonists might be used topically for symptomatic treatment of allergic rhinitis comprising mucosal congestion.     

Effects of cetirizine on substance P release in patients with perennial allergic rhinitis

To evaluate the effect of cetirizine hydrochloride on substance P release in allergic rhinitis, we performed a single-blind placebo-controlled study of 14 patients with perennial allergic rhinitis (7 treated with cetirizine and 7 with placebo). After an initial nasal allergen challenge with lavages, the subjects received treatment with placebo or cetirizine hydrochloride (10 mg by mouth daily) for 1 week, followed by the second nasal allergen challenge with lavages. The levels of albumin, histamine, and substance P in nasal lavages before and after allergen challenge were quantified by enzyme-linked immunosorbent assay. Pretreatment of subjects with cetirizine reduced the level of substance P induced by antigen challenge, but did not significantly reduce levels of histamine. These results suggest that cetirizine may reduce nasal neurogenic inflammation by modulating the release of substance P in allergic rhinitis.     

吸入性氢气清除法鼻粘膜微循环血流量测定

测定国人鼻粘膜微循环血流量。方法 应用Ａｍｅｆｌｗ－Ｈ２微循环测量仪对１３０例鼻粘膜微循环血流一在局部喷雾血管收缩剂前后进行了测量，其中健康成人９８例，鼻息肉患者１８例，应变性鼻炎患者１４例。统计学处理采用ｔ检验。结果 健康成人对照组鼻粘膜微循环血流量大于鼻息肉组及变应性鼻炎组。     

吸入性氢气清除法鼻粘膜微循环血流量测定

目的测定国人鼻粘膜微循环血流量。方法应用ＡｍｅｆｌｏｗＨ２微循环测量仪对１３０例鼻粘膜微循环血流量在局部喷雾血管收缩剂前后进行了测量，其中健康成人９８例；鼻息肉患者１８例，变应性鼻炎患者１４例。统计学处理采用ｔ检验。结果健康成人对照组鼻粘膜微循环血流量大于鼻息肉组及变应性鼻炎组（Ｐ＜０．０１）。血管收缩剂应用后各组微循环血流量均下降（Ｐ＜０．０１），以鼻息肉组下降最为明显。结论氢气清除法微循环血流量测定具有定位好、可连续测定和重复、损伤小等优点。     

Submucous electrocautery following submucous resection of turbinate bone--a rationale of surgical treatment for allergic rhinitis

OBJECTIVE: Since the majority of the key elements such as trigeminal nerves, parasympathetic nerves, nasal glands, and blood vessels targeted by histamine and leukotrienes are found in the lamina propria of the nasal mucosa, its selective electrocautery has a rationale to improve the symptoms of allergic rhinitis with preservation of epithelial layer. To achieve the above goal, we performed the submucous electrocautery of the lamina propria (SECLP) following the submucous resection of the inferior turbinate bone (submucous turbinectomy: SMT). This paper discusses the efficacy of this procedure for the patients with persistent perennial allergic rhinitis. METHODS: An intranasal initial incision was made along the piriform aperture. The mucoperiosteum was elevated from the inferior turbinate bone followed by its complete resection. The SECLP was performed by applying a high-frequency coagulation current with a ball tip electrode, which was inserted into the mucoperiosteal sack after the completion of the SMT and was drawn forward on the medial surface of the mucoperiosteum with drawing a wavy line. We performed this surgery in 43 patients with perennial allergic rhinitis who were refractory to pharmacotherapy or were reluctant to take medicine. Symptoms, macroscopic intranasal findings, the results of allergic tests, nasal resistance, mucociliary function with saccharin, and the number of mast cells were compared pre- and postoperatively. RESULTS: The patients exhibited satisfactory improvement in symptoms only with a few crust formations. The macroscopic intranasal findings and allergic tests improved after surgery. Saccharin transport time remained normal. The number of anti-tryptase positive mast cells significantly decreased in the epithelial layer and in the superficial layer of the lamina propria of the postoperative inferior turbinate mucosa. CONCLUSION: The SECLP following the SMT is evaluated to be a useful surgical modality for allergic rhinitis with preservation of the nasal mucosal function.     

Histopathological verification of clinical indications to partial inferior turbinectomy.

