Expression and mechanism of mast cell activating molecules and their antibodies in allergic rhinitis and nasal polyps
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摘要: 目的:探讨肥大细胞(MC)与变应性鼻炎(AR)及鼻息肉(NP)发生的关系及其发病机制。方法:选取2018-01-2018-06期间就诊的患者为研究对象,所有患者均经过术前鼻内镜及鼻窦CT检查。分为3个组:AR组(30例),NP组(30例),行单纯下鼻甲部分切除术的鼻中隔矫正术者为对照组(30例)。收集患者的临床资料和外周血及鼻黏膜组织。检测外周血中嗜酸粒细胞百分率、血清IgE水平,抗IgE抗体、FcεRIα和抗FcεRIα抗体水平。观察3组的组织病理改变,免疫组织化学方法分析类胰蛋白酶和FcεRIα的表达。结果:AR组中嗜酸粒细胞百分率、IgE、抗IgE抗体、FcεRIα、抗FcεRIα抗体水平均明显高于对照组(P<0.05);NP组中嗜酸粒细胞百分率、FcεRIα、抗FcεRIα抗体水平均明显高于对照组(P<0.05),IgE和抗IgE抗体与对照组相比,差异无统计学意义(P>0.05);AR组的嗜酸粒细胞百分率、IgE和抗IgE抗体水平高于NP组(P<0.05);AR组、NP组中FcεRIα、抗FcεRIα抗体水平无差异(P>0.05)。AR组、NP组中嗜酸粒细胞浸润无明显差异,鼻黏膜下层和黏膜间质中发现棕色的类胰蛋白酶阳性、膜表面FcεRIα阳性的MC。结论:AR组、NP组患者血清中高表达FcεRIα及其抗体,提示该抗体系统参与了AR和NP的发生、发展;以MC为核心的局部变态反应可能参与了鼻息肉的发生、发展,MC影响着鼻息肉形成的可能作用及具体机制值得进一步探讨。Abstract: Objective: To analyze the relationship and mechanism of mast cell with allergic rhinitis and nasal polyps. Method: From January 2018 to June 2018, all the inpatients in Otolaryngology Department were examined by nasal endoscopy and CT before operation. They were divided into three groups: 30 patients with allergic rhinitis(AR group) and 30 patients with nasal polyps(NP group) as the experimental group; 30 patients with nasal septum correction after partial inferior turbinectomy alone as the control group(N group). Clinical data, peripheral blood and nasal mucosa were collected. The percentage of eosinophils in peripheral blood was detected by automatic hematology analyzer. The levels of anti-IgE antibody, FcεRIα and anti-FcεRIα antibody in serum were detected by ELISA. The levels of serum IgE were detected by velocity scattering turbidimetry. HE was used to observe the histopathological changes in the three groups. Immunohistochemical method was used to analyze the expression of tryptase and FcεRIα in the experimental group and the control group. Result: The percentage of eosinophils, IgE, anti-IgE antibody, FcεRIα and anti-FcεRIα antibodies in AR group were significantly higher than those in control group(P<0.05); the percentage of eosinophils, FcεRIα and anti-FcεRIα antibodies in NP group were significantly higher than those in healthy control group(P<0.05). There was no significant difference in IgE and anti-IgE antibodies among three groups(P>0.05). The eosinophil percentage, IgE and anti-IgE antibody levels in AR group were significantly higher than that in NP group(P<0.05); there were no differences in FcεRIα and anti-FcεRIα antibody levels between AR group and NP group(P>0.05); There was no significant difference in eosinophil infiltration between the two groups; The brown tryptase-positive mast cells and FcεRIα-positive mast cells were found in the submucosa and interstitium of nasal mucosa.Conclusion: The high expression of FcεRIα and its antibody in the serum of patients with allergic rhinitis and nasal polyps indicated that this antibody system was involved in the occurrence and development of allergic rhinitis and nasal polyps. Local allergy with mast cells as the core might play an important role in the occurrence and development of nasal polyps. The possible role of mast cells in the formation of nasal polyps and the specific mechanism deserve further study.
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Key words:
- mast cells /
- IgE /
- FcεRIα /
- rhinitis /
- allergic /
- nasal polyps
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