鼻内针刺对变应性鼻炎兔神经源性炎性反应的影响

目的:观察鼻内针刺对变应性鼻炎(AR)新西兰兔鼻黏膜P物质(SP)、血管活性肠肽(VIP)、神经肽Y(NPY)蛋白表达及血清免疫球蛋白E(IgE)、白细胞介素4(IL-4)、干扰素-γ(IFN-γ)含量的影响,探讨鼻内针刺治疗AR的机制。方法:新西兰兔采用随机数字表法随机分为正常组、模型组、非经非穴组和鼻内针刺组,每组8只。采用卵蛋白腹腔注射及鼻黏膜刺激法建立AR新西兰兔模型。鼻内针刺组针刺两侧鼻腔"内迎香"穴(下鼻甲前端附着区距鼻阈1 cm处),非经非穴组浅刺面部两颊外缘处(非穴位浅刺),两组均留针20 min,隔日治疗1次,共7次。干预前后观察各组新西兰兔行为学变化,采用免疫组织化学法检测鼻黏膜SP、VIP、NPY的表达,采用酶联免疫吸附法检测血清IgE、IL-4、IFN-γ含量。结果:治疗前后,模型组症状积分均明显高于正常组(P<0.01);治疗后,与模型组及非经非穴组比较,鼻内针刺组症状积分明显下降(P<0.05)。模型组新西兰兔鼻黏膜SP、VIP表达明显高于正常组(P<0.01),NPY的表达明显低于正常组(P<0.05);鼻内针刺组鼻黏膜SP、VIP表达明显低于模型组及非经非穴组(P<0.01),NPY的表达明显高于模型组及非经非穴组(P<0.05)。模型组血清IgE、IL-4含量明显高于正常组(P<0.05),IFN-γ含量明显低于正常组(P<0.01);鼻内针刺组血清IgE、IL-4含量明显低于模型组及非经非穴组(P<0.05),IFN-γ含量显著高于模型组及非经非穴组(P<0.01)。鼻黏膜SP、VIP积分吸光度值与血清IgE、IL-4含量呈正相关(P<0.05),与血清IFN-γ含量呈负相关(P<0.05)。结论:鼻内针刺治疗可明显降低鼻黏膜感觉神经及副交感神经兴奋性,提升交感神经兴奋性,并以相应神经肽为介质,通过神经免疫系统调控免疫应答,进而改善神经源性炎性反应,缓解鼻部症状。

Effect of intranasal acupuncture on neurogenic inflammation in allergic rhinitis rabbits

Objective To observe the effect of intranasal acupuncture on allergic rhinitis(AR), and expression of substance P(SP), vasoactive intestinal peptide(VIP) and neuropeptide Y(NPY) proteins in the nasal mucosa and contents of serum immunoglobulin E(IgE), interleukin 4(IL-4) and interferon-γ(IFN-γ) in AR rabbits, so as to explore its mechanisms underlying improvement of AR.Methods New Zealand rabbits were randomly divided into normal control, AR model, non-acupuoint acupuncture(NAA) and intranasal acupuncture(INA) groups, with 8 rabbits in each group. The AR model was established by intra-peritoneal injection of egg protein and nasal mucosal stimulation. In the INA group, bilateral "Neiyingxiang"(EX-HN9) within the nasal cavity(the anterior attachment area of the inferior turbinate, about 1 cm away from the nasal limen) were acupunctured by mani-pulating the filiform needles for a while with uniform reinforcing and reducing methods, followed by keeping the needles for 20 min. In the NAA group, shallow acupuncture was applied to the skin of the outer margin of the cheeks, followed by keeping the needle for 20 min. The acupuncture treatment was conducted once every other day for 7 days. The symptoms of sneezing frequency, nasal secretion amount and nasal itching were scored. The expression levels of SP, VIP and NPY in the nasal mucosa tissue were detected by immunohistochemistry, and the serum IgE, IL-4, and IFN-γ contents were detected by ELISA.Results After modelling, the symptom score, expression of SP and VIP, and serum IgE and IL-4 contents were significantly higher(P<0.01,P<0.05), NPY expression and serum IFN-γ content significantly lower(P<0.05, P<0.01) in the model group than in the normal control group. Following the intervention, the symptom scores, expressions of SP and VIP, and serum IgE and IL-4 contents were remarkably decreased(P<0.05, P<0.01), while the NPY expression and serum IFN-γ content were significantly up-regulated(P<0.05, P<0.01) in the INA group than in the model group. The effects of INA group were significantly superior to those of NAA group in reducing symptom score, SP and VIP expression, and serum IgE and IL-4 contents and up-regulating NPY expression and IFN-γcontent(P<0.05, P<0.01). There were a positive correlation between the expressions of SP and VIP and contents of serum IgE and IL-4(P<0.05), and a negative correlation between the expressions of SP and VIP and IFN-γ content(P<0.05).Conclusion INA treatment can relieve symptoms of AR in AR rabbits, which may be associated with its effects in regulating the expression of SP, VIP and NPY of the nasal mucosa, and contents of serum IgE, IL-4 and IFN-γ to improve neurogenic inflammation.