Nasal mucosa in natural colds: effects of allergic rhinitis and susceptibility to recurrent sinusitis
Nasal mucosa in natural colds: effects of allergic rhinitis and susceptibility to recurrent sinusitis
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DOI：
10.1111/j.1365-2249.2004.02530.x
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发表时间：
2004-08-01
影响因子：
4.6
通讯作者：
Karttunen, TJ
中科院分区：
文献类型：
--
作者：
Alho, OP;Karttunen, R;Karttunen, TJ
病毒诱导的哮喘和过敏的呼吸道高反应性以及继发性呼吸道感染患者的宿主防御失败的机制仍在很大程度上尚不清楚。本研究的目的是研究变应性鼻炎的存在或对复发性鼻窦炎的易感性是否会影响自然感冒和康复期间鼻粘膜的结构和细胞变化。我们比较了9例变应性鼻炎患者(n=9)、19例鼻窦炎易感性患者(n=19)和20例健康对照(n=20)在急性自然感冒(发病第2-4天)和恢复期(3周后)活检标本中的粘膜变化。与恢复期相比，在急性感冒期间，我们看到所有三组患者的粘膜T、B淋巴细胞和肥大细胞数量以及血管密度都有类似的增加。与对照组相比，变态反应组急性期嗜酸性粒细胞水平升高(P=0.03)，上皮性T细胞水平升高(P=0.04)，肥大细胞水平降低(P=0.005)。易患鼻窦炎的受试者在恢复期缺乏上皮内细胞毒性细胞。变态反应组急性期网状基底膜较恢复期增厚(P=0.05)。这些结果表明，呼吸道的各种细胞，包括炎症细胞和结构细胞，参与了变应性鼻炎患者的病毒性呼吸道感染。鼻窦炎易感人群中肥大细胞和细胞毒性淋巴细胞数量较少，可能与其对细菌并发症的易感性有关。
The mechanisms of virus-induced airway hyperresponsiveness in asthma and allergy and the failure of host defence in patients suffering from secondary airway infections are still largely unknown. The aim of this study was to examine whether the presence of allergic rhinitis or susceptibility to recurrent sinusitis affects the structural and cellular changes in nasal mucosa during natural colds and convalescence. We compared the mucosal changes in biopsy samples during acute natural colds (days 2-4 of illness) and convalescence (3 weeks later) in patients with allergic rhinitis (n = 9), patients with susceptibility to sinusitis (n = 19) and healthy controls (n = 20). We saw similarly increased numbers of mucosal T and B lymphocytes and mast cells and increased vascular density during the acute colds compared to convalescence in all the three groups. The allergic subjects had elevated levels of eosinophils in the acute phase (P = 0.03), and the allergic and sinusitis-prone subjects had elevated levels of epithelial T cells (P = 0.04) and low levels of mast cells (P = 0.005) in convalescence compared to the control group. The sinusitis-prone subjects lacked intraepithelial cytotoxic cells in convalescence. In the allergic subjects, the reticular basement membrane was thicker in the acute phase compared to the convalescence (P = 0.05). These results suggest that various cells of the airways, including inflammatory and structural cells, are involved during viral respiratory infections in subjects with allergic rhinitis. The small numbers of mast cells and cytotoxic lymphocytes in the sinusitis-prone subjects may be related to their susceptibility to bacterial complications.