Rhinophototherapy: A new therapeutic tool for the management of allergic rhinitis
Rhinophototherapy: A new therapeutic tool for the management of allergic rhinitis
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DOI：
10.1016/j.jaci.2004.11.005
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发表时间：
2005-03-01
影响因子：
14.2
通讯作者：
Kemeny, L
中科院分区：
文献类型：
--
作者：
Koreck, AI;Csoma, Z;Kemeny, L
背景：光疗具有深远的免疫抑制作用，能够抑制皮肤的过敏反应。目的：我们评估了使用 UV-B (5%)、UV-A (25%) 和可见光 (70%) 组合的光疗（称为 mUV/VIS）是否能有效治疗过敏性鼻炎。方法：我们对 49 名花粉症患者进行了一项随机、双盲研究。该研究是在豚草季节进行的。每个鼻腔每周用 mUV/VIS 或低强度可见光照明 3 次，持续 3 周。在鼻腔灌洗中评估症状评分、炎症细胞及其介质。检测了 mUV/VIS 照射对 T 细胞和嗜酸性粒细胞凋亡的体外影响及其对嗜碱性粒细胞介质释放的抑制作用。结果：鼻光疗法耐受性良好，打喷嚏 (P < .016)、鼻漏 (P < .007)、鼻痒 (P < .014) 和鼻总评分 (P < .004) 等临床症状显着改善。对照组的所有分数均无显着改善。 mUV/VIS 治疗后鼻塞评分略有改善，而对照组则显着增加 (P < .017)。在鼻腔灌洗中，光疗显着降低了嗜酸性粒细胞的数量以及嗜酸性粒细胞阳离子蛋白和IL-5的水平。用 mUV/VIS 光体外照射 T 细胞和嗜酸性粒细胞，剂量依赖性诱导细胞凋亡。此外，mUV/VIS照射抑制了RBL-2H3嗜碱性粒细胞的介质释放。结论：这些结果表明光疗是治疗过敏性鼻炎的有效方法，并为治疗免疫介导的粘膜疾病提供了新的选择。
Background: Phototherapy has a profound immunosuppressive effect and is able to inhibit hypersensibility reactions in the skin.Objective: We evaluated whether phototherapy using a combination of UV-B (5%), UV-A (25%), and visible light (70%), referred to as mUV/VIS, is effective in treating allergic rhinitis. Methods: We conducted a randomized, double-blind study, in 49 patients with hay fever. The study was performed during the ragweed season. Each intranasal cavity was illuminated 3 times a week for 3 weeks with mUV/VIS or with low-intensity visible light. Symptom scores, inflammatory cells, and their mediators were assessed in nasal lavages. In vitro effects of mUV/VIS irradiation on T-cell and eosinophil apoptosis and its inhibitory effect on mediator release from basophils were examined.Results: Rhinophototherapy was tolerated well and resulted in a significant improvement of clinical symptoms for sneezing (P < .016), rhinorrhea (P < .007), nasal itching (P < .014), and total nasal score (P < .004). None of the scores improved significantly in the control group. Scores for nasal obstruction slightly improved after mUV/VIS treatment and significantly increased in the control group (P < .017). In the nasal lavage, phototherapy significantly reduced the number of eosinophils and the level of eosinophil cationic protein and IL-5. In vitro irradiation of T cells and eosinophils with mUV/VIS light dose-dependently induced apoptosis. Furthermore, mUV/VIS irradiation inhibited the mediator release from RBL-2H3 basophils.Conclusion: These results suggest that phototherapy is an effective modality to treat allergic rhinitis and offer new options for the treatment of immune-mediated mucosal diseases.