Nasal lavage mediator profile and cellular composition of nasal brushing material during latex challenge tests

Background Recent studies have shown that airborne latex allergens cause al lergic rhinitis and bronchial asthma. Objective The aim of this study was to investigate the association between the development of rhinitis reactions during workplace-related inhalative c hallenge tests and nasal allergic inflammation. Methods Thirty-two health care workers (HCWs) with suspected respiratory hy persensitivity to latex allergens underwent an inhalative workplace-related challenge test with powdered latex gloves. Nasal lavage fluid (NALF) and n asal brushing (NAB) material were collected before and after exposure (30 m in. 2, 6 and 24 h) to determine mediator and cellular composition. In addit ion, lung function parameters and nasal flow were recorded. Furthermore, si x healthy controls underwent nasal brushing and nasal lavage without latex allergen challenge at the same time intervals. Results Twenty-six HCWs showed acute rhinitis by contact to airborne latex allergen exposure and 10 of them had an additional asthma response. Only in responders, significantly increased eosinophil levels were found 6 h (P < 0.00001) and 24 h (P < 0.0005) post-challenge when compared with the precha llenge values. The ECP levels measured 2, 6 and 24 h post-challenge in the responder group were significantly elevated when compared with the prechall enge values as well as with the non-responders (6 h: P < 0.05, 24 h: P < 0. 00001 afterwards). Only in some concentrated NALF samples of responders col lected 30 min post-challenge (seven out of 15) tryptase concentration above the detection limit were found. The NO derivative concentrations in NALF w ere significantly increased 6 h post-challenge compared with the prechallen ge values (P < 0.05) and were significantly higher in responders than in no n-responders and in controls (P < 0.002). IL-5 levels increased post-challe nge in the responder group with a pronounced effect 6 h after challenge (P < 0.001). Overall, a variety of parameters was significantly correlated (e. g. ECP with NO derivatives, r = 0.792 P < 0.002). Conclusions Our data demonstrate for the first time that nasal and bronchia l hyperreactivity to airborne latex allergens are associated with an increa se of eosinophils and mediators (e.g, ECP, NO derivatives, IL-5, tryptase) in nasal mucosa. The combined use of NAB (for cells) and NALF (for mediator s) appears to be a useful model to monitor nasal inflammation during workpl ace-related challenge tests.