CYTOKINES IN NASAL FLUIDS FROM SCHOOL-CHILDREN WITH SEASONAL ALLERGICRHINITIS

Allergic rhinitis is a particularly good model for studies of cytokine production in vivo. In this study the occurrence of the cytokines IL- 4, IL-5, IL-10 and IFN-gamma as well as the soluble receptor for IL-4 in nasal lavage fluids were assayed in 38 school children, with season al allergic rhinitis, and 19 healthy age-matched, non-atopic controls, using highly sensitive enzyme immunoassays. IL-4 levels in patients w ith seasonal allergic rhinitis were markedly increased in comparison w ith those in non-atopic controls or in atopic patients before the star t of the pollen season. In controls, but not in the atopic patients, l evels of IFN-gamma and IL-5 were significantly higher in specimens obt ained during the pollen season than in those obtained outside the seas on. The IL-4/IFN-gamma ratios were significantly higher in atopic than in nonatopic subjects and further increased in atopic patients during the season. In addition to IL-4, elevated levels of IL-10 were observ ed in association with seasonal rhinitis. Following treatment with a t opical steroid (budesonide) there was a statistically significant incr ease of the levels of soluble IL-4 receptor. These findings indicate t hat nonatopic and atopic individuals react to pollen exposure with dis tinct cytokine patterns in agreement with the Th1/Th2 concept. Topical steroids may possibly decrease inflammation by increasing the formati on of soluble IL-4 receptor.