Forced expiration through the nose is a stimulus for NANIPER but not for controls

Objective: Is forced expiration through the nose a mechanical stimulus to w hich patients with nasal hyperreactivity react Do parameters, such as peak nasal expiratory flow rate (PNEF), influence nasal airway resistance (NAR) in these patients? Method: NAR, mucus production and sneezing were measured on 2 occasions two weeks apart. Measurements were conducted before and during a period of 10 minutes after 3 repeated PNEFs in 15 non-allergic non-infectious perennial rhinitis (NANIPER) patients suffering from nasal hyperreactivity, and in 15 controls. Results: In NANIPER versus controls PNEF measurements attributed to a stati stically significant increase in NAR. The main effect was within the first minute after stimulus, suggesting a neuronal mechanism. Mucus secretions an d sneezing were hardly present. PNEF (highest of 3) and bronchial peak expi ratory flow rate (BpEFR) are lower in NANIPER than controls but are correla ted. Impaired bronchial capacity is likely to influence PNEF resulting in a lower decrease of nasal patency. Conclusion: PNEF depends on BpEFR and is an adequate mechanical stimulus fo r NANIPER patients, but not for non-rhinitic controls, resulting in a brief increase in NAR.