METHODS: Patients aged 2-8 years (recruited from January 2019 to December 2022) with nasal symptoms were assessed for allergies, adenoid size, and respiratory viral infection history. The serum total immunoglobulin E (IgE) and specific IgE levels were measured, and flexible nasal endoscopy was performed. The relationship between AH, aeroallergen sensitization patterns, and lymphocyte subpopulations in adenoid samples was analyzed using flow cytometry.
RESULTS: In total, 5281 children were enrolled (56.5% with AR; and 48.6% with AH). AH was more prevalent in children with AR. Compared to nonsensitized individuals, those polysensitized to molds had a higher prevalence of AH (adjusted OR 1.61, 95% CI 1.32-1.96) and a greater occurrence of two or more respiratory viral infections, particularly in adenoidectomy patients. The percentages and corrected absolute counts of regulatory T (Treg) cells, activated Tregs, class-switched memory B cells (CSMBs), natural killer (NK) T cells, and NK cell subpopulations were reduced in the adenoid tissues of children with both AH and AR (AH-AR) compared to AH-nAR children. Polysensitization in AH-AR children correlated with lower CSMB percentages.
CONCLUSIONS: Polysensitivity to molds is associated with an increased risk of AH in children with AR. Fewer B cells, NK cells, and Treg cells with an effector/memory phenotype were detected in the adenoids of AR children, and these lower percentages of immune cells, particularly CSMBs, were closely linked to aeroallergen sensitization models and respiratory viral infection.
方法:对2-8岁(2019年1月至2022年12月招募)有鼻部症状的患者进行过敏评估,腺样体大小,呼吸道病毒感染史。检测血清总免疫球蛋白E(IgE)和特异性IgE水平,并进行了柔性鼻内窥镜检查。AH之间的关系,空气过敏原致敏模式,使用流式细胞术分析腺样体样品中的淋巴细胞亚群。
结果:总计,5281名儿童入组(56.5%患有AR;48.6%患有AH)。AH在AR儿童中更为普遍。与非敏感个体相比,对霉菌多敏的患者AH的患病率较高(校正OR1.61,95%CI1.32-1.96),并且两种或多种呼吸道病毒感染的发生率更高,特别是在腺样体切除术患者中。调节性T(Treg)细胞的百分比和校正的绝对计数,激活的Tregs,类别交换存储器B单元(CSMB),自然杀伤(NK)T细胞,与AH-nAR儿童相比,AH和AR(AH-AR)儿童的腺样体组织中NK细胞亚群减少。AH-AR儿童的多敏化与较低的CSMB百分比相关。
结论:对霉菌的多敏感性与AR患儿的AH风险增加相关。B细胞越少,NK细胞,在AR儿童的腺样体中检测到具有效应/记忆表型的Treg细胞,这些较低百分比的免疫细胞,特别是CSMB,与空气过敏原致敏模型和呼吸道病毒感染密切相关。