Response of upper and lower airway inflammation to bronchial challenge with house dust mite in Chinese asthmatics: a pilot study

Journal of Thoracic Disease

article

Zheng Zhu¹  Nanshan Zhong²  Hongyu Wang³  Yanqing Xie²  Jiaying An²  Qiurong Hu¹  Shu Xia²  Jing Li¹  Paul O’Byrne³  Jinping Zheng² 

[1] Department of Allergy and Clinical Immunology, State Key Lab of Respiratory Disease, Guangzhou Institute of Respiratory Health, the FirstAffiliated Hospital of Guangzhou Medical University;State Key Lab of Respiratory Disease, National Clinical Research Centerfor Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University;Department of Medicine, Firestone Institute for Respiratory Health, the Research Institute of St. Joe’s Hamilton, St. Joseph’s Healthcare, McMaster University

关键词: Allergic rhinitis (AR);    asthma;    allergen;    challenge;    eosinophils;   

DOI  :  10.21037/jtd-20-2876

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: Allergen nasal challenge can induce increase of eosinophils in sputum, but report about eosinophilic inflammation in upper airway after allergen bronchial challenge in Chinese asthmatics was rare. The article aims to evaluate response of upper and lower airways to house dust mite (HDM) allergen bronchial challenge.Methods: HDM allergen bronchial challenge was carried out in asthmatic patients with allergic rhinitis (AR). Bronchial methacholine challenge and blood test were performed before and at 24 hours after allergen challenge. Nasal lavage and induced sputum for differential cells count and fractional exhaled nitric oxide (FeNO) measurement were performed before, 7 and 24 hours after allergen challenge.Results: Eighteen asthmatic patients with AR underwent HDM allergen bronchial challenge with no serious adverse events reported. Fifteen patients showed dual asthmatic response (DAR), while 2 patients showed early (EAR) and 1 late asthmatic response (LAR) only. At 24 hours after allergen bronchial challenge testing, average PC 20 FEV 1 to methacholine significantly decreased (1.58 to 0.81 mg/mL, P=0.03), while both FeNO and the percentage of eosinophils in blood and sputum were significantly increased [52.0 (54.0) to 69.0 (56.0) ppb, P=0.01; 4.82% to 6.91%, P<0.001; 20.70% to 27.86%, P=0.03, respectively], but with no significant differences found in the percentage of eosinophils in nasal lavage (39.36% to 38.58%, P=0.89). However, at 7 hours after allergen challenge, the eosinophils in sputum were significant increased to 40.45% (P<0.001), but there was an increase (39.36% to 48.07%) with no statistical difference (P=0.167) found in nasal lavage.Conclusions: HDM allergen bronchial challenge induced different response of airway inflammation in upper and lower airways.

【 授权许可】

Unknown