An approach of immunoneurological aspects in nasal allergic late phase

This examination is an approach of the allergic early phase reaction (EPR) and late-phase reaction (LPR) via quality of life (QoL), acoustic rhinometry, and eosinophilic cationic protein (ECP), interleukin (IL)-5, and leukotriene C4 (LTC4). Results are discussed under consideration of a possible neurological participation in the occurrence and persistence of the allergic inflammatory process. Thirteen patients suffering from seasonal allergic rhinitis were challenged intranasally by their specific allergen. In a time window of 8 hours after provocation, patients completed QoL questionnaires, and underwent acoustic rhinometry. Nasal secretions were analyzed for total protein, ECP, IL-5, and LTC4 The need to sneeze and a runny nose were the strongest symptoms during the EPR and LPR. Restriction of overall QoL persisted much longer than any other symptom. Evaluation of acoustic rhinometry revealed an EPR in 100% and a LPR in 92%. The EPR was marked by increases in volume of nasal secretions, total protein, and elevations in LTC4. Allergic LPR was marked by increases in nasal secretions, total protein, ECP, IL-5, and LTC4. Both the need to sneeze as strongest and announcing symptom of the allergic LPR and the persisting restriction in overall QoL seem to propose a possible neurological participation in the development of the allergic late-phase inflammation and consequent hyperresponsiveness of the nasal mucosa. In addition, the persistence and enhancement of the nasal cycle during the allergic LPR can be interpreted in favor of a hypothetical activation of the autonomous nervous system. LTC4 enters this discussion as a promising link at the immunoneurological interface.