本文選題：鼻炎 + 變應性��； 參考：《廣州醫(yī)學院》2010年碩士論文

【摘要】：研究背景: 變應性鼻炎(allergic rhinitis,AR)和支氣管哮喘(bronchial asthma,BA)是上、下氣道常見的變應性疾病,其發(fā)病率有逐年增高的趨勢,嚴重影響人類的生活質量。研究表明變應性鼻炎和支氣管哮喘常同時存在。哮喘患者常伴有鼻炎,而鼻炎患者更易出現(xiàn)哮喘。大約38%的變應性鼻炎患者并發(fā)哮喘,而大概80%的哮喘患者有慢性鼻部癥狀。現(xiàn)在“一種氣道,一種疾病”的觀點已被廣泛接受。“整合性氣道疾病”、“慢性變應性氣道炎癥綜合征”等概念形象地體現(xiàn)了這種一致性和相關性。2001年世界衛(wèi)生組織出版的《變應性鼻炎及其對哮喘的影響(》ARIA),在論述了變應性鼻炎的同時,專門指出了對伴發(fā)哮喘的影響。 目前,變應性氣道炎癥的治療方法主要有:避免接觸變應原、藥物治療和免疫治療等。避免接觸變應原難以做到,藥物治療只是改善癥狀,而免疫治療從疾病發(fā)生的始動環(huán)節(jié)進行免疫調節(jié),是世界衛(wèi)生組織(WHO)推薦使用的唯一對因治療手段。結核分枝桿菌培養(yǎng)濾液蛋白(Culture filtrate protein, CFP)是結核分枝桿菌培養(yǎng)上清中的蛋白混合物,能刺激T細胞高效分泌IFN-γ,目前主要用于結核的診斷方面。 本研究以卵蛋白為致敏原建立變應性鼻炎大鼠模型,觀察上、下氣道的炎癥反應及IFN-γ和IL-5表達的改變。同時CFP經鼻腔給藥干預,觀察CFP對變應性鼻炎大鼠上、下氣道炎癥反應及IFN-γ和IL-5表達的影響,為CFP作為一種免疫調節(jié)劑治療變應性氣道炎癥提供試驗依據(jù)。 第一部分變應性鼻炎大鼠氣道炎癥反應的研究 目的: 通過對大鼠變應性鼻炎模型上、下氣道炎癥反應的研究,探討上、下氣道炎癥反應的相關性。 方法: 雄性SD(SPF級)大鼠隨機分為2組:正常對照組、模型組,每組10只。以卵蛋白為致敏原建立大鼠變應性鼻炎模型。HE染色觀察鼻和肺組織的病理學改變;免疫組化檢測鼻和肺組織中IL-5和IFN-γ的表達;以酶聯(lián)免疫吸附測定法(enzyme-linked immunosorbent assay,ELISA)檢測支氣管肺泡灌洗液(bronchial alveolus lavage fluid,BALF)中IL-5和IFN-γ的水平。 結果: 1.變應性鼻炎大鼠模型組鼻和肺組織有明顯炎癥細胞浸潤。 2.模型組鼻和肺組織IL-5的表達明顯高于對照組,并且和嗜酸性粒細胞的數(shù)量呈正相關。模型組鼻和肺組織IFN-γ的表達低于對照組。 3.模型組BALF中IL-5的含量高于對照組,而IFN-γ的含量低于對照組 結論: 變應性鼻炎大鼠上、下氣道存在Th1和Th2的失衡、Th2優(yōu)勢表達;上、下氣道炎癥反應具有一致性和相關性。 第二部分:結核桿菌培養(yǎng)濾液蛋白對變應性鼻炎大鼠氣道IFN-γ和IL-5表達的影響 目的: 觀察結核桿菌培養(yǎng)濾液蛋白(Mycobacterium tuberculosis culture filtrate protein , CFP)對變應性鼻炎大鼠氣道炎癥反應及IFN-γ和IL-5表達的影響。 方法: 雄性SD(SPF級)大鼠隨機分為5組:正常對照組、模型組、CFP治療組、布地奈德治療組、CFP對照組,每組10只。以卵蛋白為致敏原建立變應性鼻炎大鼠模型,CFP經鼻腔給藥干預,觀察大鼠鼻塞、打噴嚏、抓鼻等鼻部癥狀,HE染色觀察鼻粘膜、肺組織的病理學改變;免疫組化檢測鼻粘膜、肺組織中白細胞介素5 (interleukin-5, IL-5)和干擾素γ(IFN-γ)的表達水平;以酶聯(lián)免疫吸附測定法(enzyme-linked immuno- sorbent assay,ELISA)檢測支氣管肺泡灌洗液(bronchial alveolus lavage fluid,BALF)中IL-5、IFN-γ的水平。 結果: 1.大鼠變應性鼻炎模型成功建立; 2. CFP可明顯改善變應性鼻炎的鼻部癥狀,減輕鼻粘膜、肺組織的炎癥反應,使Th1類細胞因子IFN-γ水平升高,Th2類細胞因子IL-5水平下降 結論: CFP作為一種免疫調節(jié)劑,能有效增加變應性鼻炎大鼠上下氣道IFN-γ的表達和減少IL-5的表達,提示CFP可能對糾正變應性氣道炎癥Th1和Th2的失衡有作用,對防治變應性氣道炎癥具有潛在的應用前景。
[Abstract]:Background of Study :

