Comparison of rhinomanometry, symptom score, and inflammatory cell counts in assessing the nasal late-phase reaction to allergen challenge

Pastorello, Elide A.; Riario-Sforza, Gian Galeazzo; Incorvaia, Cristoforo; Segala, M; Fumagalli, M; Gandini, R

doi:10.1016/0091-6749(94)90236-4

Cited by 49 publications

(36 citation statements)

References 29 publications

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“…Based on symptom scores and mediator release, NACLERIO et al [13] reported 75% late responders. PASTORELLI et al [21] reported a comparable number of late responders as in our study (47%), using rhinomanometry for the follow-up of the allergic reaction. However, when the definition of a late reaction in the same study was based on symptom scores or on a significant influx of inflammatory cells, the percentage of late responders was 13 and 100%, respectively.…”

Section: Discussionsupporting

confidence: 54%

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Early and late allergic reaction in the nose assessed by whole body plethysmography

Bruin‐Weller¹,

Weller²,

Scholte³

et al. 1996

Eur Respir J

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Physiological changes during late phase nasal responses after allergen challenge are difficult to establish and different criteria are used for the definition of a positive late phase nasal reaction. The objective of this study was to assess the value of whole body plethysmography in detecting changes in nasal airway resistance after allergen challenge and to suggest criteria for the definition of early and late phase nasal reactions.Nasal challenge with allergen was performed in 15 allergic patients. Nasal resistance was followed until 10 h after allergen challenge and on a control day using whole body plethysmography.The mean percentage changes in the inspiratory nasal resistance during the early phase period (0.25-2 h) and the late phase period (4-10 h) were significantly higher on the allergen challenge day than on the control day (p=0.001 and p=0.01, respectively). The mean percentage change in the inspiratory nasal resistance during the early and late phase period on the control day plus 2 times the standard deviation served as cut-off point for a positive reaction. Using this definition, all patients had early reactions and 7 of the 15 patients (47%) also had late reactions.We conclude that whole body plethysmography is a useful, noninvasive method for the measurement of the physiological changes in the nose following allergen challenge.

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Section: Discussionsupporting

confidence: 54%

“…Late phase nasal responses after allergen challenge have been reported in 3-75% of allergic patients. This variation in reported late reactions depends largely on differences in investigational techniques and different positivity cut-offs [21]. Based on symptom scores and mediator release, NACLERIO et al [13] reported 75% late responders.…”

Section: Discussionmentioning

confidence: 99%

Early and late allergic reaction in the nose assessed by whole body plethysmography

Bruin‐Weller¹,

Weller²,

Scholte³

et al. 1996

Eur Respir J

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“…In this study, we observed that during the placebo period, allergen challenge increases eosinophils and neutrophils in the nasal lavage-fluid at both 1 and 5 h. It should be noted, however, that the number of cells recovered in our patients was lower than the number reported in a previous study in similar patients [21]. This difference may be due to the technique of nasal fluid recovery.…”

Section: Prechallengecontrasting

confidence: 55%

Effect of slow-release theophylline on nasal antigen challenge in subjects with allergic rhinitis

