Study Of The Relation Between The Allergic Inflammation In The Upper And Lower Airway

Objective To investigate the relation between the allergic inflammation in the upper and lower airway.Methods In 54 patients with allergic rhinitis (AR) and 20 controls, the levels of intercellular adhesion molecule-1 (ICAM-1) and interleukin-6 (IL-6) in nasal lavage fluid, gathered in 1 hour after specific nasal provocation test (SNPT), were detected by sandwich enzyme-linked immunosorbent assay (ELISA) technique. The pulmonary function (FEV1.0%F) and nonspecific bronchial provocation test were measured in 54 patients with AR.N 36 patients with AR and bronchial asthma (BA) and 20 controls. At the same time, the correlation between the levels of ICAM-1 and IL-6 in nasal lavage fluid and pulmonary function (FEV1.0%F) was studied. Samples of nasal and bronchial mucosa were from 28 patients with AR and 12 controls and their paraffin sections were studied with immunohistochemical technique staining with ICAM-1 monoclonal antibodies and IL-6 polyclonal antibodies.Results The levels of ICAM-1 and IL-6 in nasal lavage fluid of patients with AR were 272.75 ±32.25pg/ml and 52.11 ± 16.54pg/ml. They were both significantly higherthan those of the controls, 158.82 ±33.88pg/ml and 25.64±10.14pg/ml. The differences between them had very significant meaning, P<0.01.The pulmonary function (FEV1.0%F) of patients with AR and BA was (78.82 ± 7.41)%. It was obviously lower than that of patients with AR, (83.90 ±4.87)%. Both of them were much lower than that of normal controls, (90.25 ± 4.69)%. The difference among them had very significant meaning. In patients of AR, the positive percentage of bronchial provocation test was 64.81%, that of patients with AR and BA was 83.33% and that of normal controls was 0. The differences among them had very significant meaning.The levels of ICAM-1 and IL-6 in nasal provocation fluid had closely negative correlation with pulmonary function (FEV1.0%F), rICAM-1= - 0.7071, P<0.01; rIL-6= -0.6248, P<0.01.The positive expression percentage of ICAM-1 in mucosa of nasal and bronchial in patients with AR were 100% and 92.86%. No difference were observed between them, P>0.05. But in group of controls, those were obviously lower, 66.67%, 58.33%. The difference between them had significant meaning, PO.05. The positive expression percentage of IL-6 in mucosa of nasal and bronchial in patients with AR were 100% and 82.14%. No difference were observed between them, P> 0.05. But in group of normal controls, those were obviously lower, 41.67%, 41.67%. The difference between them had significant meaning, PO.05.Conclusion ICAM-1 and IL-6 are important cytokines in the allergic inflammation in airway. The closely correlation was observed between the allergic inflammation in upper and lower airway, so that the upper and lower airway should be treated as a united one. To Otorhinolaryngologists and respiratory doctors, it is safe and efficient treatment to treat the inflammatory diseases in upper and lower airway at the same time.Postgraduate Zheng Dongshu (Otorhinolaryngology) Directed by Zhang Qiugui...