原標(biāo)題：鼻變應(yīng)原激發(fā)和環(huán)境暴露艙激發(fā):一項(xiàng)比較對(duì)貓過(guò)敏原的臨床和生物學(xué)反應(yīng)的隨機(jī)試驗(yàn)
①背景：直接滴鼻過(guò)敏原激發(fā)（NAC）和環(huán)境暴露室（EEC）是進(jìn)行受控過(guò)敏原激發(fā)的兩種方法。這些方法的臨床和生物學(xué)可比性尚未得到徹底研究。②目的:比較貓過(guò)敏原在NAC和EEC中的臨床和免疫反應(yīng)。③方法：24名參與者被隨機(jī)分為兩組，一組先接受NAC，然后在EEC中接受為期兩天的激發(fā)；另一組先在EEC接受為期兩天的激發(fā)，然后再接受NAC，兩次激發(fā)之間有28天的洗脫間隔。我們測(cè)量了鼻癥狀評(píng)分(TNSS)、鼻吸氣峰值流量(PNIF)、鼻(0-8小時(shí))和血清細(xì)胞因子、血清抗體、外周血抗原特異性T淋巴細(xì)胞和鼻刮片中的基因表達(dá)。主要結(jié)果是在NAC或在EEC過(guò)敏原暴露后3小時(shí)內(nèi)TNSS在曲線下的面積。④結(jié)果：這兩種激發(fā)都增加了鼻液和血清中IL-5和IL-13的含量，并導(dǎo)致與粘膜生物學(xué)和轉(zhuǎn)錄調(diào)節(jié)相關(guān)的基因模塊在鼻細(xì)胞表達(dá)改變?；蚰K的變化比細(xì)胞因子的測(cè)量更顯示出與TNSS和PNIF的顯著相關(guān)性?？偟膩?lái)說(shuō)，與NAC相比，EEC暴露產(chǎn)生的反應(yīng)更大，反應(yīng)終止的更早。雖然這兩項(xiàng)激發(fā)在癥狀嚴(yán)重程度或時(shí)間上沒(méi)有相關(guān)性，但在細(xì)胞因子水平上發(fā)現(xiàn)了驚人的相關(guān)性。⑤結(jié)論：雖然NAC和EEC的臨床結(jié)果在時(shí)間和大小上是不同的，但是免疫反應(yīng)是相似的。選擇特定的過(guò)敏原攻擊方法應(yīng)取決于研究目標(biāo)和成本。
延伸閱讀
JACI：                                              
Nasal Allergen Challenge and Environmental Exposure Chamber Challenge: A Randomized Trial Comparing Clinical and Biological Responses to Cat Allergen
https://doi.org/10.1016/j.jaci.2020.02.024
Abstract:
Abstract
Background
The direct-instillation nasal allergen challenge (NAC) and the environmental exposure chamber (EEC) are two methods of conducting controlled allergen provocations. The clinical and biological comparability of these methods has not been thoroughly investigated.
Objective
To compare clinical and immunologic responses to cat allergen in NAC versus EEC.
Methods
Twenty-four participants were randomized to receive either NAC followed by a two-day challenge in an EEC or a two-day challenge in EEC followed by NAC. Challenges were separated by 28-day washout periods. We measured total nasal symptom scores (TNSS), peak nasal inspiratory flow (PNIF), nasal (0-8hours) and serum cytokines, serum antibodies, peripheral blood antigen-specific T-lymphocytes, and gene expression in nasal scrapings. The primary outcome was the TNSS area under the curve for the first 3 hours after allergen exposure in NAC or after initiation of exposure in EEC.
Results
Both challenges increased IL-5 and IL-13 in nasal fluids and serum and resulted in altered nasal cell expression of gene modules related to mucosal biology and transcriptional regulation. Changes in gene modules, more so than cytokine measurements, showed significant associations with TNSS and PNIF. Overall, EEC exposure generated larger responses and more early terminations compared to NAC. Although the two challenges did not correlate in symptom magnitude or temporality, striking correlations were observed in cytokine levels.
Conclusion
Although clinical outcomes of NAC and EEC were temporally different and non-equivalent in magnitude, immunologic responses were similar. Selection of a particular allergen challenge method should depend on considerations of study objectives and cost.
All Author:David Larson PiyushPate Anne MarieSalapatek PeterCouroux Don Whitehouse AdelaPina Jacqueline L.Johnson Michelle L.Sever SrinathSanda JulianPoyser, MS5TheresaAllio Guy W.Scadding TielinQin Mohamed H.Shamji William W.Kwok Eddie A.JamesDeanna French AlinaLelic …Stephen R.Durham
　　創(chuàng)建過(guò)敏性疾病的科研、科普知識(shí)交流平臺(tái)，為過(guò)敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺(tái)。