EOSINOPHIL INFLAMMATION OF THE NASAL-MUCOSA IN ALLERGIC AND NONALLERGIC RHINITIS MEASURED BY EOSINOPHIL CATIONIC PROTEIN-LEVELS IN NATIVE NASAL FLUID AND SERUM

Eosinophil inflammation is essential in many cases of allergic and non -allergic rhinitis. Activated eosinophils release toxic granule protei ns. In this study, we compared the degree of local nasal and systemic eosinophil activation by the determination of eosinophil cationic prot ein (ECP) in serum and native nasal fluid from 119 patients. We found no significant differences in serum ECP levels of the various patient groups. In all patient groups, except in the vasomotor rhinitis group, nasal fluid ECP levels differed significantly from normal controls. W e found a nasal fluid ECP (mean +/- SEM) of 32.6 +/- 8.1 ng/ml for nor mals, 106 +/- 39.7 for non-rhinitic atopics, 87.6 +/- 20.8 ng/ml for p atients with chronic non-allergic sinusitis, 101.3 +/- 40.4 ng/ml for patients with a history of pollinosis, 150.5 +/- 35.1 ng/ml for patien ts with acute pollinosis, 84.7 +/- 24.7 ng/ml for individuals with per ennial allergic rhinitis and 112.9 +/- 25.6 ng/ml for patients with bo th perennial and seasonal allergy. Patients with nasal polyps had mean nasal ECP levels of 146.9 +/- 57.7 ng/ml in absence of allergy and 14 7.9 +/- 54.9 ng/ml in the presence of allergy. Nasal ECP was 67.0 +/- 22.4 for patients with hyperreactive rhinitis. We found a significant correlation of 0.95 between nasal eosinophils and nasal ECP. Nasal ECP and a subjective symptom score only correlate significantly for chron ic sinusitis. We conclude that monitoring native nasal fluid ECP level s may be useful in the diagnosis and mangement of nasal inflammation. Elevated ECP in nasal secretion may originate from upregulated eosinop hil degranulation and thus is a marker for local inflammation although not specific for any particular nasal disease.