THE INFLUX OF INFLAMMATORY CELLS INTO NASAL WASHINGS DURING THE LATE RESPONSE TO ANTIGEN CHALLENGE - EFFECT OF SYSTEMIC STEROID PRETREATMENT
THE INFLUX OF INFLAMMATORY CELLS INTO NASAL WASHINGS DURING THE LATE RESPONSE TO ANTIGEN CHALLENGE - EFFECT OF SYSTEMIC STEROID PRETREATMENT
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DOI：
10.1164/ajrccm/138.2.406
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发表时间：
1988-08-01
期刊：
影响因子：
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通讯作者：
NACLERIO, RM
中科院分区：
文献类型：
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作者：
BASCOM, R;PIPKORN, U;NACLERIO, RM
先前的研究表明，在特定的过敏性受试者中，鼻腔抗原攻击后长达11小时的症状和介质释放。全身类固醇治疗可减少症状和包括组胺、驯化酯酶活性和激动素在内的介质。本研究的目的是描述抗原攻击反应后期的细胞内流特征，并确定全身类固醇对这一反应的影响。我们检测了10名有季节性鼻炎病史的无症状变态反应性受试者和5名正常的非过敏性受试者在鼻抗原攻击前和之后每小时获得的鼻洗液的细胞质玻片。过敏受试者接受口服泼尼松(20 mg，每天3次)或安慰剂，以随机、双盲交叉方式进行为期2天的两次挑战，每次挑战间隔1个月。在安慰剂日，过敏受试者在晚期反应期间出现混合细胞流入，这是非过敏对照组受试者细胞流入的50倍(p<；0.005)。在抗原攻击后的前3小时内，均可见嗜酸性粒细胞(P<；0.005)，但未见中性粒细胞或单核细胞。晚期(4~11h)中性粒细胞、嗜酸性粒细胞和单核细胞均升高。口服类固醇可阻止嗜酸性粒细胞的流入(p<；0.005)，但不能阻止其他细胞的流入。这些数据显示与鼻腔晚期反应相关的炎性细胞流入，并提示嗜酸性粒细胞的重要致病作用。以前观察到的全身激素治疗晚期反应中介质的减少很可能是由于细胞内流的改变，但也可能涉及炎性细胞功能的改变。
Previous studies have demonstrated symptoms and mediator release occurring as long as 11 h after nasal challenge with antigen in selected allergic subjects. Pretreatment with systemic steroids reduced symptoms and mediators including histamines, TAME-esterasse activity, and kinins. The aims of the present study were to characterize the cell influx during the late-phase response to antigen challenge and to determine the effect of pretreatment with systemic steroids on this response. We examined cytospin slides of nasal washings obtained before and hourly for 11 h after nasal antigen challenge in 10 asymptomatic allergic subjects with a history of seasonal rhinitis and 5 normal, nonallergic subjects. Allergic subjects received oral prednisone (20 mg 3 times a day) or placebo in a random, double-blind crossover manner for 2 days before each of 2 challenges 1 month apart. On placebo days, a mixed cell influx occurred in allergic subjects during the late response that was 50-fold greater than the cell influx in the nonallergic control subjects (p < 0.005). During the first 3 h after antigen challenge, eosinophils (p < 0.005), but not neutrophils or mononuclear cells were all observed. During the late phase (4 to 11 h), neutrophils, eosinophils, and mononuclear cells were all increased. Oral steroid pretreatment blocked the influx of eosinophils (p < 0.005), but not that of other cells. These data demonstrate an inflammatory cell influx associated with the nasal late-phase response and suggest an important pathogenetic role for the eosinophil. The previously observed reduction in mediators during the late response with systemic steroid pretreatment is most likely due to an altered cell influx but may also involve altered inflammatory cell function.