COMPARISON OF RHINOMANOMETRY, SYMPTOM SCORE, AND INFLAMMATORY CELL COUNTS IN ASSESSING THE NASAL LATE-PHASE REACTION TO ALLERGEN CHALLENGE

Inspiratory nasal resistance symptom score, and influx of inflammatory cells into the nose were evaluated before and after a nasal challenge in 15 patients with grass pollen rhinitis and in sir nonallergic cont rol subjects, to study the nasal late-phase reaction and its relations hip with nasal cytology. All patients had an immediate positive reacti on to specific nasal challenge. In seven allergic subjects we observed a late inspiratory nasal resistance increase, but only two had a sign ificant late symptom score. Inflammatory cells increased by 8 hours in all the patients; the higher the cell influx, the higher the symptom score. Close correlations were found between the inspiratory nasal res istance increase, nasal obstruction at hours 8 and 24, and all cell co unts. In control challenges there were no significant increases of sym ptom score or inspiratory nasal resistance either during the challenge or in the next 24 hours. A weakly significant increase was found only for neutrophil counts at 8 hours. These results indicate that an infl ammatory reaction constantly occurs after a specific nasal challenge; its extent is closely related to inspiratory nasal resistance and to t he intensity of nasal obstruction. Moreover, our data outline the pivo tal role played by eosinophils and basophils in the genesis of an alle rgic late-phase reaction in the nose.