INTRANASAL COLD DRY AIR IS SUPERIOR TO HISTAMINE CHALLENGE IN DETERMINING THE PRESENCE AND DEGREE OF NASAL HYPERREACTIVITY IN NONALLERGIC NONINFECTIOUS PERENNIAL RHINITIS

The objective of the study was to compare cold dry air (CDA) and hista mine in differentiating patients with nonallergic noninfectious perenn ial rhinitis (NANIPER) from control subjects. Nasal reactivity (nasal patency, mucus production, and sneezing) in 16 symptomatic nonsmoking patients with NANIPER and seven nonsmoking control subjects was measur ed with standardized CDA and histamine provocation series in a randomi zed crossover study. Intranasal CDA resulted in increased mucus produc tion and nasal blockage in a dose-dependent manner in patients with NA NIPER but not in control subjects. Sneezing did not occur. The reprodu cibility of CDA for patency and mucus production was good. Sensitivity for CDA was 87% compared with 100% for histamine. However, specificit y was 71% for CDA and 0% for histamine. It is concluded that the new s tandardized intranasal CDA provocation method uses a recognizable natu ral nonspecific stimulus and seems to be more suitable than histamine for characterizing and assessing the presence and degree of nasal reac tivity in NANIPER.