Allergic rhinitis ( AR ) and bronchial asthma ( BA ) are a common allergic disease in the upper and lower airways . The incidence of allergic rhinitis and bronchial asthma has a tendency of increasing year by year . The study shows that allergic rhinitis and bronchial asthma are often accompanied by asthma .

At present , the treatment method of allergic airway inflammation is mainly to avoid contact allergen , drug therapy and immunotherapy , etc . It is difficult to avoid contact allergen , drug therapy is only improving symptoms , and immunotherapy is the only treatment method recommended by the World Health Organization ( WHO ) . It is the only treatment method recommended by the World Health Organization ( WHO ) , which can stimulate T cells to secrete IFN - 緯 efficiently , and is mainly used in the diagnosis of tuberculosis .

The inflammatory response of the upper and lower airways and the changes of IFN - 緯 and IL - 5 expression were observed in the rat model of allergic rhinitis by using egg protein as the allergen , and the effects of the expression of IFN - 緯 and IL - 5 on the upper and lower airways of allergic rhinitis rats were observed .

Study on airway inflammation in rats with first partial allergic rhinitis

Purpose :

To study the correlation between upper and lower airway inflammatory responses by studying the inflammatory response of the upper and lower airways of the allergic rhinitis model in rats .

Method :

Male SD ( SPF ) rats were randomly divided into 2 groups : normal control group , model group , 10 rats in each group . The pathological changes of nasal and lung tissues were observed by HE staining . The levels of IL - 5 and IFN - 緯 were detected by enzyme - linked immunosorbent assay ( ELISA ) in bronchial alveolar lavage fluid ( BALF ) by enzyme - linked immunosorbent assay ( ELISA ) .

Results :

1 . There was an obvious infiltration of inflammatory cells in the nasal and lung tissues of the model group of allergic rhinitis rats .

2 . The expression of IL - 5 in the nasal and lung tissues of the model group was significantly higher than that of the control group , and the expression of IFN - 緯 in the nasal and lung tissues of the model group was lower than that of the control group .

3 . The content of IL - 5 in BALF of model group was higher than that of control group , and the content of IFN - 緯 was lower than that of control group .

Conclusion :

Th1 and Th2 imbalance in the upper and lower airways of allergic rhinitis rats , Th2 dominant expression , upper and lower airway inflammation responses were consistent and correlated .

The second part : Effect of Mycobacterium tuberculosis culture filtrate protein on the expression of IFN - 緯 and IL - 5 in airway of allergic rhinitis rats

Purpose :

To observe the effect of Mycobacterium tuberculosis culture filtrate protein ( cfp ) on airway inflammation and expression of IFN - 緯 and IL - 5 in allergic rhinitis rats .

Method :

Male SD ( SPF ) rats were randomly divided into 5 groups : normal control group , model group , P - P treatment group , Buchenne treatment group and control group ( 10 rats in each group ) . The expression level of IL - 5 and IFN - 緯 in nasal mucosa and lung tissues was observed by using enzyme - linked immunosorbent assay ( ELISA ) .

Results :

1 . The model of allergic rhinitis in rats was successfully established .

2 . The nasal symptom of allergic rhinitis can be obviously improved , the inflammatory reaction of nasal mucosa and lung tissue can be relieved , the level of IFN - 緯 in Th1 type cytokines is increased , and the level of Th2 cytokines IL - 5 is decreased .

Conclusion :

The expression of IFN - 緯 in the upper and lower airways of allergic rhinitis rats can be effectively increased and the expression of IL - 5 can be reduced . It is suggested that it may play a role in correcting the imbalance of Th1 and Th2 in allergic airway inflammation , and has potential application prospect in preventing and treating allergic airway inflammation .

【學位授予單位】：廣州醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R765.21

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