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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

MCT linear regression versus the eosinophil percentages in nasal smear in the NARES group (R2 = 0.72; p = 0.001).
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Figure 5: MCT linear regression versus the eosinophil percentages in nasal smear in the NARES group (R2 = 0.72; p = 0.001).

Mentions: The MCT average (SD) values of the NARES group, expressed in minutes, was higher than that of controls (30 ± 7 minutes versus 14 ± 2 minutes; p = 0.001), and the related mean values matched with the reactivity classes. These values were as follows: 37 ± 4 minutes for the very high class, 27 ± 2 minutes for the high class, 24 ± 3 minutes for the medium class, and 19 minutes for the low class (Table 2). MCT was related to the percentage of eosinophils in the nasal smear of the NARES group (Fig. 5), and linear regression analysis showed a determination coefficient of the two variables, of R2 = 0.71, with p = 0.001. MCT and TNR responses after NSNPT with histamine in the NARES group (Fig. 6) exhibited a significant linear correlation (R2 = 0.89; p = 0.001), whereas there was no correlation for the control group (R2 = 0.05; p = not significant). In regard to the TNR, MCT and nasal eosinophilia (Table 2) in the NARES group were observed with significant differences between before and after NSNPT for all classes of nasal reactivity (p > 0.0005) and for the TNR between NARES and control groups both before and after NSNPT (p < 0.0005). In the end, the correlations among TNR, MCT, and nasal eosinophilia were strong or moderate for every reactivity class (Table 1).


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)

MCT linear regression versus the eosinophil percentages in nasal smear in the NARES group (R2 = 0.72; p = 0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: MCT linear regression versus the eosinophil percentages in nasal smear in the NARES group (R2 = 0.72; p = 0.001).
Mentions: The MCT average (SD) values of the NARES group, expressed in minutes, was higher than that of controls (30 ± 7 minutes versus 14 ± 2 minutes; p = 0.001), and the related mean values matched with the reactivity classes. These values were as follows: 37 ± 4 minutes for the very high class, 27 ± 2 minutes for the high class, 24 ± 3 minutes for the medium class, and 19 minutes for the low class (Table 2). MCT was related to the percentage of eosinophils in the nasal smear of the NARES group (Fig. 5), and linear regression analysis showed a determination coefficient of the two variables, of R2 = 0.71, with p = 0.001. MCT and TNR responses after NSNPT with histamine in the NARES group (Fig. 6) exhibited a significant linear correlation (R2 = 0.89; p = 0.001), whereas there was no correlation for the control group (R2 = 0.05; p = not significant). In regard to the TNR, MCT and nasal eosinophilia (Table 2) in the NARES group were observed with significant differences between before and after NSNPT for all classes of nasal reactivity (p > 0.0005) and for the TNR between NARES and control groups both before and after NSNPT (p < 0.0005). In the end, the correlations among TNR, MCT, and nasal eosinophilia were strong or moderate for every reactivity class (Table 1).

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