过敏性鼻炎和带有息肉的慢性鼻炎中的鼻腔过敏反应:神经元通路的作用
W Backaert1, B Steelant2, T Wils2
1KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium; University Hospitals Leuven, Department of Otorhinolaryngology, Head and Neck surgery, Leuven, Belgium.
过敏性鼻炎和慢性鼻炎中的鼻腔过敏反应 (NHR) 与神经性炎症和胰岛素相关. 这种反应性存在于光谱上,而不是作为一个由这些因素影响的开/关条件.
科学领域:
- 免疫学 免疫学 免疫学
- 神经科学是一个神经科学.
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 鼻腔过敏反应 (NHR) 在过敏性鼻炎 (AR) 和带鼻息肉的慢性鼻炎 (CRSwNP) 中很常见.
- 虽然非过敏性鼻炎的NHR涉及神经元通路,但AR和CRSwNP主要与2型炎症有关.
研究的目的:
- 用冷干空气 (CDA) 挑试验客观地诊断NHR.
- 研究AR/CRSwNP中NHR的潜在机制,重点关注神经性炎症和上皮反应.
主要方法:
- 45名AR/CRSwNP患者和18名健康对照患者接受了CDA挑.
- 分析了鼻子分泌物和活检,以检测神经性炎症的标志物 (物质P,CGRP,NKA),上皮细胞激活 (IL-33) 和组胺.
- 评估了神经元标记表达 (PGP9.5,TRPV1,TRPM8) 和对神经元通道的基因素影响.
主要成果:
- 在主观NHR患者中,CDA挑降低了鼻腔吸气流 (PNIF),与客观测量相关.
- 在鼻分泌物/活检中增加的神经,组胺和增加PGP9.5,TRPV1和TRPM8的表达,与CDA诱导的PNIF减少相关.
- 通过CDA挑战增加了IL-33水平,而胰岛素使 afferent神经元上的TRPV1和TRPA1通道敏感.
结论:
- NHR是一个连续的反应频谱,而不是一个二进制条件.
- 神经性炎症和升高的组胺水平被确定为AR/CRSwNP中NHR的危险因素.
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