Mv. White, NASAL CHOLINERGIC HYPERRESPONSIVENESS IN ATOPIC SUBJECTS STUDIED OUT-OF-SEASON, Journal of allergy and clinical immunology, 92(2), 1993, pp. 278-287
Background: Atopic individuals have previously been shown to have an a
utonomic imbalance consisting of heightened cholinergic responsiveness
in the lung, skin, and eyes, and beta-adrenergic hyporesponsiveness i
n the lungs, eyes, and vasculature. This array of abnormalities is oft
en accompanied by nonspecific bronchial hyperresponsiveness, as well a
s alpha-adrenergic hyperresponsiveness in individuals with asthma. Met
hods: To determine whether atopic individuals have intrinsic nasal air
way hyperresponsiveness to methacholine, 21 nonatopic subjects and 37
subjects with allergic rhinitis were studied. All subjects were studie
d out of their allergy seasons, and all allergy-related medications we
re discontinued before the study began. Subjects underwent nasal chall
enge with methacholine (1 to 25 mg), and lavaged nasal secretions were
analyzed for total protein, the plasma marker albumin, and the glandu
lar marker lactoferrin. Results: Atopic subjects demonstrated increase
d glandular responsiveness to methacholine as evidenced by an increase
in the secretion of lactoferrin in response to individual doses of me
thacholine. Although the maximal lactoferrin secretion did not increas
e, glandular sensitivity to methacholine was heightened because the do
se of methacholine required to induce lactoferrin secretion achievable
by 60% of the study population was significantly lower in the atopic
group. The volume of lavaged secretions recovered and congestion score
s were also higher in the atopic group as compared with the normal con
trol group. Conclusions: These data strongly suggest that atopic indiv
iduals have intrinsic nasal glandular hyperresponsiveness to cholinerg
ic stimulation.