The Clinical Stage of Allergic Rhinitis is Correlated to Inflammation as Detected by Nasal Cytology

Gelardi, Matteo; Incorvaia, Cristoforo; Fiorella, Maria Luisa; Petrone, Paolo; Quaranta, Nicola; Russo, Cosimo Roberto; Panina-Bordignon, Paola; Dell’Albani, Ilaria; Riario-Sforza, Gian Galeazzo; Cattaneo, Eleonora; Passalacqua, G.; Frati, Franco

doi:10.2174/187152811798104917

Cited by 19 publications

(14 citation statements)

References 18 publications

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“…Our data confirm that the type of inflammation influences the clinical features, and in particular the severity of symptoms and risk of comorbidities. In our opinion, nasal cytology is a very useful test in outpatient clinical rhinological evaluation, allowing for correct differential diagnosis of various forms of NAR (31)(32)(33)(34)(35) . Its impact on differential diagnosis is valuable as it allows identification of patients with NAR who have a significantly reduced quality of life.…”

Section: Resultsmentioning

confidence: 99%

Role of inflammation in non-allergic rhinitis

Corso¹,

Battista²,

Pandolfini³

et al. 2014

Rhin

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Objective: To investigate the role of inflammation in non-allergic rhinitis (NAR) patients in a large series to establish the prevalence of different NAR-subtypes, clinical features and the role of nasal cytology in the diagnostic algorithm. Methodology:Patients were selected out of 3650 individuals who spontaneously presented at our institution. We consecutively enrolled 519 NAR-patients in an analytical cross-sectional study between November 2007 and June 2013 (level of evidence: 3b).All patients underwent rhinological evaluation including symptoms questionnaire, endoscopy, CT scan, allergy tests and nasal cytology. Results:The inflammatory cell infiltrate affects the severity of symptoms differently, allowing for identification of different phenotypes of NAR. We distinguished two groups: "NAR without inflammation"(NAR-) and "NAR with inflammation"(NAR+), in addition to different NAR-subtypes with inflammation. A significant difference was observed in terms of clinical symptoms and association with comorbidities (previously diagnosed asthma and aspirin intolerance) between NAR-, NAR+ and between different NAR+ subtypes. Conclusion:Our data suggest that NAR-and NAR with neutrophils behave similarly, showing lower symptom score values and a lower risk of association with comorbidities compared to NAR with eosinophils and mast cells (singularly or mixed). In our belief it is very important to establish the presence and type of inflammation in non-allergic rhinitis patients and nasal cytology is a very useful test in correct differential diagnosis.

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Section: Resultsmentioning

confidence: 99%

Role of inflammation in non-allergic rhinitis

Corso¹,

Battista²,

Pandolfini³

et al. 2014

Rhin

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“…This was obtained in patients sensitized to grass pollen. In a study on 64 patients with grass pollen-induced AR, 22 patients (34.4%) had mild intermittent, 21 (32.8%) had moderate-to-severe intermittent, ten (15.6%) had mild persistent, and eleven (17.2%) had moderate-to-severe persistent AR 12. Nasal cytology detected neutrophils in 49 patients, eosinophils in 41 patients, mast cells in 21 patients, and lymphocytes or plasma cells in 28 patients.…”

Section: Discussionmentioning

confidence: 99%

“…The following steps characterize the cytological technique: sampling, processing (with fixing and staining), and observation through microscopy. The cytological sampling consists of collecting the nasal mucosa surface cells by the Rhino-probe (Arlington Scientific, Springville, UT, USA) 12. The sampling step must be carefully performed through anterior rhinoscopy, using a nasal speculum and good lighting.…”

Section: Methodsmentioning

confidence: 99%

“…The changes in mite allergen concentration have an obvious influence on allergic symptoms in sensitized subjects, and also on the production of mite-specific immunoglobulin E (IgE) antibodies 8. A further approach to assess the variations in nasal inflammation caused by exposure to HDMs is nasal cytology, which was proposed as a nasal test in the 1970s9 and later showed the characteristics to be used in clinical practice10 and the capacity to provide very useful data in staging the severity of AR 11,12. This present study aimed to evaluate, by nasal cytology, whether nasal inflammation in mite-allergic patients changes with the seasons of the year.…”

