Segmental bronchial provocation induces nasal inflammation in allergic rhinitis patients

Allergic rhinitis and asthma often coexist and share a genetic background. Pathophysiologic connections between the nose and lungs are still not entirely understood. This study was undertaken to compare allergic inflammation and clinical findings in the upper and lower airways after segmental bronch...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2000-06, Vol.161 (6), p.2051-2057
Main Authors: BRAUNSTAHL, G.-J, KLEINJAN, A, OVERBEEK, S. E, PRINS, J.-B, HOOGSTEDEN, H. C, FOKKENS, W. I
Format: Article
Language:English
Subjects:
Adult
Allergic diseases
Asthma - diagnosis
Asthma - immunology
Biological and medical sciences
Biopsy
Bronchial Provocation Tests
Chemokine CCL11
Chemokines, CC
Cytokines - metabolism
Eosinophils - immunology
Female
Humans
Immunopathology
Interleukin-5 - metabolism
Leukocyte Count
Male
Medical sciences
Nasal Mucosa - immunology
Nasal Mucosa - pathology
Respiratory and ent allergic diseases
Rhinitis, Allergic, Seasonal - diagnosis
Rhinitis, Allergic, Seasonal - immunology
Risk Factors
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Summary:Allergic rhinitis and asthma often coexist and share a genetic background. Pathophysiologic connections between the nose and lungs are still not entirely understood. This study was undertaken to compare allergic inflammation and clinical findings in the upper and lower airways after segmental bronchial provocation (SBP) in nonasthmatic allergic rhinitis patients. Eight nonasthmatic, grass pollen-sensitive patients with allergic rhinitis and eight healthy controls were included. Bronchial biopsies and blood samples were taken before (T(0)) and 24 h (T(24)) after SBP. Nasal biopsies were obtained at T(0), 1 h after SBP (T(1)), and T(24). Immunohistochemical staining was performed for eosinophils (BMK13), interleukin (IL)-5, and eotaxin. The number of eosinophils increased in the challenged and unchallenged bronchial mucosa (p < 0.05) and in the blood (p = 0.03) of atopic subjects at T(24). We detected an increase of BMK13-positive and eotaxin-positive cells in the nasal lamina propria and enhanced expression of IL-5 in the nasal epithelium of atopic subjects only at T(24) (p < 0.05). SBP induced nasal and bronchial symptoms as well as reductions in pulmonary and nasal function in the allergic group. No significant changes could be observed in healthy controls. The study shows that SBP in nonasthmatic allergic rhinitis patients results in peripheral blood eosinophilia, and that SBP can induce allergic inflammation in the nose.
ISSN:1073-449X
1535-4970
DOI:10.1164/ajrccm.161.6.9906121