Nasal challenge with allergen leads to maxillary sinus inflammation
Nasal challenge with allergen leads to maxillary sinus inflammation
复制标题
DOI：
10.1016/j.jaci.2008.02.010
复制
发表时间：
2008-05-01
影响因子：
14.2
通讯作者：
Naclerio, Robert M.
中科院分区：
文献类型：
--
作者：
Baroody, Fuad M.;Mucha, Samantha M.;Naclerio, Robert M.
背景：过敏性鼻炎和慢性鼻窦炎均以慢性炎症为特征。目的：探讨过敏原激发对上颌窦的影响及氯雷他定的治疗效果。方法：对20例过敏性鼻炎患者进行双盲交叉随机安慰剂对照研究。用安慰剂或氯雷他定(每天10 mg，PO)治疗1周后，将导管插入一个上颌窦并用来冲洗空洞。然后，受试者接受鼻腔攻击，用变应原提取物稀释剂，然后是3种浓度的草或豚草。在每次挑战后进行鼻腔和同侧鼻窦冲洗，然后每小时冲洗一次，持续8小时。记录打喷嚏和症状，并对灌洗标本进行嗜酸性粒细胞和嗜酸性粒细胞阳离子蛋白、白蛋白和组胺水平的评估。结果：与乳酸林格液激发相比，变应原激发导致大多数早期和晚期鼻部参数显著增加。鼻部过敏原激发也导致晚期反应中上颌窦嗜酸性粒细胞和白蛋白、嗜酸性粒细胞阳离子蛋白和组胺水平显著增加。与安慰剂相比，氯雷他定对鼻腔早期反应有明显的抑制作用(P
Background: Allergic rhinitis and chronic rhinosinusitis are both characterized by chronic inflammation.Objective: We sought to investigate the effect of nasal allergen challenge on the maxillary sinus and study the effect of premedication with loratadine.Methods: We performed a double blind, crossover, randomized, placebo-controlled study in 20 allergic subjects out of season. After treatment with either placebo or loratadine (10 mg PO daily) for I week, a catheter was inserted into one maxillary sinus and used to lavage the cavity. The subjects then underwent nasal challenge with diluent for the allergen extract, followed by 3 concentrations of grass or ragweed. Nasal and ipsilateral sinus lavages were performed after each challenge and then hourly for 8 hours. Sneezes and symptoms were recorded, and the lavage specimens were evaluated for eosinophils and levels of eosinophil cationic protein, albumin, and histamine. Eleven of the subjects underwent a similar challenge with lactated Ringer's solution.Results: Compared with the lactated Ringer's solution challenge, allergen challenge resulted in significant increases in most early- and late-phase nasal parameters. Allergen challenge of the nose also led to a significant increase compared with control values in maxillary sinus eosinophils and the levels of albumin, eosinophil cationic protein, and histamine during the late response. Loratadine resulted in significant inhibition of the nasal early response compared with that seen with placebo (P