季节性过敏性鼻炎(SAR)病理机制和防治策略研究进展

Research Progress on Pathological Mechanism and Intervention Strategies of Seasonal Allergic Rhinitis(SAR)

过敏性鼻炎(AR)是由IgE介导的鼻黏膜慢性非感染性炎性疾病,由特应性个体暴露于变应原引起。作为全球影响人数较多的过敏性疾病,AR可造成严重的社会和经济负担,而季节性过敏性鼻炎(SAR)作为其主要发病类型更应引起重视。SAR主要由IgE介导的炎症以及2型先天性淋巴细胞(ILC2s)和2型辅助T细胞(Th2细胞)介导的2型免疫反应诱导,ILC2s和Th2细胞通过释放细胞炎性因子,驱动免疫细胞,促进蛋白转换,激活信号通路从而吸引炎症细胞并干扰完整鼻黏膜屏障,以诱导SAR的发生和维持。SAR具有复杂的免疫调控和炎性机制,受遗传、环境、气象、生活方式等多种因素的影响,针对性使用鼻用糖皮质激素、抗组胺药物、白三烯受体拮抗剂、变应原特异性免疫治疗以及中药治疗能够对SAR产生较好的缓解作用。本研究主要针对SAR的致病因素和发病机制的病理生理学途径进行综述,阐述近年研究的最新进展,以期为SAR预防和治疗策略提出依据。

Allergic rhinitis is a chronic non-infectious inflammatory disease of the nasal mucosa that is mainly mediated by IgE after exposure to allergens.As the allergic disease affecting the largest number of people in the world,AR causes a serious social and economic burden,and seasonal allergic rhinitis(SAR)is particularly noteworthy as its main type.SAR is inflammation mainly induced by IgE-mediated and type 2 immune response mediated by ILC2s and Th2 cells.ILC2s and Th2 cells attract inflammatory cells and interfere with the intact nasal mucosal barrier to induce SAR by releasing cellular inflammatory factors,driving immune cells,promoting protein conversion and activating signaling pathways.SAR has complex immunoregulation and inflammatory mechanisms make it to be affected by genetics,environment,meteorological,lifestyle and other factors.Targeted use of intranasal corticosteroids,antihistamines,leukotriene receptor antagonists,allergen-specific immunotherapy and traditional Chinese medicine treatment can effectively alleviate SAR.This study mainly reviews the pathogenic factors and pathophysiological pathways of SAR,and elaborates the latest research progress,with a view to providing a basis for prevention and treatment strategies of SAR.