小児潜在性鼻アレルギーの鼻腔病態—喘息患者を対象にして

Pathogenesis of Latent Nasal Allergy in Children with Asthma

I．はじめに

　小児喘息患者には下気道の症状以外に高度の鼻症状を合併しているものもあるが，多くは鼻症状を欠くか，あっても軽度である。

　奥田の報告^1）によれば小児のアトピー性気管芝喘息患者の80％にアレルギーを合併しているといわれる。我々の調査^2）では小児の外因性気管支喘息患者の90％が軽症もしくは無症状であったのにかかわらず鼻汁中の好酸球検査や，鼻粘膜誘発反応を行うと陽性に出ることが多く，鼻内所見は鼻症状のある顕性の鼻アレルギーのそれとほとんど大差なく，これらはいわゆる潜在性鼻アレルギーとみなすことができる。

　Pathogenesis of latent nasal allergy in children with asthma were investigated. Nasal mucociliary transport time, nasal mucosal hypersensitivity, concentration of histamine in nasal secretion, and the numbers of basophilic and eosinophilic cells in the superficial mucous layer of the inferior turbinate were measured in the asthma group with latent nasal allergy. These results were compared with those of the nasal allergy group without asthma. It was concluded that the difference of nasal symptoms between latent nasal allergy in the asthma group and nasal allergy in the children without asthma might be explained by nasal mucosal hypersensitivity and concentration of histamine released from basophilic cells.