Lp. Nielsen et al., ASSESSMENT OF THE ALLERGIC REACTION IN SEASONAL RHINITIS - ACOUSTIC RHINOMETRY IS A SENSITIVE AND OBJECTIVE METHOD, Clinical and experimental allergy, 26(11), 1996, pp. 1268-1275
Background Seasonal allergic rhinitis constitutes an excellent in vivo
model of an allergic mucosal inflammatory reaction. This offers the o
pportunity of studying the fundamentals of allergic inflammation in ad
dition to improvement of knowledge on the basal pathophysiological mec
hanisms of the disease, So far, monitoring methods of disease activity
and treatment efficacy have mainly been based upon subjective assessm
ents, illustrating the impact of introducing reliable objective method
s. Objective To investigate the allergic inflammatory reaction of seas
onal rhinitis through different objective methods and evaluate these a
s indicators of disease activity and treatment efficacy. Methods Funct
ional parameters, i.e. acoustic rhinometry and nasal metacholine chall
enge, and biological markers, i.e. blood eosinophil count, eosinophil
cationic protein in serum (s-ECP) and nasal lavage fluid (n-ECP), were
assessed before and at peak pollen season in 27 patients with grass p
ollen induced rhinitis, Patients were randomized to either nasal corti
costeroid or placebo treatment and recorded nasal symptom scores. Resu
lts Acoustic rhinometry revealed a significant difference in favour of
steroid treatment (P < 0.05) comparing nasal volumes before and durin
g season. This difference primarily relied upon a decrease in the plac
ebo group (P= 0.05). A reduction from baseline of s-ECP in the steroid
group (P < 0.01) was obtained. N-ECP demonstrated a difference betwee
n treatment groups, although not significant. Symptom scores increased
in all patients during the pollen season, although this was only sign
ificant in the placebo treated patients (P < 0.01). The remaining meth
ods applied did not demonstrate further differences, either within or
between treatment groups. Conclusion Our results demonstrate acoustic
rhinometry to be a sensitive and objective method of assessment of nas
al obstruction, Furthermore, acoustic rhinometry and s-ECP reflect the
impact of nasal steroid therapy on seasonal allergic rhinitis.