Search

To investigate the relationship between local responsiveness and allergic symptoms, bronchial and nasal responsiveness were measured in the following four groups of subjects: (i) bronchial asthma patients with serum house dust mite (HDM)-specific IgE antibody; (ii) allergic rhinitis patients with serum HDM-specific IgE antibody; (iii) normal control subjects with HDM-specific IgE antibody; and (iv) normal control subjects without IgE antibody specific for 10 common aero-allergens. Bronchial hyperresponsiveness was detected in all subjects with asthma (group 1) and in some subjects from groups 2 and 3, but not in subjects from group 4. Nasal hyperresponsiveness was found in all subjects with allergic rhinitis (group 2) and in some subjects from groups 1 and 3, but not in subjects from group 4. These findings indicate that local hyperresponsiveness of the non-diseased organ is influenced by an individual's atopic status. Interleukin (IL)-4 and IL-5 production by peripheral blood mononuclear cells (PBMC) was measured after stimulation with HDM in groups 1, 2 and 3 and was found to be similar in all three groups. A correlation between bronchial hyperresponsiveness and in vitro cytokine production was noted in asthma patients. These results suggest that the capacity of IL-4 or IL-5 production by PBMC may reflect local hyperresponsiveness in case of asthma.

Background We have previously proposed that, compared with rhinitis alone, theconstellation of upper and lower airway allergic disease is a manifestation of a more severe form of a syndrome affecting the entire airway. If this is correct, not only the lower, but also the upper airways of patients with asthma and rhinitis should demonstrate more abnormalities compared with patients with rhinitis alone, including higher sensitivity to irritant factors. Objective To test the hypothesis that, a previously well-studied natural nasal stimulus, cold, dry air (CDA), produces a stronger response in subjects with allergic rhinitis (AR) and asthma compared with subjects with AR alone. Methods We performed nasal provocation with CDA on 24 individuals with asthma and rhinitis and 17 with rhinitis alone. Prior to and after the challenge, nasal symptoms were recorded using visual analogue scales and nasal lavages were performed to determine histamine and lysozyme levels. Results The two groups reacted differently to CDA: after the challenge, patients with rhinitis and asthma reported significantly higher scores for nasal congestion, rhinorrhea and lacrimation. Also in this group, significant increases in histamine and in lysozyme levels in nasal lavage fluids were induced by CDA. In subjects with rhinitis alone, CDA failed to increase histamine or lysozyme levels above baseline. The CDA-induced change from baseline in histamine was significantly higher in the patients with rhinitis and asthma, compared with the rhinitis-only group. Conclusion Patients with AR and asthma have stronger nasal responsiveness to CDA compared with patients with rhinitis alone. This observation is consistent with the notion that compared with rhinitis alone, the presence of asthma and rhinitis signifies a higher degree of functional abnormality of the entire airway. [ABSTRACT FROM AUTHOR]

Summary Background Butterbur (BB) or Petasites hybridus , a herbal remedy, exhibits in vitro inhibition of cysteinyl leukotriene biosynthesis. However, no placebo-controlled studies have been performed to evaluate the effectiveness of BB on objective outcomes such as nasal provocation testing in seasonal allergic rhinitis (SAR). Methods Twenty patients with grass-pollen-sensitized SAR were randomized in a double-blind, cross-over manner to receive for 2 weeks either BB 50 mg twice daily or placebo (PL) twice daily during the grass pollen season. Nasal adenosine monophosphate (AMP) challenge (the primary outcome) was administered as a single 400 mg/mL dose after each randomized treatment. Results Spontaneous recovery following AMP challenge (area under the response time profile curve as %.min±SEM) was significantly attenuated (P =0.028) with BB (584±289) compared to PL (1438±240); mean difference: 854 (95% CI 95–1614), and the maximum % peak nasal inspiratory flow reduction from baseline following AMP challenge was significantly blunted (P =0.036) with BB (30±4) compared to PL (43±5); mean difference: 13 (95% CI 1–25). Conclusions BB exhibited protection against AMP-induced nasal responsiveness during the grass pollen season in sensitized patients. This is turn may explain its potential clinical efficacy in patients with SAR. [ABSTRACT FROM AUTHOR]

Background: Thenasal and bronchial mucosa present similarities and mostpatients with asthma also have rhinitis, suggesting the concept of ‘one airway one disease’. Although many studies may suggest the relationship between nasal and bronchial responsiveness in patients with allergic rhinitis and asthma, few studies have been published which address this question directly. The aim of this study is to investigate whether the relationship between nonspecific nasal and bronchial responsiveness exists in perennial allergic rhinitic patients with asthma. Methods: Fifty-one perennial allergic rhinitic patients with the definitive or suspected asthma underwent methacholine bronchial provocation tests and nasal histamine challenge tests. A slope of the absolute changes in nasal symptoms score/log concentrations of histamine was calculated by linear regression analysis. A ratio of the final absolute change in nasal symptoms score to the sum of all the doses of histamine given to the subject was also calculated. The degree of bronchial responsiveness to methacholine was categorized as positive bronchial hyperresponsiveness (BHR) if PC[sub 20] (provocative concentration of methacholine resulting in 20% fall in FEV[sub 1] ) was <4 mg/ml, borderline BHR if PC[sub 20] was ≥4 but ≤16 mg/ml, and negative BHR if PC[sub 20] was >16 mg/ml. Another index of bronchial responsiveness (BRindex) was calculated as the log [(% decline in FEV[sub 1] /log final methacholine concentration as mg/dl) + 10]. Results: The geometric means of the slope (4.47 vs. 2.95, p < 0.05) and the ratio (1.68 vs. 0.54, p < 0.01) were higher in patients with positive BHR (n = 23) than in patients with negative BHR (n = 19), respectively. The geometric means of the slope (3.50) and the ratio (1.13) in patients with borderline BHR (n = 9) were between the two groups, respectively. In all patients, the log-slope (r = 0.48, p < 0.001) and the log-ratio (r = 0.51, p < 0.001) were correlated well with the BRindex, respectively. Even in allergic rhinitic patients with definitive asthma, the log-slope was correlated with the BRindex (r = 0.39, p < 0.05) or log-PC[sub 20] (r = –0.36, p < 0.05). Conclusions: The nonspecific nasal responsiveness may be related to the nonspecific bronchial responsiveness in patients with allergic rhinitis and asthma, which may support the viewpoint that allergic rhinitis and asthma represent a continuum of inflammation involving one common airway.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Ten patients with strictly seasonal allergic rhinitis were challenged with 132 μg PAF-acether in each nasal cavity outside their relevant pollen season. Cells from the nasal mucosa were collected by nasal lavage prior to and every second hour up to 8 h after the PAF challenge. At the same times the volume of methacholine-induced secretory responsiveness was measured. A brush specimen was harvested from the nasal mucosa prior to and 8 h after the PAF challenge. PAF led to an increase in the number of eosinophils from an initial 6.1 to 64.4 per glass 2 h later. The number of eosinophils in the nasal lavage fluid then decreased to its initial baseline value. By 8 h after PAF challenge the number of eosinophils collected with the brush was still elevated as compared to the initial brush sample (3.1 vs 24.1). PAF did not produce any change in methacholine-induced secretory responsiveness at any time. It appears that PAF possesses eosinophil chemotactic properties in the human nasal airway without altering the nasal secretory responsiveness. This confirms previous findings that the induction of nasal responsiveness is a more complex phenomenon than just the recruitment of eosinophils into the airway mucosa. [ABSTRACT FROM AUTHOR]