Acta clinica Croatica, Vol. 46 No. 2, 2007.
Original scientific paper
Impact of Inflammatory Cell Activation on Nasal Hyperreactive Response to Distilled Water Nasal Provocation
Krešo Zurak
Željka Bukovec
Srđan Ante Anzic
Tomislav Baudoin
Livije Kalogjera
Abstract
The aim of the study was to compare hyperreactive response to nasal distilled water provocation in patients with allergic and non-allergic hyperreactive rhinitis, and to correlate the severity of hyperreactivity with inflammatory cell activation. Cellular activity was measured by the concentration of cellular activation markers in nasal lavage prior to provocation, eosinophil cationic protein (ECP) for eosinophil granulocytes, myeloperoxidase (MPO) for neutrophilic granulocytes and tryptase for mast cells. The study was performed in a group of 78 patients with a history of nasal hyperreactivity, i.e. 48 patients with allergic rhinitis and 30 patients with non-infectious non-allergic rhinitis (NINAR). Prior to provocation, basal nasal airway resistance was measured by active anterior rhinomanometry, and nasal lavage with 5 ccm of saline was taken. Provocation was made by inhalation of 10 ccm of distilled water over 10 minutes. The patients were subdivided into groups according to nasal airway resistance (NAR) increase. In the whole group the provocation induced a significant increase in nasal resistance on the better patent side prior to provocation (p<0.005). The only significant difference between allergic and non-allergic patients was recorded in tryptase concentration in nasal lavage, which was significantly higher in the group of allergic patients. No correlation was found between any of the cellular markers and the level of nasal hyperreactivity. The correlation between ECP and MPO in nasal lavage was significant. As no correlation was found between inflammatory cell activation and hyperreactivity, it appears that neural reflexes in addition to inflammation must be involved in the regulation of hyperreactive response.
Keywords
Rhinitis - diagnosis; Rhinitis - physiopathology; Rhinitis, allergic - diagnosis; Nasal provocation tests; Water diagnostic use; Nasal mucosa - drug effects
Hrčak ID:
13595
URI
Publication date:
30.6.2007.
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