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Nasal histamine responses in nonallergic rhinitis with eosinophilic syndrome.

Zambetti G, Ciofalo A, Romeo R, Soldo P, Fusconi M, Greco A, Magliulo G, de Vincentiis M - Allergy Rhinol (Providence) (2015)

Bottom Line: This correlation improved when using the composite symptom score.Unlike controls, a significant correlation was observed between the increase in MCT and TNR.In NARES, nonspecific nasal hyperreactivity is the result of epithelial damage produced by eosinophilic inflammation, which causes MCT slow down, an increase in TNR, and nasal reactivity classes, with possible impact on classification, prognosis, and treatment control.

View Article: PubMed Central - PubMed

Affiliation: Rhinology and Immuno-Allergy Unit, Sense Organs Department, Otolaryngology Section, Rome "Umberto I" General Hospital, "La Sapienza" University, Rome, Italy.

ABSTRACT

Background: Nonallergic rhinitis with eosinophilic syndrome (NARES) is persistent, without atopy, but with ≥25% nasal eosinophilia. Hypereosinophilia seems to contribute to nasal mucosa dysfunction.

Objectives: This analytical case-control study aimed at assessing the presence and severity of nonspecific nasal hyperactivity and at finding out whether eosinophilia may be correlated with the respiratory and mucociliary clearance functions.

Materials: The symptom score was assessed in 38 patients and 15 controls whose nasal smear was also tested for eosinophils and mucociliary transport (MCT). Nonspecific nasal provocation tests (NSNPT) with histamine were also carried out, and total nasal resistance (TNR) was determined.

Results: The symptom score of NARES after NSNPT were not significantly different from the control group, and there was poor or no correlation among the single symptoms and the differences studied for every nasal reactivity class. This correlation improved when using the composite symptom score. The most severe eosinophilia was observed in high reactivity groups, and it was correlated with an increase in TNR. MCT worsened as eosinophilia and nasal reactivity increased. Unlike controls, a significant correlation was observed between the increase in MCT and TNR.

Conclusions: In NARES, nonspecific nasal hyperreactivity is the result of epithelial damage produced by eosinophilic inflammation, which causes MCT slow down, an increase in TNR, and nasal reactivity classes, with possible impact on classification, prognosis, and treatment control.

No MeSH data available.


Related in: MedlinePlus

TNR linear regression after NSNPT with histamine versus the eosinophil percentages in nasal smear in the NARES group (R2 = 0.82; p = 0.001).
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Figure 4: TNR linear regression after NSNPT with histamine versus the eosinophil percentages in nasal smear in the NARES group (R2 = 0.82; p = 0.001).

Mentions: TNR values after NSNPT with histamine in the NARES group are shown in Fig. 3. The pretest average (SD) values were 0.22 ± 0.03 Pa × sec × cm−3 for the controls and 0.65 ± 0.27 Pa × sec × cm−3 for the NARES group (p < 0.0005). The average (SD) values after NSNPT were 4.28 ± 2.31 Pa × sec × cm−3 for the NARES group, and 0.31 ± 0.15 Pa × sec × cm−3 for the control group, and a comparison of the two groups showed significant results (p < 0.0005). In fact, after NSNPT, 20% of the controls showed an increase in TNR average value (0.57 ± 0.02 Pa × sec × cm−3), that is, low reactivity, whereas 39% of the patients with NARES were in the very high reactivity class (average, 6.72 ± 1.32 Pa × sec × cm−3), 37% showed high reactivity (average, 3.40 ± 0.49 Pa × sec × cm−3), 21% showed medium reactivity (average, 1.7 ± 0.44 Pa × sec × cm−3), and 3% showed low reactivity (Table 2). These percentages of the subjects were similar to those mentioned above for the nasal obstruction symptom after NSNPT. In the NARES group, the mean percentage of eosinophils in the nasal smear was 45 ± 9%. The mean eosinophilia values matched with the reactivity classes were 54 ± 4% for the very high class, 45 ± 2% for the high class, 32 ± 5% for the medium class, and 25% for the low class (Table 2). The linear regression analyses of the relationship between the TNR increase after NSNPT and the eosinophils counted in the nasal smear of patients of NARES (Fig. 4) showed remarkable correlation between the two variables (R2 = 0.82; p = 0.001). Conversely, there were no eosinophils in the nasal smear of the control group.


