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비염을 가진 소아 및 청소년 환자에서 비호산구와 흡입항원 감작의 상관성

The association between nasal eosinophilia and aeroallergen sensitization in children and adolescents with rhinitis

  • 양은애 (가톨릭대학교 의과대학 소아과학교실) ;
  • 박유미 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김경훈 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이혜진 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김환수 (가톨릭대학교 의과대학 소아과학교실) ;
  • 전윤홍 (가톨릭대학교 의과대학 소아과학교실) ;
  • 윤종서 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김현희 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김진택 (가톨릭대학교 의과대학 소아과학교실)
  • Yang, Eun Ae (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Park, Yu Mi (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Kyung Hoon (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Hye Jin (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hwan Soo (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Chun, Yoon Hong (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Yoon, Jong-Seo (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hyun Hee (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Jin Tack (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 투고 : 2017.09.08
  • 심사 : 2018.01.10
  • 발행 : 2018.05.31

초록

Purpose: To identify the correlation between nasal eosinophilia and aeroallergen sensitization in children and adolescents. Methods: This is a retrospective study of patients below 18 years of age who had a history of rhinitis that lasted more than 2 weeks or had been repeated more than once a year, received nasal eosinophil examinations, and had serum specific IgE to aeroallergens measured at an Allergy Clinic in a single tertiary teaching hospital in Seoul, Korea. The percentage of nasal eosinophils was calculated by the number of eosinophils per total leukocytes in a high-power field of $1,000{\times}$. Data was analyzed to determine the association between nasal eosinophilia and 18 aeroallergens. Results: Of the 245 patients included, 156 (63.7%) were male and the mean age (${\pm}$ standard deviation) was 7.9 years (${\pm}3.8$). In total, 175 patients (71.4%) were sensitized to at least 1 of the 18 aeroallergens tested, and sensitization to house dust mite was most common. In addition, 118 (48.2%) and 69 patients (28.2%) had nasal eosinophilia of at least 1% and 5%, respectively. There were no significant correlations between serum total IgE or age and the percentage of nasal eosinophils. However, the percentage of nasal eosinophils in the group sensitized to any aeroallergens was significantly increased compared to the nonsensitized group (P= 0.002). The percentage of nasal eosinophils was significantly higher in patients who were sensitized to Birch-Alder Mix, oak white, Bermuda grass, orchard grass, timothy grass, sweet vernal grass, rye, mugwort, short ragweed, Alternaria alternata, cats, dogs or Dermatophagoides farinae compared to those nonsensitized. Conclusion: Nasal eosinophilia was significantly associated with sensitization to aeroallergens.