Aubier¹,

Neukirch²,

Maachi³

et al. 1998

Eur Respir J

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It has been recognized recently that theophylline possesses anti-inflammatory effects that could be of clinical interest in patients with airway inflammatory diseases such as asthma and allergic rhinitis (AR). The aim of the present study was to explore the effect of theophylline on the nasal eosinophilic inflammatory response following allergen challenge in patients with AR. Fourteen subjects suffering from seasonal rhinitis with an early reaction after nasal allergen provocation were challenged outside the pollen season after pretreatment for 3 weeks with placebo or slow-release theophylline (Euphylong in a randomized double-blind, cross-over study. Nasal blocking index (NBI), nasal airway resistance and symptoms were recorded before, and 1 and 5 h after challenge; additionally, nasal lavage fluid was collected before, as well as 1 and 5 h after challenge. Eosinophil cationic protein (ECP) was measured in the lavage as well as the number of eosinophils before, and 1 h and 5 h after allergen challenge. After 3 weeks of treatment, baseline concentrations of ECP in nasal lavage amounted to 826+/-329 ng x L(-1) (placebo) and 936+/-351 ng x L(-1) (theophylline). The ECP levels did not increase during the early phase response. Five hours after challenge, ECP in the placebo group increased markedly (p<0.01), whereas no significant increase was observed during theophylline treatment. In parallel, the number of eosinophils in the nasal lavage fluid was lower during theophylline treatment. Additionally, theophylline therapy also significantly reduced the nasal symptoms and had some protective effect against nasal obstruction following allergen challenge. These results confirm the anti-inflammatory effects of theophylline and suggest that these effects may be of clinical benefit in patients with allergic rhinitis.

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“…2,3 Despite technological advances, no method for studying the nose and the severity of nasal inflammation in children has been fully standardized and widely accepted. 4 A review of the relevant literature suggests that most existing assessment techniques have 2 basic defects: wide variability and, hence, weak clinical significance of the reported values.…”

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confidence: 99%

“…2,5,6 Among these methods, nasal scraping is the most simple and noninvasive procedure suitable for studying a large population such as unselected schoolchildren. Few studies have validated measurements of nasal cellularity, and most results refer to preselected population.…”

mentioning

confidence: 99%

Nasal Cellularity in 183 Unselected Schoolchildren Aged 9 to 11 Years

Ronchetti¹,

Villa²,

Martella³

et al. 2002

Pediatrics

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ABSTRACT. Objective. Although rhinitis is extremely frequent in children, methods for assessing the severity of nasal inflammation produce results with wide variability and hence weak clinical significance. We designed this epidemiologic investigation to define the clinical usefulness of assessing nasal cellularity in children.Methods. We studied 183 of 203 eligible unselected schoolchildren who were aged 9 to 11 years and whose parents gave informed consent and completed a questionnaire on the history of atopic and respiratory symptoms. In all children, nasal swabs were obtained from both nostrils and eluted in saline and slides were prepared from cytospin preparations for staining and white cell counts. Children also underwent determination of nasal volume, skin prick tests with 7 common local allergens, flow volume curves, and nitric oxide measurement in expired air. Blood samples were drawn for the measurement of total immunoglobulin E, eosinophil percentage, and detection of Chlamydia pneumoniae antibodies. C pneumoniae DNA was also sought in eluates from nasal swabs. The percentage, standard deviations, and percentiles of the various nasal white cell populations were determined.Results. No correlation of the percentage of these cells was found with the history of allergies or respiratory disease or with functional or laboratory finding. Repeat nasal swabs obtained 1 month after the initial examination in 31 children (20 with neutrophils higher and 11 lower than 14%) in 77.4% of the cases confirmed the previous (high or normal) result. Twelve of the 16 eligible children with persistently high nasal neutrophil counts completed a 15-day cycle of intranasal flunisolide therapy (200 g twice a day). Therapy significantly reduced nasal neutrophil percentage and increased nasal volume.Conclusions. Increased nasal neutrophils, although related neither to the clinical history nor to laboratory variables, are a common important finding in children. A 15-day cycle of intranasal flunisolide is sufficient to restore normal nasal neutrophilia.

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Comparison of rhinomanometry, symptom score, and inflammatory cell counts in assessing the nasal late-phase reaction to allergen challenge

Cited by 49 publications

References 29 publications

Early and late allergic reaction in the nose assessed by whole body plethysmography

Early and late allergic reaction in the nose assessed by whole body plethysmography

Effect of slow-release theophylline on nasal antigen challenge in subjects with allergic rhinitis

Nasal Cellularity in 183 Unselected Schoolchildren Aged 9 to 11 Years

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