engleski

Impact of inflammatory cells activation on nasal hyperreactive response to distilled water nasal provocation

The purpose of the study was to compare hyperreactive response to nasal distilled water provocation in the patients with allergic and non-allergic hyperreactive rhinitis and to correlate the severity of hyperreactivity with inflammatory cells activation. Cellular activity measured by the concentrations 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 conducted in a group of 78 patients with nasal hyperreactivity according to patients history, 48 patients with perennial or seasonal allergic rhinitis and 30 patients with NINAR were included. 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 applied by inhalation of 10 ccm of distilled water during 10 minutes. Patients were divided in groups according to increase in NAR (no response, mild to moderate or severe response. In the whole group the provocation has induced a significant increase in nasal resistance on the better patent side prior to provocation (p<0, 005). The only significant difference detected between allergic and non-allergic patients was the tryptase concentration in nasal lavage, which was significantly higher in the allergic patients. No correlation was found between any of cellular markers and level of nasal hyperreactivity. The correlation between ECP and MPO in nasal lavage was significant. As no correlation between inflammatory cells activation and hyperreactivity was found, neural reflexes, besides inflammation, are probably involved in regulation of hyperreactive response.

nasal hyperreactivity ; inflammatory cells activity ; ECP-eosinophil cationic potein ; TRY-tryptase MPO-myeloperoxidase ; nasal provocation ; nasal lavage ; active anterior rhinomanometry

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