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Comparative responses to nasal allergen challenge in allergic rhinitic subjects with or without asthma.

Rousseau MC, Boulay ME, Goronfolah L, Denburg J, Keith P, Boulet LP - Allergy Asthma Clin Immunol (2011)

Bottom Line: Subjects underwent a control challenge (normal saline) followed by 4 consecutive daily NAC.Compared with the control day, there was a significant increase in symptom scores and NBI 10 minutes after each last daily NAC in both groups (p < 0.05).No cumulative effect or any late response were observed in any of the groups over the challenge period.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre de recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada. lpboulet@med.ulaval.ca.

ABSTRACT

Background: Nasal allergen challenge (NAC) is useful to study the pathophysiology of rhinitis, and multiple challenges may more adequately approximate natural exposure.

Objective: To determine the effect of 4 consecutive daily NAC, on clinical and inflammatory parameters in rhinitics with or without asthma.

Methods: Rhinitic subjects were recruited: 19 with mild asthma and 13 without asthma. Subjects underwent a control challenge (normal saline) followed by 4 consecutive daily NAC. Allergen challenge consisted of spraying the chosen allergen extract into each nostril until a positive nasal response occurred. Symptoms were recorded on a Likert scale, and oral peak expiratory and nasal peak inspiratory flows allowed assessment of a nasal blockage index (NBI), for a period of 7 hours. Induced sputum and nasal lavage were performed on control day and after 1 and 4 days of NAC.

Results: Compared with the control day, there was a significant increase in symptom scores and NBI 10 minutes after each last daily NAC in both groups (p < 0.05). Symptom scores and NBI were similar for the 2 groups, except for nasal obstruction and rhinorrhea, which were more marked in subjects with asthma and rhinitis, respectively. Nasal lavage eosinophils were increased after 4 days of challenges in both groups, but there was no change in sputum eosinophils. No cumulative effect or any late response were observed in any of the groups over the challenge period.

Conclusion: Multiple NAC may be a useful tool to study the pathophysiology of allergic rhinitis or its relationships with asthma.

Trial registration: ClinicalTrials.gov NCT01286129.

No MeSH data available.


Related in: MedlinePlus

Study design. The protocol was divided into 3 different parts: a baseline visit, a control day (nasal challenge with 0.9% saline) and 4 consecutive days of nasal allergen challenge (days 1-4).
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Figure 1: Study design. The protocol was divided into 3 different parts: a baseline visit, a control day (nasal challenge with 0.9% saline) and 4 consecutive days of nasal allergen challenge (days 1-4).

Mentions: The study design is presented in Figure 1. The study was performed outside the pollen season. On a baseline visit, 2 to 7 days prior to control challenge, allergy skin prick tests and methacholine inhalation challenge were done. Subsequent to baseline visit, a control challenge was done, followed, a week later, by repeated NACs. NACs were performed over 4 consecutive days, in the morning. Nasal peak inspiratory flows (NPIF), oral peak expiratory flows (PEF), and symptoms were recorded at baseline and at regular intervals over 7 hours post-challenge on each challenge day. Induced sputum and nasal lavage specimen were obtained 7 hours following the control challenge and the first and last NAC.


Comparative responses to nasal allergen challenge in allergic rhinitic subjects with or without asthma.

Rousseau MC, Boulay ME, Goronfolah L, Denburg J, Keith P, Boulet LP - Allergy Asthma Clin Immunol (2011)

Study design. The protocol was divided into 3 different parts: a baseline visit, a control day (nasal challenge with 0.9% saline) and 4 consecutive days of nasal allergen challenge (days 1-4).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104480&req=5

Figure 1: Study design. The protocol was divided into 3 different parts: a baseline visit, a control day (nasal challenge with 0.9% saline) and 4 consecutive days of nasal allergen challenge (days 1-4).
Mentions: The study design is presented in Figure 1. The study was performed outside the pollen season. On a baseline visit, 2 to 7 days prior to control challenge, allergy skin prick tests and methacholine inhalation challenge were done. Subsequent to baseline visit, a control challenge was done, followed, a week later, by repeated NACs. NACs were performed over 4 consecutive days, in the morning. Nasal peak inspiratory flows (NPIF), oral peak expiratory flows (PEF), and symptoms were recorded at baseline and at regular intervals over 7 hours post-challenge on each challenge day. Induced sputum and nasal lavage specimen were obtained 7 hours following the control challenge and the first and last NAC.

Bottom Line: Subjects underwent a control challenge (normal saline) followed by 4 consecutive daily NAC.Compared with the control day, there was a significant increase in symptom scores and NBI 10 minutes after each last daily NAC in both groups (p < 0.05).No cumulative effect or any late response were observed in any of the groups over the challenge period.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre de recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada. lpboulet@med.ulaval.ca.

ABSTRACT

Background: Nasal allergen challenge (NAC) is useful to study the pathophysiology of rhinitis, and multiple challenges may more adequately approximate natural exposure.

Objective: To determine the effect of 4 consecutive daily NAC, on clinical and inflammatory parameters in rhinitics with or without asthma.

Methods: Rhinitic subjects were recruited: 19 with mild asthma and 13 without asthma. Subjects underwent a control challenge (normal saline) followed by 4 consecutive daily NAC. Allergen challenge consisted of spraying the chosen allergen extract into each nostril until a positive nasal response occurred. Symptoms were recorded on a Likert scale, and oral peak expiratory and nasal peak inspiratory flows allowed assessment of a nasal blockage index (NBI), for a period of 7 hours. Induced sputum and nasal lavage were performed on control day and after 1 and 4 days of NAC.

Results: Compared with the control day, there was a significant increase in symptom scores and NBI 10 minutes after each last daily NAC in both groups (p < 0.05). Symptom scores and NBI were similar for the 2 groups, except for nasal obstruction and rhinorrhea, which were more marked in subjects with asthma and rhinitis, respectively. Nasal lavage eosinophils were increased after 4 days of challenges in both groups, but there was no change in sputum eosinophils. No cumulative effect or any late response were observed in any of the groups over the challenge period.

Conclusion: Multiple NAC may be a useful tool to study the pathophysiology of allergic rhinitis or its relationships with asthma.

Trial registration: ClinicalTrials.gov NCT01286129.

No MeSH data available.


Related in: MedlinePlus