Rg. Vanwijk et al., NASAL HYPERREACTIVITY AND ITS EFFECT ON EARLY AND LATE SEQUELAE OF NASAL CHALLENGE WITH HOUSE-DUST MITE EXTRACT, Allergy proceedings, 14(4), 1993, pp. 273-281
For a study on the relationship between nasal hyperreactivity to hista
mine and the nasal response to allergen, 14 rhinitis patients allergic
to house-dust mites were challenged with histamine and 5 days later w
ith a house-dust mite (HDM) extract. According to symptom scores, afte
r allergen challenge two groups of patients were distinguished, i.e.,
isolated early and dual responders. The nasal response to histamine wa
s significantly correlated with the amount of secretion (r = 0.71; p =
0.0039) and the number of sneezes (r = 0.78; p = 0.0016) induced by t
he HDM extract during the early reaction. The amount of allergen-induc
ed secretion could be predicted from the response to histamine, skin r
eactivity to allergen, and blood eosinophils (multiple r = 0.90; p < 0
.0001). Late-phase symptoms appearing between 3.5 and 9.5 hour after a
llergen challenge could be predicted from histamine responsiveness and
skin reactivity (multiple r = 0.67, p = 0.004). Compared with early r
esponders (LAR-) (n = 8), patients with early and late symptoms (LAR+)
(n = 6) were characterized by a higher secretory responsiveness to hi
stamine (p = 0.033), increased production of leukotrienes determined i
n nasal lavage fluid during the early response (p = 0.033), and elevat
ed albumin levels occurring between 3.5 and 9.5 hours after challenge
(p = 0.043). Late-phase symptoms were significantly correlated with al
bumin influx (r = 0.73; p = 0.001) and leukotrienes production (r = 0.
60; p = 0.011) during the early reaction. In summary, nasal responsive
ness to HDM extract was found to be closely associated with pre-existe
nt nasal hyperreactivity. The degree of mediator involvement during th
e early reaction seems to be of importance for the development of late
-phase symptoms.