Small bowel of patients with asthma and allergic rhinitis: absence of inflammation despite the presence of major cellular components of allergic inflammation.
Small bowel of patients with asthma and allergic rhinitis: absence of inflammation despite the presence of major cellular components of allergic inflammation.
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哮喘和过敏性鼻炎患者的小肠：尽管存在过敏性炎症的主要细胞成分，但没有炎症。
DOI：
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发表时间：
2004
影响因子：
2.8
通讯作者：
J. R. Lapa e Silva
中科院分区：
文献类型：
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作者：
G. Pires;H. Souza;C. Elia;C. Zaltman;A. Carvalho;C. Tortori;Henrique C Garrofé;J. R. Lapa e Silva
嗜酸性粒细胞参与呼吸道和肠道炎症性疾病的发病机制。我们研究了哮喘和变应性鼻炎患者十二指肠粘膜中嗜酸性粒细胞和单核细胞的组成。对16例哮喘患者和13例变应性鼻炎患者进行上消化道症状常规内镜检查，获得宏观正常十二指肠标本。12例非特应性肠易激综合征患者作为对照研究。采用免疫组化方法对标本进行分析，抗体分别为人嗜酸性粒细胞阳离子蛋白克隆EG1 （EG1）和克隆EG2 （EG2）、抗人白细胞介素（抗hil）-5、抗hil -4、抗cd4和抗cd68。与对照组相比，哮喘和变应性鼻炎患者十二指肠中EG1和EG2染色的嗜酸性粒细胞数量明显增加。哮喘和鼻炎患者十二指肠黏膜IL-5+细胞和IL-4+细胞数量均明显高于对照组。与对照组相比，哮喘和鼻炎患者十二指肠黏膜中表达CD4（辅助性T细胞）和CD68（巨噬细胞）的单核细胞也显著增加。嗜酸性粒细胞与IL-4+细胞和IL-5+细胞在非炎症性十二指肠黏膜的积累可能反映了哮喘和变应性鼻炎患者主要的T辅助细胞亚群2的全身免疫反应。尽管存在与变应性炎症相关的细胞，但没有肠道炎症，这表明局部机制可能决定了哮喘和变应性鼻炎患者肠道黏膜的无反应状态。
Eosinophils participate in the pathogenesis of inflammatory diseases of the respiratory tract and the gut. We investigated the constitutive presence of eosinophils and mononuclear cells in the macroscopically normal duodenal mucosa of patients with asthma and allergic rhinitis. Macroscopically normal duodenal specimens were obtained at routine endoscopy for upper gastrointestinal symptoms from 16 patients with asthma and 13 patients with allergic rhinitis. Twelve nonatopic patients with irritable bowel syndrome were studied as controls. Specimens were analyzed by immunohistochemistry using a panel of antibodies to human eosinophil cationic protein clone EG1 (EG1) and clone EG2 (EG2), anti-human interleukin (anti-hIL)-5, anti-hIL-4, anti-CD4, and anti-CD68. Significantly increased numbers of eosinophils stained with EG1 and EG2 were found in the duodenum of patients with asthma and allergic rhinitis compared with controls. IL-5+ cells and IL-4+ cells were detected in significantly increased numbers in the duodenal mucosa of patients with asthma and rhinitis compared with controls. Mononuclear cells expressing CD4 (helper T cells) and CD68 (macrophages) also were significantly increased in the duodenal mucosa of asthma and rhinitis compared with controls. Accumulation of eosinophils in conjunction with IL-4+ cells and IL-5+ cells in the noninflamed duodenal mucosa may reflect a predominant T helper cell subset 2 systemic immune response in patients with asthma and allergic rhinitis. The absence of intestinal inflammation despite the marked presence of cells implicated in the allergic inflammation suggests that local mechanisms might determine the state of nonresponsiveness in the gut mucosa of patients with asthma and allergic rhinitis.