Surgical treatment in cases where disturbances of the nasal patency causes changes in the nasal inferior turbinates is controversial. The authors performed light- and electron microscopy and morphometric examinations of the mucous membrane of the nasal inferior turbinates obtained after partial inferior turbinectomy in patients with vasomotor and perennial allergic rhinitis and compensation hypertrophy of the nasal inferior turbinate accompanied by nasal deviation of the septum. In specimens obtained from patients with vasomotor rhinitis, a small number of glands and fibrosis of the lamina propria was observed. In specimens obtained from perennial allergic rhinitis patients, plenty of glands and large oedema was observed. In the group with compensatory hypertrophy of the inferior turbinate, normal glands and fibred areas around the vessels were observed. The largest histopathological changes of degeneration and hypertrophy of the nasal mucosa were observed in vasomotor rhinitis patients. Histopathological examination of nasal mucosa slides confirmed the usefulness of a partial inferior turbinectomy, but only in vasomotor rhinitis patients.     

Distilled water nasal provocation in hyperreactive patients.

Nonisotonic aerosol may act as a provocation agent in the upper and lower airways of hyperreactive individuals. The purpose of the study was to compare the results of nasal challenge with distilled water in patients with allergic rhinitis to those with noninfective nonallergic rhinitis (NINAR), with respect to the potential clinical use of the obtained data. A group of 68 ambulatory patients with allergic rhinitis or NINAR (39 perennial allergic, 6 seasonal, 23 NINAR) were challenged with 10 mL of distilled water aerosol after the baseline active anterior rhinomanometry. Patients with nasal polyposis at endoscopy, significant unilateral septal deviation, positive bacteriologic swab, recent nasal surgery, and uncertain anamnestic data about the medication taken 6 weeks before the provocation were excluded from the study. After 10 minutes of nasal provocation, rhinomanometry was repeated to assess the response. In 15 patients of the perennial allergic group, the same measurements were performed after a 2-week oral antihistamine and topical steroid therapy. Nasal resistance was significantly increased on the more patent side of the nose after nasal provocation with distilled water aerosol in allergic patients in comparison to the nasal resistance before provocation. In the patients with NINAR, the provocation resulted in a significant rise on the more patent side, but the total nasal airway resistance (NAR) levels were also significantly increased. The systemic antihistamine and topical steroid 2-week therapy in patients with perennial allergic rhinitis significantly reduced the response to nasal distilled water provocation. Nasal provocation with distilled water aerosol is a cheap, simple, and acceptable method that provides useful clinical data on the level of nonspecific nasal hyperreactivity and the therapy success.     

Detection of platelet-activating factor in nasal lavage fluid from patients with pollinosis and experimental animals with nasal allergy

Platelet-activating factor (PAF) is released in vitro by the reaction of antigen and IgE antibody on basophilic cells. In order to clarify that PAF was released in vivo during nasal allergic response, we measured PAF activities in nasal lavage fluids from both 10 patients with pollinosis and ovalbumin (OA)-sensitized guinea pigs before and after topical antigenic challenge. PAF activities were measured by their aggregating ability of washed rabbit platelets. The levels of lyso-PAF were determined after acetylation of lyso-form into the biologically active form of PAF. PAF or Lyso-PAF activities were detected in the nasal lavage fluids soon after the topical antigenic challenge in 7 patients. They were also found during late phase of between 3 and 8 hours after the challenge in 8 patients. In sensitized animals, PAF activities in the nasal lavage fluids significantly increased soon after topical antigenic stimulations. These data suggested that PAF was released during both early and late-phase nasal allergic reactions and might account for pathogenesis of allergic rhinitis.     

Thresholds in nasal histamine challenge in patients with allergic rhinitis, patients with hyperreflectory rhinopathy, and healthy volunteers

