ALLERGIC RHINITIS TO GRASS-POLLEN - MEASUREMENT OF INFLAMMATORY MEDIATORS OF MAST-CELL AND EOSINOPHILS IN NATIVE NASAL FLUID LAVAGE AND IN SERUM OUT OF AND DURING POLLEN SEASON

Background: In allergic rhinitis, mast cells, activated by cross-linki ng of allergen to mast cell-bound specific IgE, release both vasoactiv e mediators related to the early nasal symptoms and chemotactic mediat ors that attract inflammatory cells, such as eosinophils, related to t he late-phase response. Objective: We have analyzed, during and out of pollen season, in blood and nasal fluid from patients allergic to gra ss pollen, histamine and tryptase to monitor the early phase markers a nd eosinophil and eosinophil cationic protein (ECP) to monitor the lat e phase. Methods: Twenty patients were enrolled in the study. As a con trol, we studied 10 nonatopic subjects. Mediators and eosinophils were assessed in blood and nasal fluid. Histamine was tested only in nasal fluid. Results: During pollen season, tryptase but not histamine incr eased in nasal fluids from patients (2.96 vs 0.22 U/ml, p = 0.001) and correlated with symptom scores (r(s) = 0.63, p = 0.003). Tryptase was not detected in serum. Eosinophils increased in nasal cytology (17.0% vs 2.0%, p = 0.001) and in the blood (26.5 vs 12.7 x 10(6) L, p = 0.0 01) from patients, but they did not correlate with symptom scores. ECP increased only in the nasal lavage (16.33 vs 1.30 ng/ml, p = 0.001) a nd correlated with symptom scores (r(s) = 0.53, p = 0.016). Conclusion s: Both ECP and tryptase increase in nasal secretion in natural diseas e. Therefore the measurement of tryptase and ECP levels in nasal fluid might be a useful clinical test for monitoring disease activity and t he effects of therapeutic agents.