Section: Introductionmentioning

confidence: 99%

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Seasonal changes in nasal cytology in mite-allergic patients

Gelardi¹,

Peroni²,

Incorvaia³

et al. 2014

JIR

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BackgroundHouse dust mites (HDMs) are a major cause of allergic rhinitis (AR) and asthma worldwide. Recent studies suggested that the allergen load presents seasonal modifications, giving rise to seasonal variation in nasal inflammation and symptoms. The aim of this study was to evaluate by nasal cytology whether nasal inflammation in mite-allergic patients changes with the seasons of the year.MethodsThe study included 16 patients (seven males and nine females, mean age 38.1 years) with persistent AR caused by monosensitization to HDMs. Nasal cytology was performed in all patients once monthly for 1 year.ResultsNasal cytology showed that the cells most commonly detected in the nasal mucosa were neutrophils. During the period from October to April, a peak in the number of neutrophils and also the presence of significant numbers of eosinophils, mast cells, and lymphocytes/plasma cells were found, which shows the occurrence of more intense inflammation during these months.ConclusionNasal cytology provides useful data in detecting nasal inflammation and its association with the clinical stage of AR. The seasonal variations in nasal cytology are likely to be induced by the fluctuations in the HDM allergen that have been uncovered in recent investigations.

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“…However, the ARIA classification redefined the criteria for identifying the phenotype of patients with AR, by the duration – intermittent or persistent – regardless of the season, and the severity of symptoms with their impact in daily life, classified as mild and moderate-to-severe [9]. Recent studies showed that the ARIA severity classification clearly discriminates the impact of AR in all domains of quality of life and categorized symptom score [16], and that the ARIA classification was correlated with the nasal cytology, which showed different cell types and counts according to different severity, with higher counts of mast cells and lymphocyte/plasma cells in moderate-to-severe AR [17]. The SURF study was aimed at investigating the features of AR in a large population of children and adults.…”

Section: Discussionmentioning

confidence: 99%

A Survey of Clinical Features of Allergic Rhinitis in Adults

Frati¹,

Dell’Albani²,

Passalacqua

et al. 2014

Med Sci Monit

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BackgroundAllergic rhinitis (AR) has high prevalence and substantial socio-economic burden.Material/MethodsThe study included 35 Italian Centers recruiting an overall number of 3383 adult patients with rhinitis (48% males, 52% females, mean age 29.1, range 18–45 years). For each patient, the attending physician had to fill in a standardized questionnaire, covering, in particular, some issues such as the ARIA classification of allergic rhinitis (AR), the results of skin prick test (SPT), the kind of treatment, the response to treatment, and the satisfaction with treatment.ResultsOut of the 3383 patients with rhinitis, 2788 (82.4%) had AR: 311 (11.5%) had a mild intermittent, 229 (8.8%) a mild persistent, 636 (23.5%) a moderate-severe intermittent, and 1518 (56.1%) a moderate-severe persistent form. The most frequently used drugs were oral antihistamines (77.1%) and topical corticosteroids (60.8%). The response to treatment was judged as excellent in 12.2%, good in 41.3%, fair in 31.2%, poor in 14.5%, and very bad in 0.8% of subjects. The rate of treatment dissatisfaction was significantly higher in patients with moderate-to-severe AR than in patients with mild AR (p<0.0001). Indication to allergen immunotherapy (AIT) was significantly more frequent (p<0.01) in patients with severe AR than with mild AR.ConclusionsThese findings confirm the appropriateness of ARIA guidelines in classifying the AR patients and the association of severe symptoms with unsuccessful drug treatment. The optimal targeting of patients to be treated with AIT needs to be reassessed.

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The Clinical Stage of Allergic Rhinitis is Correlated to Inflammation as Detected by Nasal Cytology

Cited by 19 publications

References 18 publications

Role of inflammation in non-allergic rhinitis

Role of inflammation in non-allergic rhinitis

Seasonal changes in nasal cytology in mite-allergic patients

A Survey of Clinical Features of Allergic Rhinitis in Adults

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