NASAL CHALLENGE WITH RAGWEED POLLEN IN HAY-FEVER PATIENTS - EFFECT OF IMMUNOTHERAPY
NASAL CHALLENGE WITH RAGWEED POLLEN IN HAY-FEVER PATIENTS - EFFECT OF IMMUNOTHERAPY
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DOI：
10.1172/jci112233
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发表时间：
1985-12-01
影响因子：
15.9
通讯作者：
NORMAN, PS
中科院分区：
文献类型：
--
作者：
CRETICOS, PS;ADKINSON, NF;NORMAN, PS
过敏受试者的鼻粘膜受到特定过敏原的刺激，不仅会引起预期的打喷嚏和流鼻涕，还会在鼻分泌物中出现通常与肥大细胞或嗜碱性粒细胞活化相关的介质：组胺、白三烯、前列腺素 D2 (PGD2)、激肽和 TAME ([3H]-N-α-甲苯磺酰基-L-精氨酸甲酯)-酯酶。为了确定特异性免疫疗法是否改变体内介质释放，使用鼻花粉激发来比较27名未经治疗的高度敏感豚草（RW）过敏受试者与12名接受RW提取物（中位剂量，6μgRW抗原E）长期免疫疗法（3-5年）的类似敏感患者。根据皮肤测试和嗜碱性粒细胞组胺释放，两组的敏感性相同。免疫组的反应减弱，如下所示：(a) 治疗组需要更高的花粉剂量来刺激打喷嚏或介质释放； (b) 治疗组中释放任何剂量介质的受试者显着减少（TAME 酯酶 [P = 0.005]、PGD2 [P = 0.04]），以及 (c) 治疗组释放的介质减少 3-5 倍（TAME 酯酶 [P = 0.01] 和组胺 [P = 0.02]）。
Challenge of the nasal mucosa of allergic subjects with specific allergen induces not only the expected sneezing and rhinorrhea, but also the appearance in nasal secretions of mediators commonly associated with activation of mast cells or basophils: histamine, leukotrienes, prostaglandin D2 (PGD2), kinins, and TAME ([3H]-N-.alpha.-tosyl-L-arginine methyl ester)-esterase. To determine whether specific immunotherapy alters mediator release in vivo, nasal pollen challenge was used to compare 27 untreated highly sensitive ragweed (RW)-allergic subjects with 12 similarly sensitive patients receiving long-term immunotherapy (3-5 yr) with RW extract (median dose, 6 .mu.g RW antigen E). The two groups were equally sensitive based on skin tests and basophil histamine release. The immunized group had a diminished response as demonstrated by (a) the treated group required higher pollent dose to excite sneezing or mediator release; (b) significantly fewer subjects in the treated group released mediators at any dose (TAME-esterase [P = 0.005], PGD2 [P = 0.04]), and (c) the treated group released 3-5-fold less mediator (TAME-esterase [P = 0.01], and histamine [P = 0.02]).