Nasal secretion analysis in allergic rhinitis, cystic fibrosis, and nonallergic fibromyalgia/chronic fatigue syndrome subjects

Rhinitis symptoms are present in approximately 70% of subjects with fibromy algia and chronic fatigue syndrome (FM/CFS). Because only 35% to 50% have p ositive allergy skin tests, nonallergic mechanisms may also play a role. To better understand the mechanisms of nonallergic rhinitis in FM/CFS, nasal lavages were performed, and markers of vascular permeability, glandular sec retion, and neutrophil and eosinophil infiltration measured in 27 nonallerg ic FM/CFS, 7 allergic rhinitis, 7 cystic fibrosis, and 9 normal subjects. A llergic rhinitis subjects had significantly increased vascular permeability (IgG) and ECP levels. Cystic fibrosis subjects had significantly higher el astase and total protein levels. There were no significant differences betw een FM/CFS and normal lavage fluids. Analysis of the constituents of nasal mucus provides information about ongoing secretory processes in rhinitis. T here were no differences in the basal secretion of these markers of vascula r permeability, submucosal gland serous cell secretion, eosinophil and neut rophil degranulation in nonallergic FM/CFS subjects. This suggests that con stitutively active secretory processes that regulate continuous production of nasal secretions are not altered in FM/CFS. Future studies should examin e alternative mechanisms such as inducible, irritant-activated or reflex-me diated effects.