Effect of intranasal corticosteroid on pre-onset activation of eosinophils and mast cells in experimental Japanese cedar pollinosis
Effect of intranasal corticosteroid on pre-onset activation of eosinophils and mast cells in experimental Japanese cedar pollinosis
复制标题
鼻内皮质类固醇对实验性日本柳杉花粉病中嗜酸性粒细胞和肥大细胞发作前激活的影响
DOI：
10.1016/j.alit.2015.12.007
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发表时间：
2016
影响因子：
6.8
通讯作者：
Nishizaki K.
中科院分区：
文献类型：
--
作者：
Noyama Y;Okano M;Fujiwara T;Kariya S;Makihara S;Haruna T;Kanai K;Higaki T;Nishizaki K.
背景变应性鼻炎的高反应性与微小持续性炎症有关。然而，关于日本雪松花粉症（JCP）中是否存在嗜酸性粒细胞和肥大细胞的发病前激活，人们知之甚少。此外，鼻内皮质类固醇对这种MPI在JCP.MethodsWe设计了一个双盲，随机，安慰剂对照，交叉试验的预防作用还没有被调查。20例JCP患者在花粉季节以外进行了检查（UMIN000008410）。用含有日本雪松花粉提取物的纸片进行鼻激发，每天一次，连续3天。在每次激发后15分钟内监测鼻部症状的发作。检测鼻分泌物中嗜酸性粒细胞阳离子蛋白（ECP）和类胰蛋白酶的水平。糠酸氟替卡松鼻喷雾剂或安慰剂治疗开始前一天的第一个factions.ResultsIn安慰剂组，25%的患者表现出发病后的第一天挑衅的鼻部症状。此外，75%和68%的患者分别在激发的第二天和第三天出现症状。第一次激发后，鼻分泌物中ECP和类胰蛋白酶水平显著升高。这些增加不仅见于有症状受试者，也见于无症状受试者对激发的反应，这些受试者之间的水平相似。预防性治疗氟替卡松显着抑制鼻ECP和类胰蛋白酶的增加与反复provocations.ConclusionsThese结果表明，发病前激活的嗜酸性粒细胞和肥大细胞是存在于实验性JCP，鼻内皮质类固醇的预防性治疗有可能控制这种激活。
BackgroundMinimal persistent inflammation (MPI) contributes to hyperreactivity in allergic rhinitis. However, little is known regarding whether pre-onset activation of eosinophils and mast cells is present or not in Japanese cedar pollinosis (JCP). Furthermore, a prophylactic effect of intranasal corticosteroids on such MPI in JCP has not been investigated.MethodsWe designed a double-blinded, randomized, placebo-controlled, crossover trial. Twenty patients with JCP were examined outside the pollen season (UMIN000008410). Nasal provocation with paper discs containing extracts of Japanese cedar pollen was performed once a day for 3 consecutive days. Onset of nasal symptoms was monitored over 15 min after each provocation. The levels of eosinophil cationic protein (ECP) and tryptase in nasal secretions were examined. Fluticasone furoate nasal spray or placebo treatment was started one day before the first provocation.ResultsIn the placebo group, 25% of the patients showed onset of nasal symptoms following provocation on the first day. In addition, 75% and 68% of the patients showed symptom onset on the second and third day of provocation, respectively. After the first provocation, the levels of ECP and tryptase in nasal secretions were significantly increased. These increases were seen not only in symptomatic but also in asymptomatic subjects in response to provocation, and the levels were similar between these subjects. Prophylactic treatment with fluticasone significantly suppressed the increase in nasal ECP and tryptase associated with repeated provocations.ConclusionsThese results suggest that pre-onset activation of eosinophils and mast cells is present in experimental JCP, and that prophylactic treatment with intranasal corticosteroids has the potential to control such activation.