BACKGROUND: Characteristic symptoms of hyperreflectory rhinopathy include recurrent sneezing, nasal obstruction, and nasal secretion without an allergic background. The diagnosis can only be made if all differential diagnoses have been excluded. So far no clinical test has been established to reliably diagnose hyperreactivity of the nasal mucosa. The present study aimed to investigate whether nasal provocation with histamine allows identification of patients with hyperreflectory rhinopathy. MATERIALS AND METHODS: One-sided nasal challenge with histamine was applied to 13 patients with allergic rhinitis, 13 patients with hyperreflectory rhinitis, and 12 healthy volunteers. Histamine concentrations used were 0.25, 0.5, 1.0, 2.0, 4.0, 8.0, and 16.0 mg/mL. Test results were quantified using a symptom score (positive at values above 3) and active anterior rhinomanometry (positive at a reduction of airflow of 40% or more in comparison to challenge with solvent). RESULTS: While there was a significant difference between controls and patients with allergic rhinitis or hyperreflectory rhinopathy, respectively, no significant difference was observed between the two groups of patients. Results indicated that one-sided nasal provocation with histamine at a concentration of 1 mg/mL is sufficient to separate healthy subjects from patients with hyperreactivity of the nasal mucosa. In terms of the differentiation between subjects with hyperreactivity of the nasal mucosa and healthy controls, the sensitivity of one-sided nasal histamine provocation with 1 mg/mL was found to be 100%; its specificity was 83% if it was evaluated by rhinomanometry and symptom score. CONCLUSION: The present results indicate that one-sided nasal challenge with histamine at a concentration of 1 mg/mL is sufficient to separate healthy subjects from patients with hyperreactivity of the nasal mucosa. However, the test does not differentiate between patients with allergic rhinitis and patients with hyperreflectory rhinitis.     

Long-term effect of submucous turbinectomy in patients with perennial allergic rhinitis

OBJECTIVES: The long-term effect of submucous turbinectomy for patients with perennial allergic rhinitis was assessed. STUDY DESIGN: A cohort study of 45 patients with severe perennial allergic rhinitis who underwent submucous turbinectomy and were followed up after surgery for more than 3 years was performed. We investigated quality of life in 30 of 45 patients who had passed over 5 years after the surgery. METHODS: Nasal symptoms were assessed with a standard symptom score by diary cards. Nasal congestion was evaluated by rhinometry. Nasal challenge tests in vivo were performed to evaluate allergic reactions. These examinations were performed before surgery and at 1 year, more than 3 years, and more than 5 years after submucous turbinectomy. We determined the symptom scores and the quality of life using card questionnaires in 30 patients at the time point of more than 5 years after surgery. RESULTS: The mean [+/- SD] total nasal symptom score (maximum 9) was significantly lower at 1 year after surgery (7.5+/-1.6 vs. 1.8+/-1.8, P <.0001) compared with before surgery. A significant improvement in nasal symptoms was noted at the 3-year (2.8+/-2.3, P <.0001) and 5-year (3.3+/-1.6, P <.0001) time points. A significant increase in total nasal airflow value was noted at each time point after surgery, with a gradual reduction in the total nasal symptom score as well (before surgery, 269.4+/-249.5 cm3/s; 1 y after surgery, 450.1+/-197.7 cm3/s; more than 3 y after surgery, 385.1+/-182.3 cm3/s). The nasal challenge test score was also reduced 1 year after surgery (2.1+/-1.0 vs. 0.6+/-0.7, P <.0001). However, there was no further significant increase at the 3-year time point (0.4+/-0.7, P <.0001) after surgery. In regard to postoperative quality of life, according to the results of the card questionnaire, 50% of the patients had not been receiving antiallergic treatments in the postoperative period. CONCLUSION: Our results suggest that submucous turbinectomy is a useful strategy for the longterm management of nasal allergic reaction and contributes to the improvement in quality of life.     

钙激活氯通道和黏蛋白在变应性鼻炎中的表达与意义

目的:探讨人钙激活氯通道1(hCLCA1)和黏蛋白MUC5AC在变应性鼻炎黏液高分泌中的表达水平及临床意义。方法:采用RT-PCR技术和免疫组织化学法,检测20例变应性鼻炎患者(变应性鼻炎组)和7例正常人(对照组)hCLCA1和MUC5AC在下鼻甲黏膜的表达水平。结果:变应性鼻炎组鼻黏膜hCLCA1mRNA表达阳性,而对照组未出现hCLCA1mRNA的表达,两者比较差异有统计学意义(P<0.01);变应性鼻炎组MUC5ACmRNA表达和MUC5AC蛋白表达均较对照组明显增多(均P<0.01);变应性鼻炎组鼻黏膜hCLCA1mRNA表达与MUC5ACmRNA和蛋白表达均呈直线正相关(r=0.752、0.694,均P<0.05)。结论:hCLCA1mRNA表达的上调可能在变应性鼻炎黏液高分泌中起着关键作用,抑制hCLCA1的表达将为变应性鼻炎的治疗提供新的策略。