Odnos specifične i nespecifične nosne hiperreaktivnosti u bolesnika sa sezonskim alergijskim rinitisom [Relationship between specific and nonspecific nasal hyperreactivity in patients with seasonal allergic rhinitis]

This study is based on the hypothesis that the intensity of non-specific nasal hyperreactivity correlates with the intensity of specific nasal hyperreactivity and the intensity of early and late phase allergic cellular reaction in patients with seasonal allergic rhinitis. It included 30 patients of both sexes, aged 18 to 65, with monoallergy to grass or ambrosia pollen. Ten patients with non-alergic rhinitis were included as a control group. An out-of-allergy-season, provocation test with a specific allergen was administered to the patients’ nasal mucosa, followed by histamine and hypertonic solutions with a 24 and 72 hour delay, respectively. The subjective intensity of nasal and ocular symptoms was recorded. Nasal patency was evaluated through acoustic rhinometry, and tryptase, eosinophillic cationic protein and substance P concentrati-ons were measured in nasal secretions and tears before and after provocation. A statistically significant correlation in immediate subjective response and tryptase le-vels after allergen and histamine provocation was noted. In addition, eosinophillic cationic protein levels correlated with subjective response 24 hours after allergen exposure. These correlations were not observed after hypertonic fluid provocation. The subjective response to allergen and histamine provocation showed a stronger correlation with mast cell degranulation than eosinophillic activation in patients with seasonal allergic rhinitis. Cellular inflammatory response seems to have a stronger correlation to subjective symptoms scores than neurogenic inflammation.