Clin Exp Otorhinolaryngol.  2011 Mar;4(1):33-39.

Changes of Alpha1-Antitrypsin Levels in Allergen-induced Nasal Inflammation

• Shin SY
• Choi GS
• Lee KH
• Kim SW
• Won KY
• Lee JH
• Cho JS
• Park HS

Abstract

OBJECTIVES
Alpha1-antitrypsin (AAT) is the main inhibitor of human neutrophil elastase, and plays a role in counteracting the tissue damage caused by elastase in local inflammatory conditions. The study evaluated the involvement of AAT in nasal allergic inflammation.
METHODS
Forty subjects with mono-sensitization to Dermatophagoides pteronyssinus (Dpt) were enrolled. Twenty allergic rhinitis patients frequently complained of nasal symptoms such as rhinorrhea, stuffiness, sneezing, and showed positive responses to the nasal provocation test (NPT) with Dpt (Group I). The other 20 asymptomatic patients showed sensitization to Dpt but negative NPT (Group II). The levels of AAT, eosinophil cationic protein (ECP), and Dpt-specific IgA antibodies were measured in the nasal lavage fluids (NLFs), collected at baseline, 10 minutes, 30 minutes, 3 hours, and 6 hours after the NPT. Nasal mucosa AAT expression was evaluated with immunohistochemical staining from Group I and Group II.
RESULTS
At baseline, only the Dpt-specific IgA level was significantly increased in the NLFs of Group I compared with Group II, while ECP and AAT levels were not significantly different between two groups. After Dpt provocation, AAT, ECP, and Dpt-specific IgA levels were significantly increased in the NLFs of Group I during the early and late responses. The protein expression level of AAT was mostly found in the infiltrating inflammatory cells of the nasal mucosa, which was significantly increased in Group I compared to Group II.
CONCLUSION
The increment of AAT showed a close relationship with the activation of eosinophils induced by allergen-specific IgA in the NLFs of patients with allergic rhinitis after allergen stimulation. These findings implicate AAT in allergen-induced nasal inflammation.

Keyword

Alpha1-antitrypsin; Allergic rhinitis; Eosinophil cationic protein; IgA; Nasal lavage fluid

MeSH Terms

Antibodies
Dermatophagoides pteronyssinus
Eosinophil Cationic Protein
Eosinophils
Humans
Immunoglobulin A
Inflammation
Leukocyte Elastase
Nasal Lavage Fluid
Nasal Mucosa
Nasal Provocation Tests
Pancreatic Elastase
Rhinitis
Rhinitis, Allergic, Perennial
Sneezing
Antibodies
Eosinophil Cationic Protein
Immunoglobulin A
Leukocyte Elastase
Pancreatic Elastase

Figure

• 

  Fig. 1 Changes in alpha1-antitrypsin (A), ECP (B), and Dpt-specific IgA antibody (C) in nasal lavage fluid during the nasal provocation test with Dpt allergen. Solid circles, Group I; open circles, Group II. The results are expressed as the mean±SD. *P<0.05 (Group I vs. Group II), †P<0.05 (baseline vs. level at elapsed time after challenge).ECP: eosinophilic cationic protein; HDM: house dust mite; Dpt: Dermatophagoides pteronyssinus.

• 

  Fig. 2 Correlation between the alpha1-antitrypsin (AAT) levels and eosinophilic cationic protein (ECP) levels collected before (A), 30 minutes after (B), and 6 hours (C) after the nasal provocation test, or Dermatophagoides pteronyssinus-specific IgA levels collected before (D), 3 minutes (E) and 6 hours (F) after the nasal provocation test in the allergic rhinitis group. r: Spearman's correlation coefficient; HDM: house dust mite.

• 

  Fig. 3 The nasal mucosa of Group I (A) was infiltrated by inflammatory cells in the stroma, In contrast, the nasal mucosa of Group II (B) showed a few inflammatory cells scattered. (H&E, ×200). Immunohistochemical expression of alpha1-antitrypsin (AAT) in nasal mucosa. Diffuse and strong expression of AAT in Group I (C). Negative expression of AAT in Group II (D) (×200).

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