EFFECT OF IPRATROPIUM ON NASAL REACTIVITY TO HISTAMINE AND EOSINOPHILINFLUX IN PERENNIAL ALLERGIC RHINITIS

In a double-blind, placebo-controlled study nasal saline and histamine provocation tests were performed in patients with perennial allergic rhinitis in order to assess changes in eosinophil influx and non-speci fic nasal reactivity after 8 days of treatment with ipratropium bromid e. A ''nasal pool'' method was used to trace changes in protein level and eosinophil influx into nasal secretions. Treatment with ipratropiu m 80 mg q.i.d. caused a significant decrease in the albumin and total protein level in saline washings and induced a five-fold increase in e osinophils as compared to the placebo treatment. The nasal mucosal res ponse to histamine, assessed as the number of sneezes and protein leve l, was more responsive to ipratropium treatment than the mucosa from p lacebo-treated subjects. Since eosinophil numbers were correlated with an increase in the vascular and sneezing responses, it appears that i pratropium potentiates inflammatory mechanisms when used in subjects w ith an allergy in the nasal mucosa.