Nasal histamine responses in nonallergic rhinitis with eosinophilic syndrome.

Zambetti G, Ciofalo A, Romeo R, Soldo P, Fusconi M, Greco A, Magliulo G, de Vincentiis M - Allergy Rhinol (Providence) (2015)

TNR linear regression after NSNPT with histamine versus the eosinophil percentages in nasal smear in the NARES group (R2 = 0.82; p = 0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541641&req=5

Figure 4: TNR linear regression after NSNPT with histamine versus the eosinophil percentages in nasal smear in the NARES group (R2 = 0.82; p = 0.001).
Mentions: TNR values after NSNPT with histamine in the NARES group are shown in Fig. 3. The pretest average (SD) values were 0.22 ± 0.03 Pa × sec × cm−3 for the controls and 0.65 ± 0.27 Pa × sec × cm−3 for the NARES group (p < 0.0005). The average (SD) values after NSNPT were 4.28 ± 2.31 Pa × sec × cm−3 for the NARES group, and 0.31 ± 0.15 Pa × sec × cm−3 for the control group, and a comparison of the two groups showed significant results (p < 0.0005). In fact, after NSNPT, 20% of the controls showed an increase in TNR average value (0.57 ± 0.02 Pa × sec × cm−3), that is, low reactivity, whereas 39% of the patients with NARES were in the very high reactivity class (average, 6.72 ± 1.32 Pa × sec × cm−3), 37% showed high reactivity (average, 3.40 ± 0.49 Pa × sec × cm−3), 21% showed medium reactivity (average, 1.7 ± 0.44 Pa × sec × cm−3), and 3% showed low reactivity (Table 2). These percentages of the subjects were similar to those mentioned above for the nasal obstruction symptom after NSNPT. In the NARES group, the mean percentage of eosinophils in the nasal smear was 45 ± 9%. The mean eosinophilia values matched with the reactivity classes were 54 ± 4% for the very high class, 45 ± 2% for the high class, 32 ± 5% for the medium class, and 25% for the low class (Table 2). The linear regression analyses of the relationship between the TNR increase after NSNPT and the eosinophils counted in the nasal smear of patients of NARES (Fig. 4) showed remarkable correlation between the two variables (R2 = 0.82; p = 0.001). Conversely, there were no eosinophils in the nasal smear of the control group.

Bottom Line: This correlation improved when using the composite symptom score.Unlike controls, a significant correlation was observed between the increase in MCT and TNR.In NARES, nonspecific nasal hyperreactivity is the result of epithelial damage produced by eosinophilic inflammation, which causes MCT slow down, an increase in TNR, and nasal reactivity classes, with possible impact on classification, prognosis, and treatment control.

View Article: PubMed Central - PubMed

Affiliation: Rhinology and Immuno-Allergy Unit, Sense Organs Department, Otolaryngology Section, Rome "Umberto I" General Hospital, "La Sapienza" University, Rome, Italy.

ABSTRACT

Background: Nonallergic rhinitis with eosinophilic syndrome (NARES) is persistent, without atopy, but with ≥25% nasal eosinophilia. Hypereosinophilia seems to contribute to nasal mucosa dysfunction.

Objectives: This analytical case-control study aimed at assessing the presence and severity of nonspecific nasal hyperactivity and at finding out whether eosinophilia may be correlated with the respiratory and mucociliary clearance functions.

Materials: The symptom score was assessed in 38 patients and 15 controls whose nasal smear was also tested for eosinophils and mucociliary transport (MCT). Nonspecific nasal provocation tests (NSNPT) with histamine were also carried out, and total nasal resistance (TNR) was determined.

Results: The symptom score of NARES after NSNPT were not significantly different from the control group, and there was poor or no correlation among the single symptoms and the differences studied for every nasal reactivity class. This correlation improved when using the composite symptom score. The most severe eosinophilia was observed in high reactivity groups, and it was correlated with an increase in TNR. MCT worsened as eosinophilia and nasal reactivity increased. Unlike controls, a significant correlation was observed between the increase in MCT and TNR.

Conclusions: In NARES, nonspecific nasal hyperreactivity is the result of epithelial damage produced by eosinophilic inflammation, which causes MCT slow down, an increase in TNR, and nasal reactivity classes, with possible impact on classification, prognosis, and treatment control.

No MeSH data available.


Related in: MedlinePlus