키워드

참고문헌

  1. Settipane RA, Lieberman P. Update on nonallergic rhinitis. Ann Allergy Asthma Immunol 2001;86:494-507. https://doi.org/10.1016/S1081-1206(10)62896-7
  2. Kay AB. Allergy and allergic diseases. First of two parts. N Engl J Med 2001;344:30-7. https://doi.org/10.1056/NEJM200101043440106
  3. Ahmadiafshar A, Taghiloo D, Esmailzadeh A, Falakaflaki B. Nasal eosinophilia as a marker for allergic rhinitis: a controlled study of 50 patients. Ear Nose Throat J 2012;91:122-4.
  4. Lans DM, Alfano N, Rocklin R. Nasal eosinophilia in allergic and nonallergic rhinitis: usefulness of the nasal smear in the diagnosis of allergic rhinitis. Allergy Proc 1989;10:275-80. https://doi.org/10.2500/108854189778959984
  5. Miller RE, Paradise JL, Friday GA, Fireman P, Voith D. The nasal smear for eosinophils. Its value in children with seasonal allergic rhinitis. Am J Dis Child 1982;136:1009-11. https://doi.org/10.1001/archpedi.1982.03970470053015
  6. Miri S, Farid R, Akbari H, Amin R. Prevalence of allergic rhinitis and nasal smear eosinophilia in 11- to 15 yr-old children in Shiraz. Pediatr Allergy Immunol 2006;17:519-23. https://doi.org/10.1111/j.1399-3038.2006.00424.x
  7. Canakcioglu S, Tahamiler R, Saritzali G, Alimoglu Y, Isildak H, Guvenc MG, et al. Evaluation of nasal cytology in subjects with chronic rhinitis: a 7-year study. Am J Otolaryngol 2009;30:312-7. https://doi.org/10.1016/j.amjoto.2008.06.015
  8. Mandhane SN, Shah JH, Thennati R. Allergic rhinitis: an update on disease, present treatments and future prospects. Int Immunopharmacol 2011;11:1646-62. https://doi.org/10.1016/j.intimp.2011.07.005
  9. Mullarkey MF, Hill JS, Webb DR. Allergic and nonallergic rhinitis: their characterization with attention to the meaning of nasal eosinophilia. J Allergy Clin Immunol 1980;65:122-6. https://doi.org/10.1016/0091-6749(80)90196-7
  10. Lee HS, Majima Y, Sakakura Y, Shinogi J, Kawaguchi S, Kim BW. Quantitative cytology of nasal secretions under various conditions. Laryngoscope 1993;103:533-7.
  11. Jirapongsananuruk O, Vichyanond P. Nasal cytology in the diagnosis of allergic rhinitis in children. Ann Allergy Asthma Immunol 1998;80:165-70. https://doi.org/10.1016/S1081-1206(10)62950-X
  12. Bentley AM, Jacobson MR, Cumberworth V, Barkans JR, Moqbel R, Schwartz LB, et al. Immunohistology of the nasal mucosa in seasonal allergic rhinitis: increases in activated eosinophils and epithelial mast cells. J Allergy Clin Immunol 1992;89:877-83. https://doi.org/10.1016/0091-6749(92)90444-7
  13. Juliusson S, Pipkorn U, Karlsson G, Enerback L. Mast cells and eosinophils in the allergic mucosal response to allergen challenge: changes in distribution and signs of activation in relation to symptoms. J Allergy Clin Immunol 1992;90(6 Pt 1):898-909. https://doi.org/10.1016/0091-6749(92)90462-B
  14. Takwoingi Y, Akang E, Nwaorgu G, Nwawolo C. Comparing nasal secretion eosinophil count with skin sensitivity test in allergic rhinitis in Ibadan, Nigeria. Acta Otolaryngol 2003;123:1070-4. https://doi.org/10.1080/00016480310002159
  15. Romero JN, Scadding G. Eosinophilia in nasal secretions compared to skin prick test and nasal challenge test in the diagnosis of nasal allergy. Rhinology 1992;30:169-75.
  16. Kim GR, Chung TI, Kim KM. Clinical and statistical study of allergens in the allergic rhinitis. Yonsei Med J 1975;16:54-64. https://doi.org/10.3349/ymj.1975.16.2.54
  17. Jung BS, Cho YS, Kim E, Yoon JS, Kim HH, Lee JS. Association between nasal eosinophil count and other clinical indices in children with chronic nasal symptoms. Korean J Asthma Allergy Clin Immunol 2008;28:214-9.
  18. Powe DG, Bonnin AJ, Jones NS. 'Entopy': local allergy paradigm. Clin Exp Allergy 2010;40:987-97. https://doi.org/10.1111/j.1365-2222.2010.03536.x
  19. Cheng KJ, Zhou ML, Xu YY, Zhou SH. The role of local allergy in the nasal inflammation. Eur Arch Otorhinolaryngol 2017;274:3275-81. https://doi.org/10.1007/s00405-017-4640-6
  20. Rondon C, Romero JJ, Lopez S, Antunez C, Martin-Casanez E, Torres MJ, et al. Local IgE production and positive nasal provocation test in patients with persistent nonallergic rhinitis. J Allergy Clin Immunol 2007; 119:899-905. https://doi.org/10.1016/j.jaci.2007.01.006
  21. Rondon C, Campo P, Herrera R, Blanca-Lopez N, Melendez L, Canto G, et al. Nasal allergen provocation test with multiple aeroallergens detects polysensitization in local allergic rhinitis. J Allergy Clin Immunol 2011; 128:1192-7. https://doi.org/10.1016/j.jaci.2011.06.012
  22. Pelikan Z. The changes in the nasal secretions of eosinophils during the immediate nasal response to allergen challenge. J Allergy Clin Immunol 1983;72:657-62. https://doi.org/10.1016/0091-6749(83)90625-5
  23. Choi SS, Shin KS, Hahn YS. Correlation of appearance of nasal eosinophils with levels of total eosinophil counts, total IgE, and house dust mite specific IgE in children with symptoms of rhinitis. Pediatr Allergy Respir Dis 2005;15:35-43.
  24. Osawa Y, Suzuki D, Ito Y, Narita N, Ohshima Y, Ishihara Y, et al. Prevalence of inhaled antigen sensitization and nasal eosinophils in Japanese children under two years old. Int J Pediatr Otorhinolaryngol 2012;76: 189-93. https://doi.org/10.1016/j.ijporl.2011.10.024

피인용 문헌

  1. 서금요법이 알레르기 비염 대학생의 비호산구, 비염증상, 비염관련 삶의 질에 미치는 효과 vol.22, pp.2, 2020, https://doi.org/10.7586/jkbns.2020.22.2.127