Nasal hyperreactivity and its effect on early and late sequelae of nasal challenge with house-dust mite extract

• Published in: Allergy and asthma proceedings Vol. 14; no. 4; p. 273
• Main Authors: van Wijk, R G, van Toorenenbergen, A W, Zijlstra, F J, Jansen, A P, Dieges, P H
• Format: Journal Article
• Language: English
• Published: United States OceanSide Publications 01.07.1993
• Subjects: Adolescent; Adult; Allergens - adverse effects; Animals; Dose-Response Relationship, Immunologic; Dust - adverse effects; Female; Histamine - adverse effects; Histamine - analogs & derivatives; Humans; Hypersensitivity, Delayed - immunology; Hypersensitivity, Immediate - immunology; Male; Middle Aged; Mites - immunology; Nasal Lavage Fluid; Nasal Provocation Tests; Regression Analysis; Rhinitis, Allergic, Perennial - diagnosis; Rhinitis, Allergic, Perennial - immunology; Skin Tests; Time Factors
• ISSN: 1046-9354; 1088-5412; 1539-6304
• DOI: 10.2500/108854193778812026

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.