title: Isolated early response after nasal allergen challenge is sufficient to induce nasal hyperreactivity.
abstract: Ten rhinitic patients allergic to grass pollen were challenged with histamine intranasally 24 hours before and 24 hours after nasal provocation with grass pollen. Up to ten hours after allergen provocation nasal lavage fluid was obtained to characterize early and late phase reactions by measuring the levels of histamine and leukotrienes as indicators of mediator release, and albumin as a marker of increased vasopermeability. Ten minutes after allergen challenge with 10,000 BU grass pollen extract LTC4,D4, and albumin significantly increased from 62 to 576 pg/mL (P = .008) and from 15 to 81 micrograms/mL (P = .008), respectively, without significant changes after placebo challenge a week earlier. Although the patients showed increased responsiveness to histamine after allergen challenge compared with a placebo-challenged control group (P = .02), one patient only demonstrated a late phase nasal allergic reaction characterized by recurrence of clinical symptoms eight to ten hours after allergen challenge and recurrence of mediators in lavage fluid. It is concluded that an isolated early response after allergen challenge is sufficient to induce nasal hyperreactivity. A biochemically or clinically defined late phase allergic reaction does not necessarily accompany allergen-induced hyperreactivity.
authors.affiliation: Department of Allergology, University Hospital, Rotterdam, The Netherlands.
authors.forename: R G
authors.initials: RG
authors.lastname: van Wijk
authors.forename: F J
authors.initials: FJ
authors.lastname: Zijlstra
authors.forename: A W
authors.initials: AW
authors.lastname: van Toorenenbergen
authors.forename: A
authors.initials: A
authors.lastname: Vermeulen
authors.forename: P H
authors.initials: PH
authors.lastname: Dieges
mesh_terms: D000293:Adolescent; D000328:Adult; D000403:Airway Resistance / Q000187:drug effects*; D016535:Bronchial Hyperreactivity / Q000139:chemically induced* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006632:Histamine / Q000032:analysis / Q000494:pharmacology*; D006801:Humans; D008297:Male; D009299:Nasal Provocation Tests; D009666:Nose / Q000502:physiology*; D013189:SRS-A / Q000032:analysis; D012709:Serum Albumin / Q000032:analysis
chemical_list: D013189:SRS-A; D012709:Serum Albumin; D006632:Histamine