ASSESSMENT OF THE ALLERGIC REACTION IN SEASONAL RHINITIS - ACOUSTIC RHINOMETRY IS A SENSITIVE AND OBJECTIVE METHOD

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.