Comparative responses to nasal allergen challenge in allergic rhinitic subjects with or without asthma (original) (raw)
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Journal of Allergy and Clinical Immunology, 1994
Inspiratory nasal resistance, symptom score, and influx of inflammatory cells into the nose were evaluated before and after a nasal challenge in 15 patients with grass pollen rhinitis and in six nonallergic control subjects, to study the nasal late-phase reaction and its relationship with nasal cytology All patients had an immediate positive reaction to specific nasal challenge. In seven allergic subjects we observed a late inspiratory nasal resistance increase, but only two had a signij'icant late symptom score. Inflammatory cells increased by 8 hours in all the patients; the higher the cell influx, the higher the symptom score. Close correlations were found between the inspiratory nasal resistance increase, nasal obstruction at hours 8 and 24, and all cell counts. In control challenges there were no significant increases of symptom score or inspiratoty nasal resistance either during the challenge or in the next 24 hours. A weakly significant increase was found only for neutrophil counts at 8 hours. These results indicate that an inflammatory reaction constantly occurs after a specijic nasal challenge; its extent is closely related to inspiratory nasal resistance and to the intensity of nasal obstruction. Moreover, our data outline the pivotal role played by eosinophils and basophils in the genesis of an allergic late-phase reaction in the nose. (J ALLERGY CLIN IMMUNOL 1994;93:85-92.)
Changes in bronchial responsiveness following nasal provocation with allergen
Journal of Allergy and Clinical Immunology, 1992
The relationship between upper airway inflammation and asthma is controversial. In the c'urretn study, we sought to investigate the relationship between allergic rhinitis and lower airwa) dysfunction by performing double-blind, randomized nasal challenges with allergen or placebo. Subjects were selected for a prior history of asthma exacerbations qfter the onset of sea.sonaI allergic rhinitis symptoms. After the induction of a marked nasal-allergic reaction (with a technique of nasal provocation that limited allergen delivery to the nose), there were no c,han,ges in FEV,, specific conductance, or lung volumes either 30 minutes or 4% hours after nasal allergen challenge, nor any changes in peakjow rates,followed hourly until the next da?. However. nasal provocation with allergen resulted in a relative increase in bronchial responsiveness to methacholine compared with that to placebo (p = 0.01 I at 30 minutes and p = 0.0009 at 4% hours after challenge). Our study suggests that, calthough a nasal-aI&+ response does not induce airf?ow limitation of the lower airways. it can alter bronchial
The pathophysiology, clinical impact, and management of nasal congestion in allergic rhinitis
Clinical Therapeutics, 2008
Background: Nasal congestion is a cardinal symptom of allergic rhinitis (AR). It is difficult to treat and is associated with decreased quality of life. Objective: This article reviews the clinical features of nasal congestion, its complex pathophysiology in the context of AR, its clinical impact, and the strengths and weaknesses of available treatments. Methods: Primary studies and reviews in the peerreviewed, English-language literature were identified through searches of MEDLINE (1966-2008) and the Cochrane Library (1996-2008) using the terms nasal congestion, allergic rhinitis, pathophysiology, quality of life, and burden. Additional references were ob-tion than oral antihistamines (95% CI for combined standardized mean difference,-0.73 to-0.53). The results of several clinical trials have suggested that leukotriene-receptor antagonists may be associated with reduced nasal congestion; however, no agents in this class are currently approved for the treatment of nasal congestion in AR. Conclusion: There is a need for therapies that are well tolerated and effective in relieving nasal congestion in AR.
Review of Symptoms Assessment During Nasal Allergen Provocation in Patients with Allergic Rhinitis
The Open Allergy Journal, 2010
Background: Allergic rhinitis is the most prevalent allergic disease. Nasal provocation tests (NPTs) may be useful for its clinical diagnostic and therapy monitoring although they are mostly used in clinical research. However, the lack of standardisation in the symptoms assessed and the variety of instruments used make effective comparison between studies difficult. Objective: To review the published literature searching for instruments assessing nasal symptoms during NPTs for allergic rhinitis. Methods: Pubmed and Embase electronic databases were reviewed, looking for all methods including an instrument assessing symptoms during or following NPTs. Studies on animal models, pediatric subjects, and patients without allergic rhinitis were excluded. Studies were also excluded if they did not assess nasal symptoms during or following the NPT. Only NPT studies performed with allergen extracts or histamine were included. Results: A total of 520 studies were retrieved, from which 81 differ...
Allergy, 2007
Allergic rhinitis (AR) is an IgE-triggered chronic inflammatory disorder of the upper airways with pathophysiological and immunological links to allergic asthma (1). Recent studies providing evidence of systemic cross-talk between upper and lower airway compartments, have resulted in the concepts of Ôallergic airway diseaseÕ or Ôcombined allergic rhinitis and asthma syndromeÕ (CARAS) (2). The hallmark of CARAS is chronic airway inflammation, mainly characterized by mast cells, eosinophils, and their pro-inflammatory products (3). Historically, airway biopsies have been regarded as the gold standard for the sampling of the allergic airway inflammation. However, the applicability of invasive methods is limited for repeated sampling, such as in clinical monitoring or intervention trials. In addition, biopsies are limited to a very small part of the airways. Therefore, several less or noninvasive methodologies are being developed, some of which have been validated (4). Nitric oxide (NO) is a gaseous molecule synthesized in the respiratory compartment by NO-synthases (NOS) and can be detected in exhaled air of various species
Allergology International, 2003
A BSTRACT Background: Adenosine monophosphate (AMP) acts by releasing inflammatory mediators from mast cells and may be used for bronchial and nasal provocation tests. The aim of the present study was to determine whether AMP could be used in a dose-response manner to evaluate nasal function and to evaluate the reproducibility of nasal function measurements with nasal challenge testing using histamine and AMP in patients with perennial allergic rhinitis. Methods: Nine patients were challenged on three separate occasions for each challenge with doubling doses of either histamine (0.25-8 mg/mL) or AMP (25-800 mg/mL). Challenge measurements were made of peak inspiratory flow rate (PIFR), acoustic rhinometry (AR) and rhinomanometry (Rhino). The provocation concentration (PC 30) was calculated in order to produce: (i) a 30% fall in PIFR; (ii) a 30% fall in AR and (iii) a 30% increase in nasal airway resistance in Rhino and a symptom score of 10 (of 40). The mean intrasubject coefficient of variation (CV) was calculated for baseline and the corresponding PC.