Asthma, Rhinitis, Other Respiratory DiseasesNasal allergen provocation induces adhesion molecule expression and tissue eosinophilia in upper and lower airways☆,☆☆
Section snippets
Subject groups
Nine patients with AR (4 men and 5 women; age range, 22-34 years) and 9 nonallergic healthy control subjects (7 men and 2 women; age range, 19-32 years) were selected for the study. Subject characteristics are shown in Table I.
Patient Age (y) Sex FEV1 (L) FEV1 (%) IVC (L) FEV1/VC BAR* (%) PC20 (mg/mL) Patients with AR 1 22 F 3.93 108 4.72 88 103 40 2 34 M 3.20 87 3.65 88 98 40 3 26 M 4.37 95 5.67 77 104 40 4 25 M 4.51 101 4.91 92 105 40 5 22 F 3.82 112 4.06 94 100 40 6 26 F 3.28 93 4.28 77 104 38.4 7 22 M 4.26 90 5.19 82 107 19.6 8 26 F 4.72 126
Clinical data
At baseline, patients with AR and control subjects were comparable for clinical parameters. At the consecutive 2-hour intervals after NP, the patients with AR had increased total nasal VAS score (P = .0002, repeated-measurement ANOVA) and lower PNIF values (P = .0001) than control subjects. The shape of the nasal VAS score (Fig 2, A ) and PNIF (Fig 2, B ) curves in patients with AR was bimodal, with peaks at T1/2 and T12.
Discussion
In the current study we were able to show increased expression of endothelial adhesion molecules and eosinophilic allergic inflammation in the nasal and bronchial mucosa of nonasthmatic patients with AR after NP. Recently, we have demonstrated that segmental bronchial provocation in patients with AR induces blood eosinophilia and mucosal inflammation characterized by increased numbers of eosinophils, IL-5+ cells, and eotaxin-positive cells in both upper and lower airways.20 The current study
Acknowledgements
We thank the Allergology Department, the Lung Function Laboratory, the Clinical Chemistry Laboratory, and co-workers of the Pulmonary and E.N.T. research departments, especially Karolina Leman, of the Erasmus University Medical Center Rotterdam for their valuable participation in this study and Sandra Reynhart for editing the manuscript.
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2022, Journal of Allergy and Clinical ImmunologyCitation Excerpt :Also, aspiration of postnasal drainage of nasal contents from patients with CRS could potentially lead to infectious agents or augmented inflammation in the lower airways. The shared similar inflammation in the upper and lower airways, as well as the expansion of inflammation in the lungs from upper airway stimuli, have been demonstrated predominantly in asthma and COPD studies with allergen and infectious challenges.41 Nasal allergen provocation leads to airway bronchoconstriction and airway hyperresponsiveness accompanied by a similar type 2 inflammatory response in both the nose and the lungs.
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Supported by a grant from the Dutch Asthma Foundation, Leusden, the Netherlands.
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Reprint requests: Gert-Jan Braunstahl, MD, Department of Pulmonary Medicine, H-Ee-22.63, EMCR, Dr. Molewaterplein 50, 3015 GE Rotterdam, the Netherlands.