title: Clinical predictors of nasal secretory cell quantities in allergy clinic patients.
abstract: BACKGROUND
  Nasal cytograms are useful in evaluating patients with inflammatory disease of the nose and paranasal sinuses. When mucosal samples are taken with curette and brush devices, significant numbers of non-leukocytic cells can also be analyzed.
  
  
  OBJECTIVE
  To examine two specific morphologic variations in granule-containing epithelial cells in nasal samples obtained from allergy clinic patients and describe their clinical associations. These two cellular variants consisted of goblet cells, with coalesced granules usually displacing the nucleus, and discrete granular mucinous cells (DGMC), which show more discrete granules not displacing the nucleus.
  
  
  METHODS
  Patients from an adult allergy clinic were studied prospectively for nasal mucosal cytology, historical clinical data, nasal physical findings, serum IgE levels, and aeroallergen-specific IgE. Proportions and absolute numbers of goblet cells and DGMC in the nasal mucosal samples were related to other data using simple and multivariate analyses.
  
  
  RESULTS
  Both goblet cells and DGMC showed absolute number increases in patients with observable nasal secretions. Discrete granular mucinous cell decreases were also observed in patients with IgE levels greater than or equal to 200 IU/mL and in asthmatic patients. In non-asthmatic patients with nasal eosinophilia, a significantly greater proportion of DGMC was observed compared with other patients (19.8 +/- 11.9% versus 8.5 +/- 5.9%, P = .007), while asthmatics with nasal eosinophilia had mean DGMC quantities closer to that observed in patients without nasal eosinophilia. Increases in goblet cell numbers were observed in patients with specific IgE to aeroallergens compared with other patients (46.5 +/- 46.7 versus 27.0 +/- 23.9, P = .014). Multivariate analysis confirmed that (1) the presence of aeroallergen-specific IgE and (2) the presence of nasal eosinophilia in the absence of asthma were differentially associated with increases in goblet cells and DGMC, respectively.
  
  
  CONCLUSIONS
  Increases in nasal DGMC and goblet cells differentially relate to specific clinical patterns of nasal cellular inflammation and aeroallergen hypersensitivity. The nasal epithelial cell profile associated with nasal eosinophilia in asthmatics may differ from that observed in non-asthmatic nasal eosinophilia.
authors.affiliation: Department of Medicine, Saint Vincents Hospital & Medical Center of New York, New York Medical College, New York 10011, USA.
authors.forename: R Y
authors.initials: RY
authors.lastname: Lin
authors.forename: A
authors.initials: A
authors.lastname: Nahal
authors.forename: M
authors.initials: M
authors.lastname: Lee
authors.forename: E
authors.initials: E
authors.lastname: Clarin
authors.forename: H
authors.initials: H
authors.lastname: Menikoff
mesh_terms: D000328:Adult; D000368:Aged; D002452:Cell Count; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000473:pathology*; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology*; D011446:Prospective Studies
chemical_list: D007073:Immunoglobulin E