Aiming toward effective preventive medicine against Japanese cedar pollinosis : -----Epidemiology, patient investigation, and integrated research including genotype analyses-

环境因素而不是遗传因素似乎是最近日本雪松花粉症流行增加的主要原因。然而，研究决定IgE水平和嗜酸性粒细胞水平的基因和分析基因多态性可能有助于寻找新的治疗方法和建立预防该病的药物。在219名经RAST检测为抗日本雪松花粉IgE抗体阳性的无症状个体中，只有少数人随后在5-14年的随访中出现了日本雪松花粉症或继发性日本雪松花粉病的症状。在随后发生继发性疾病的患者中，50%的人被发现具有较高的初始RAST评分，这表明日本雪松花粉症的发病率与RAST评分有关。因此，建议RAST评分较高的无症状个体避免接触日本雪松花粉，以延迟疾病…的发病可能是谨慎的此外，对FcεRIβ基因序列变异的分析表明，鼻变态反应患者表现出单核苷酸多态现象，其中细胞内区第237位氨基酸从谷氨酰胺转变为甘氨酸的频率比非鼻变态患者更频繁。此外，IL-4Rα基因的II同源多态与血清非特异性免疫球蛋白E和日本雪松花粉特异性免疫球蛋白E水平高于表现出IL-4R异源和Val同源表达类型的个体。比较健康型和花粉症表型中的嗜酸性粒细胞相关基因多态，揭示了不同的基因类型与特定疾病参数之间的几种关系，并提示嗜酸性粒细胞G(123G/A)和IL5(-703C/T)基因可以影响致敏后症状出现的时间以及鼻黏膜高反应性。

Environmental rather than genetic factors appear to play the major role in the recent increased prevalence of Japanese cedar pollinosis in Japan. However, investigating genes determining IgE levels, eosinophils and analyzing gene polymorphisms may contribute to finding new methods of treatment and establishing preventive medicine against this disease.Among a total of 219 asymptomatic individuals who were anti-Japanese cedar pollen IgE antibody positive as determined by RAST, only a handful subsequently developed symptoms of Japanese cedar pollinosis or secondary onset of Japanese cedar pollinosis over 5-14 years of follow-up. Among those who subsequently developed secondary onset of disease, >50% were found to have high initial RAST scores, suggesting that the incidence of Japanese cedar pollinosis is correlated with RAST score. Hence it may be prudent to advise asymptomatic individuals with high RAST scores to avoid exposure to Japanese cedar pollen so as to delay onset of the disease … More .Analysis of sequence variants of the FcεRIβ gene revealed that patients with nasal allergy exhibit a single nucleotide polymorphism(SNP) in which the amino acid at 237 of the intracellular domain changes from glutamine to glycine more frequently than individuals without nasal allergy. Furthermore, II homo polymorphism of the IL-4Rα gene is associated with higher serum nonspecific IgE and Japanese cedar pollen specific IgE levels than are seen in individuals showing Il,Val hetero and Val homo expression types. When the age of pollinosis onset was compared among these 3 genotypes, it was found significantly lower among II homo type than the other 2 expression types, suggesting that II homo type individuals seem characteristically predisposed to early onset of pollinosis.Studies comparing eosinophil-associated gene polymorphism in healthy and pollinosis phenotypes have revealed several relationships between the various genotypes and specific disease parameters and suggest that Eotaxin G (123G/A) and IL5 (-703C/T) genotypes can affect the timing of symptom onset after sensitization as well as nasal mucosal hyperresponsiveness Less