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Aggravation of airway inflammation and hyper‐responsiveness following nasal challenge with Dermatophagoides pteronyssinus in perennial allergic rhinitis without symptoms of asthma
Author(s) -
Wang W.,
Xian M.,
Xie Y.,
Zheng J.,
Li J.
Publication year - 2016
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.12808
Subject(s) - medicine , eosinophil , asthma , exhaled nitric oxide , sensitization , immunology , nasal lavage , airway , sputum , rhinomanometry , gastroenterology , airway resistance , allergy , nose , bronchoconstriction , anesthesia , pathology , surgery , tuberculosis
Abstract Background House dust mites are the most prevalent allergen causing sensitizations in patients with rhinitis and asthma in China. We aimed to investigate the changes in both upper and lower airway inflammation and responsiveness following Dermatophagoides pteronyssinus ( Der‐p ) nasal provocation test ( NPT ) in rhinitis patients. Methods Study subjects included 15 nonasthmatic Der‐p ‐sensitized rhinitis ( AR ) patients with airway hyper‐responsiveness ( AHR ) ( AR + AHR +), 15 AR patients without AHR ( AR + AHR ‐), 15 healthy controls ( HC s) with Der‐p sensitization ( HC + DP +), and 15 HC without Der‐p sensitization ( HC + DP ‐). All subjects underwent Der‐p NPT . Visual analogue scale ( VAS ) scores of nasal symptoms, nasal lavage and nasal airway resistance ( NAR ) measurement, sputum induction, and forced expiratory volume in 1 second ( FEV 1 ) were performed. Airway responsiveness to histamine bronchoprovocation ( PD 20 ‐ FEV 1 ) and exhaled nitric oxide (Fe NO ) was determined. Results NAR increased significantly in all subjects with the greatest effect seen in AR + AHR + individuals. VAS increased in all subjects at 30 min and returned to baseline at 6 h, with significantly higher levels in AR + AHR + and AR + AHR ‐ subjects ( P < 0.05). Eosinophils in nasal lavage fluid and sputum increased significantly after NPT in AR + AHR + and AR + AHR ‐ subjects ( P < 0.001). FEV 1 % and PD 20 ‐ FEV 1 decreased and Fe NO increased significantly after NPT only in AR + AHR + subjects ( P < 0.05). Nasal lavage eosinophil count was positively correlated with sputum eosinophil count and the level of Fe NO and negatively correlated with FEV 1 and PD 20 . Conclusions House dust mite nasal provocation test induces and aggravates both upper and lower airway inflammation and hyper‐responsiveness in patients with persistent allergic rhinitis without asthmatic symptoms.