In the present study, the in vitro tissue-radioallergosorbent test (t-RAST) was performed in two groups of patients: one with perennial attacks of sneezing, serous hypersecretion and nasal congestion, the other with nasal congestion only. The results obtained were compared with those obtained by a series of conventional allergy tests. We then found that t-RAST provided objective data comparable to those obtained with serum-RAST and that the t-RAST is a reliable means of quantitatively detecting specific IgE antibodies in the nasal mucosa. t-RAST is of special value to diagnosticians because it is able to discern unequivocally and easily those patients with localized nasal allergy.
Serum samples were obtained from patients with house dust mite-sensitive nasal allergies before and 6 months after immunotherapy, and the level of immunoglobulin (Ig)E, IgG1, and IgG4 antibodies in those sera was determined by the enzyme-linked immunosorbent assay. The present data showed that the mite-specific IgG4 antibodies increased in patients who responded well to immunotherapy but not in those who responded poorly. It was suggested from the present study that IgG4 antibodies seem to act as "blocking antibodies" to reduce the allergic reaction in the target organ, and that an increase of allergen-specific IgG4 antibodies following immunotherapy can be of clinical benefit to patients suffering from mite-specific nasal allergy.
Nasal allergy is a disease ensuing from type-I allergic reactions in the nasal cavity. A correct understanding of this process requires further investigation of the non-allergic pathology present. In the allergic state, the function of the nasal cilia is considered to be involved in the invasion of allergens into the nasal mucosa, and may also be involved with the manifestation and progression of the disease produced. In the present study, we examined the ciliary activity of the nasal mucosa of 35 patients with nasal allergies by using the photo-electric method of Ohashi and Nakai to better understand the non-allergic pathologies present. The nasal cilia of four healthy volunteers served as controls. In addition, a multivalent analysis was made according to quantifying theory I in order to define the effects of various factors on ciliary activity in the nasal mucosa during the allergic state. The following results were found in our present study. Ciliary activity was observed in 32 of 35 patients with nasal allergy. The mean value of the ciliary activity in these patients was 498 +/- 195 beats/min, while that of the normal controls was 753 +/- 46 beats/min. The ciliary activity in the nasal mucosa in the allergic state declined as the morbid period was prolonged; this decline in ciliary activity was relatively great in cases of perennial allergies aggravated by season-specific allergens.
Skin tests, nasal provocation tests, nasal smear tests, and serum-radioallergosorbent tests were performed on 17 patients with perennial allergic rhinitis, who had suffered nasal congestion without receiving any antiallergic treatment. After the above tests, tissue-radioallergosorbent tests (t-RAST) were conducted to determine IgE antibody levels in inferior turbinate mucosal samples taken peroperatively. The results obtained in this study suggest that the allergen sensitivity of the nasal mucosa correlates to some extent with the mucosal IgE antibody level, and that the t-RAST can provide us with objective data about nasal allergen sensitivity.
Our previous investigation using normal guinea pigs disclosed that, like respiratory mucosa, the middle ear lining has ciliary activity, and that this ciliary activity becomes more active as the location becomes more distal to the eustachian tube. In this experimental study, the effects of Staphylococcus aureus on the middle ear lining was examined from functional and morphological viewpoints. In conclusion, the ciliary activity at the entrance to the eustachian tube and that more distal to the tube present a similar pattern of reaction to S aureus in an in vitro system. On the other hand, the ciliary activity of the middle ear lining displays a varying pattern of reaction according to the locations within the tympanic cavity.
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