Nasal provocation of patients with allergic rhinitis and the hypothalamic-pituitary-adrenal axis
Nasal provocation of patients with allergic rhinitis and the hypothalamic-pituitary-adrenal axis
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DOI：
10.1016/s1081-1206(10)60717-x
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发表时间：
2007-03-01
影响因子：
5.9
通讯作者：
Theoharides, Theoharis C.
中科院分区：
文献类型：
--
作者：
Kalogeromitros, Demetrios;Syrigou, E. Katerini I.;Theoharides, Theoharis C.
背景：变应性鼻炎是一种常见的问题，涉及鼻肥大细胞活化和过敏。情绪或环境应激可刺激下丘脑-垂体-肾上腺（HPA）轴，肥大细胞参与应激诱导的免疫反应目的：探讨对单一抗原过敏的患者鼻内激发是否会刺激HPA轴。在20、40、60、80、100、1在健康志愿者（n = 3）和对Parietaria过敏的鼻炎患者（n = 10）中鼻内抗原给药后120分钟结果：患者的平均+/- SD促肾上腺皮质激素水平为24.43 +/- 14.38 pg/mL，而对照组为8.83 +/- 5.02 pg/mL，这一增加具有统计学意义（P = 0.049）。患者皮质醇水平也增加至平均SD 8.87 +/- 4.90 pg/mL（40分钟时），而对照组为4.36 +/- 1.72 pg/mL（由于1个离群值，P = 0.11）。与个体患者激发前水平相比，在40 min时，7例患者的促肾上腺皮质激素水平升高，5例患者的皮质醇水平升高。结论：这些结果表明，变应性鼻炎可能激活HPA轴。需要一项具有额外对照的更大规模研究才能得出明确结论。
Background: Allergic rhinitis is a common problem involving activation of nasal mast cells and irritability. The hypothalamic-pituitary-adrenal (HPA) axis is stimulated in cases of emotional or environmental stress, and mast cells have been implicated in stress-induced immune responses.Objective: To investigate whether intranasal challenge of patients allergic to a single antigen would stimulate the HPA axis.Methods: Plasma corticotropin and cortisol levels were measured 20, 40, 60, 80, 100, and 120 minutes after intranasal antigen administration in healthy volunteers (n = 3) and in patients with rhinitis who are allergic to Parietaria (n = 10).Results: Mean +/- SD corticotropin levels were 24.43 +/- 14.38 pg/mL in patients compared with 8.83 +/- 5.02 pg/mL in controls, and this increase was statistically significant (P = .049). Patient cortisol levels also increased to a mean SD of 8.87 +/- 4.90 pg/mL (at 40 minutes) compared with 4.36 +/- 1.72 pg/mL in controls (P = .11 due to 1 outlier). Compared with individual patient prechallenge levels, corticotropin levels increased in 7 patients and cortisol levels increased in 5 at 40 minutes.Conclusion: These results suggest that allergic rhinitis may activate the HPA axis. A larger study with additional controls is required for definitive conclusions.