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Nasal hyperreactivity and its effect on early and late sequelae of nasal challenge with house-dust mite extract
R G van Wijk1, A W van Toorenenbergen, F J Zijlstra
1Department of Allergology, University Hospital Rotterdam, Dijkzigt, The Netherlands.
Abstract:
For a study on the relationship between nasal hyperreactivity to histamine and the nasal response to allergen, 14 rhinitis patients allergic to house-dust mites were challenged with histamine and 5 days later with a house-dust mite (HDM) extract. According to symptom scores, after allergen challenge two groups of patients were distinguished, i.e., isolated early and dual responders. The nasal response to histamine was significantly correlated with the amount of secretion (r = 0.71; p = 0.0039) and the number of sneezes (r = 0.78; p = 0.0016) induced by the HDM extract during the early reaction. The amount of allergen-induced secretion could be predicted from the response to histamine, skin reactivity to allergen, and blood eosinophils (multiple r = 0.90; p < 0.0001). Late-phase symptoms appearing between 3.5 and 9.5 hour after allergen challenge could be predicted from histamine responsiveness and skin reactivity (multiple r = 0.67; p = 0.004). Compared with early responders (LAR-) (n = 8), patients with early and late symptoms (LAR+) (n = 6) were characterized by a higher secretory responsiveness to histamine (p = 0.033), increased production of leukotrienes determined in nasal lavage fluid during the early response (p = 0.033), and elevated albumin levels occurring between 3.5 and 9.5 hours after challenge (p = 0.043). Late-phase symptoms were significantly correlated with albumin influx (r = 0.73; p = 0.001) and leukotrienes production (r = 0.60; p = 0.011) during the early reaction. In summary, nasal responsiveness to HDM extract was found to be closely associated with pre-existent nasal hyperreactivity.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Nasal hyperreactivity to histamine predicts allergic rhinitis responses to house dust mites. Pre-existing nasal sensitivity influences both early and late allergic reactions, impacting symptom severity and inflammatory markers.
Area of Science:
- Allergy and Immunology
- Otorhinolaryngology
Background:
- Allergic rhinitis involves complex nasal responses to allergens.
- Nasal hyperreactivity is a key feature in rhinitis patients.
- Understanding the link between histamine response and allergen challenge is crucial.
Purpose of the Study:
- To investigate the relationship between nasal hyperreactivity to histamine and the nasal response to house dust mite (HDM) allergen.
- To identify predictors of early and late-phase allergic rhinitis symptoms.
Main Methods:
- 14 rhinitis patients allergic to HDM underwent histamine challenge followed by HDM extract challenge.
- Patients were categorized into early and dual responders based on symptom scores.
- Nasal lavage fluid was analyzed for leukotrienes and albumin levels.
Main Results:
- Histamine response correlated significantly with secretion and sneezes during early HDM reaction.
- Allergen-induced secretion was predictable by histamine response, skin reactivity, and blood eosinophils.
- Late-phase symptoms were predictable by histamine responsiveness and skin reactivity.
- Dual responders (early and late symptoms) showed higher histamine responsiveness, leukotriene production, and albumin levels compared to early responders.
Conclusions:
- Pre-existing nasal hyperreactivity to histamine is closely associated with the nasal response to HDM allergen.
- Histamine responsiveness can predict both early and late-phase allergic rhinitis symptoms.
- Inflammatory markers like leukotrienes and albumin are linked to late-phase symptom development.