Nasal response to allergen challenge in patients with immediate asthmatic reaction

Ten patients with bronchial asthma and allergy to house-dust mite (HDM) and ten normal, nonatopic control subjects underwent a bronchial challenge with flour. Before and 24 hr after the allergen provocation with flour, the levels of eosinophil cationic protein (ECP) and myeloperoxidase (MPO) were determined in the serum and nasal lavage fluid. All allergics showed an isolated immediate asthmatic reaction (IAR). After the flour challenge only in asthmatic patients the increase was detected in the mean values of: 1) eosinophils (mean value before 16.7 x 103/mm3; mean after: 10 min 132.9 x 103/ml; 3 hr 183.6 x 103/mm3; 24 hr 110.6 x 103/mm3, p < 0.05), 2) basophils (mean before 1.2 x 103/mm3; mean after: 10 min 5.3 x 103/ml; 3 hr s 14.1 x 103/mm3 24 hr was 18.3 x 103/mm3, p < 0.05), 3) neutrophils (mean before 9.2 x 103/mm3; mean after 24 h 18.2 x 103/mm3, p < 0.05) in the nasal lavage fluid. In contrast to a group of normal subjects, asthmatics were found to have higher postchallenge levels of ECP and MPO in the nasal secretions as compared with the prechallenge levels (ECP-mean 3.85 ug/l compared with 32.17 ug/l, p < 0.05; MPO-mean 120-02 ug/l compared with 1313.2 ug/l, p < 0.05). The authors did not find any significant difference between pre- and postchallenge levels of ECP and MPO in the serum of asthmatics and controls. The higher levels of MPO as well as higher count of neutrophils observed in asthmatic patients 24 hr after allergen challenge support the neutrophil involvement in the allergic inflammation. Our results indicate that both neutrophils and eosinophils take part in allergic reaction in the mucosa.