Studies On The Association Of Trace Elements And Cytokines With Syndrome Differentiation Of Allergic Rhinitis

ObjectiveTwo goals were aimed at in this work. Firstly, serum and hair levels of trace elements were determined and their correlation with the status of humral immunic function and the patterns based on syndrome differentiation was investigated among the patients with perennial allergic rhinitis (PAR) to analyse their pathological implications in this lesion. Secondly, animal model with allergic rhinitis induced on the basis of Lung Qi deficiency (LQD) pattern established earlier was prepared among gunia pigs in the way of combination with disease and pattern modeling. Then, their serum levels of trace elements and cytokines were determined in order to investigate the influence of imbalenced Th1/Th2 cytokine network on the pathological process of experimental allergic rhinitis (EAR) with the pattern of LQD and the association of their contents and levels changes with the development of this lesion.MethodsIn the clinical investigation, the procedures of atomic absorption spectrophtometry (AAS) were utilyzed to determine the serum and hair levels of trace elements, like Zn, Cu, Fe, Ca, Mg, Mn and Sr, among these PAR cases. On the basis of trace element determination, mathematical formulae were to be established as theoretic models to make prediction on the ill condition in the terms of disease and pattern differentiation. Furthermore, the procedures of transmission turbidimetry were taken to detect the serum levels of IgG, IgA and IgM and the techniques of enzyme linked immunosorbent assay (ELISA) were used to test the serum evel of IgE. Then, correlation analysis was made between the contents of trace element and the levels of immunoglobulin to investigate the rules of changes in trace elements among the three patterns of PAR.In the experimental studies, the animal model with allergic rhinitis induced on the basis of LQD pattern was established among guinea pigs in a way of combining a disease inducing and a pattern preparation, by using the procedures of smoke inhalation and TDI nose dropping. Then, A AS was taken to detect the serum contents of trace elements Zn, Cu and Ca of them and double antibody sandwitch ELISA tecniques were used to measure the serum levels of IFN-γand IL-4 among them. At last, carried out was a correlation analysis of trace element contents with cytokine levels to evaluate their implications in the pathogenesis of PAR.ResultsThe results of these studies were as follows.1. As shown in the clinical investigation, the patients with PAR in any one of the three patterns showed significantly reduced serum and hair levels of trace elements Mn and Sr (P<0.01), decreased hair Zn level, increased hair Cu content, and declined Zn/Cu ratio (P<0.05) than those of controlling group. Furthermore, analysis on the relationship between trace elements and serum immunoglobulins showed that a negative correlation was present with hair Sr content and serum IgM, a positive correlation was seen with serum Mn level and IgE value, and a positive correlation was also true with serum Mg value and IgE and IgA. All these correlations had been expressed as mathematical models respectively based on multiple step regression analysis.2. As shown in the experimental studies, the modeling animals with EAR induced on the basis of LQD pattern showed significantly elevated serum level of IL-4, reduced serum level of IFN-γand declined ratio of IFN-γ/IL-4, with very significant differences in these values, when compared with that of healthy controls (P<0.01). Meanwhile, the content of Zn was significantly increseaed in serum of the modeling animals (P<0.05) as well. As suggested by correlation analysis, Zn content was positively correlated with IL-4 level and negatively correlated with the ratio of IFN-γ/IL-4, while Ca content was correlated with IL-4 level negatively and correlated with the ratio of IFN-γ/IL-4 positively.ConclusionsBased on these studies, we can conclud as following.1. The disterburned immunne function of cases with PAR might be closely related with the abnormal changes in the serum and hair levels of trace elements Zn, Cu, Mn and Sr. Especially, it should be true that reduced levels of Zn, Mn and Sr and increased level of Cu played their roles underlying the pathogenesis of allergic rhinitis via the effects, as very important intrinsic factors, on this pathological process.2. The basic pathogenesis of PAR was Qi-Yang deficiency and failure of the Lung, Spleen and Kidney. In the developing process of this lesion, it showed an aggravated tendency gradually in its severity of ill situation from Qi deficiency to Yang deficiency, even leading to a pathologilcal status of Yang failure at a late stage. An imbalenced situation of trace elements was accompanying this process of lesion, particularly reduced Mn and Sr contents in serum and hair. These two kind of trace element might play some roles in the occurrence of Qi-Yang deficiency and injurning of the Lung, Spleen and Kidney, when their levels decreased to a lower limit. The implication of reduced Mn content might hold much more important pathological effect on the development of PAR in the pattern of Kidney Yang deficiency. Moreover, reduced content of Zn, increased level of Cu and decreased ratio of Zn/Cu might play the role in clinical practice as a line to differentiate the patterns from Spleen Qi deficiency to Kidney Qi deficiency.3. Several mathematical models were set up based on multiple step regression analysis on the relationship between the contents of trace elements in serum and hair and the clinical manifestation of PAR cases. This could promote the investigation on PAR in a new field of thinking.4. An animal modeling procedure was set up to prepare EAR model in gunea pigs in a way combining the techniques of disease inducing and pattern preparing.5. The clinical process of PAR lesion itself and the accompanied pattern of LQD with this condition was closely related with the imbalanced cytokine network of Th1/Th2. The allergic inflammation in nasal mucosa of cases with PAR might be mainly induced by dominant Th2 immunoreaction, while the pattern of LQD accompanied with this condition should be the result of disterburnce in the homestatic mechanism of cytokine network dynamic balance.6. In the pathogenesis process of PAR, trace elements Zn and Ca might play some roles in the regulating mechanism of Th1/Th2 cytokine network balance. This suggested that favorate therapeutic effects might be achieved on the treatment of PAR through supplementing or reducing the serum contents of trace element.