Læknablaðið - 15.05.1994, Page 46

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LÆKNABLAÐIÐ 1994; 80:210-211
NÝR DOKTOR í LÆKNISFRÆÐI
SIGURÐUR JÚLÍUSSON
Þann 26. nóvember síðastliðinn var Sigurði
Júlíussyni veitt doktorsnafnbót við háskólann
í Gautaborg í Svíöjóð. Ritgerðin nefnist á
frummálinu: Allergic inflammation in the
nasal mucosa. A clinical, morphological and
biochemical study in allergic rhinitis with
special reference to mast cells. Fer ágrip hér
á eftir.
Mast cells are the primary effector cells
in acute allergic reactions in mucosal
membranes and in the skin. The acute
symptoms after allergen exposure of the
sensitised individual are mainly caused by
mast-cell-derived mediators. The aim of
this study was to investigate the function
of the mast cell in allergic inflammation by
morphological and biochemical analysis of
the nasal mucosa and by clinical study of
patients with seasonal allergic rhinitis before
and after allergen provocation as well as
before and during the pollen season. Nasal
biopsies were performed and brush and
lavage samples were collected from the nasal
mucosa. Mast cells were morphologically
identified based on their metachromatic
properties on staining with toluidine blue as
well as with immunohistological methods
with monoclonal antibodies against IgE,
and two mast cell proteases, tryptase and
chymase. Sensitivity to aldehyde fixation on
metachromacy was studied. The histamine
content of tissue samples was determined
by high performance liquid chromatography.
The levels of histamine and tryptase in the
returned fluid of nasal lavages were analysed
by radioimmunoassay and the TAME-esterase
activity in the lavage fluid was determined
with a radiochemical method. The effects of
topical treatment with corticosteroids were
studied.
Mast cells were found in increased numbers in
the nasal epithelium in patients with allergic
rhinitis even when free of symptoms. This
increase in intra-epithelial cells consisted
mostly of cells containing tryptase and lacking
chymase but also of cells containing both
tryptase and chymase. There was also an
increase in the stroma of mast cells containing
tryptase only. The metachromatic staining
properties of mast cells in the specimens
from the allergic patients were found to be
decreased and highly aldehyde sensitive. The
numbers of mast cells in the epithelium before
allergen provocation correlated with nasal
symptoms after the provocation. After an
initial decrease after the allergen challenge,
the numbers of metachromatic, tryptase-
containing and IgE-bearing cells increased
as well as the histamine content of cellular
material from the nasal epithelium. The levels
of histamine and tryptase and the TAME-
esterase activity in the lavage fluid increased
after allergen provocation. After topical
treatment with a corticosteroid a decrease