Segmental bronchial provocation induces nasal inflammation in allergic rhinitis patients

Allergic rhinitis and asthma often coexist and share a genetic background. Pathophysiologic connections between the nose and lungs are still not entir ely understood. This study was undertaken to compare allergic inflammation and clinical findings in the upper and lower airways after segmental bronch ial provocation (SBP) in nonasthmatic allergic rhinitis patients. Eight non asthmatic, grass pollen-sensitive patients with allergic rhinitis and eight healthy controls were included. Bronchial biopsies and blood samples were taken before (T-0) and 24 h (T-24) after SBP. Nasal biopsies were obtained at T-0, 1 h after SEP (T-1), and T-24. Immunohistochemical staining was per formed for eosinophils (BMK13), interleukin (IL)-5, and eotaxin. The number of eosinophils increased in the challenged and unchallenged bronchial muco sa (p < 0.05) and in the blood (p = 0.03) of atopic subjects at T-24. We de tected an increase of BMK13-positive and eotaxin-positive cells in the nasa l lamina propria and enhanced expression of IL-5 in the nasal epithelium of atopic subjects only at T-24 (p < 0.05). SEP induced nasal and bronchial s ymptoms as well as reductions in pulmonary and nasal function in the allerg ic group. No significant changes could be observed in healthy controls. The study shows that SEP in nonasthmatic allergic rhinitis patients results in peripheral blood eosinophilia, and that SEP can induce allergic inflammati on in the nose.