EOSINOPHIL CATIONIC PROTEIN (ECP) AND TRYPTASE IN THE NASAL LAVAGE FLUID (NLF) OF CHILDREN WITH GRASS-POLLEN RHINITIS - LEVOCABASTINE EFFECT

This study was carried out to determine the concentrations of eosinoph il cationic protein (ECP) and tryptase in the nasal lavage fluid (NLF) of 24 children (C) with grass pollen rhinitis as well as rhinitis sym ptoms before and after nasal provocation tests with or without a levoc abastine (anti-HI topical antihistamine) pretreatment All C were monos entitized to grasses only. Twelve patients (Active Group = AG) were re sted with a nasal provocation test with grass pollen (NPT) carried out by the insufflation of increasingly higher doses of an allergenic ext ract powder, while the other 12 patients (Placebo Group = PG) underwen t just a nasal provocation test with lactose (placebo) (NPTp). The pre challenge NLF, obtained both before (C) and after (AG) levocabastine p retreatment, was compared to that obtained after periods of 2 and 24 h ours postchallenge. In the AG, before and after levocabastine pretreat ment, the tryptase concentrations had not significantly increased, whe reas the ECP concentrations were found to be significantly higher (p < 0.05) in just the 24-hour postchallenge samples. In the PG the rhinit is symptoms were not induced by the NPTp and there was no significant change in either ECP or tryptase concentrations. In the AG a levocabas tine pretreatment induced a significant increase (p < 0.05) in the cum ulative allergen doses administered by the NPT. There was a reduction of the nasal symptoms in 7 patients, while in 3 subjects there was onl y a slight improvement but in 2 subjects no effect was encountered In conclusion this study shows that a levocabastine pretreatment before a n NPT in patients with grass pollen rhinitis, outside the grass pollen season, induces a significant increase in the cumulative allergen dos es (administered by the NPT) which provoked rhinitis symptoms but is n ot able to demonstrate any significant reduction in the ECP concentrat ions of the NLF.