Sinus CT scans and mediator release in nasal secretions after nasal challenge with cypress pollens.
BACKGROUND
Involvement of paranasal sinuses has been suggested in allergic rhinitis but not clearly demonstrated.


OBJECTIVE
To investigate the relationship between intermittent allergic rhinitis and computerized tomography (CT).


METHODS
Twenty patients with intermittent rhinitis and sensitized to cypress pollens underwent unilateral nasal provocation tests (NPTs) using increasing concentrations of cypress pollens out of the pollen season. Sinus CT-scans were carried out just before a NPT and 24 h later. Nasal lavage was carried out just before a NPT, 30 min after a positive challenge and again 24 h later. Leucotriene C4/D4, intracellular adhesion molecule-1 and eosinophil cationic protein were measured in nasal secretions.


RESULTS
Thirteen patients (65%) showed an alteration in their CT-scans after allergen challenge. Ten of them showed sinus changes controlateral to their allergenic provocation. Radiological changes mainly affected the osteomeatal complex and the ethmoid sinuses. Pre-existing abnormalities (13 of 20 cases) mainly concerned the maxillary sinuses. There was no correlation between CT-scan abnormalities and levels of mediators released in nasal secretions.


CONCLUSIONS
We have shown that nasal allergen challenge can produce radiological changes in the paranasal sinuses. This mainly concerned the ethmoid sinuses.
Piette
V
V
Maladies Respiratoires, INSERMU454, IFR3, Hôpital Arnaud de Villeneuve, CHU Montpellier, 34295 Montpellier Cedex 5, France.
Bousquet
C
C
Kvedariene
V
V
Dhivert-Donnadieu
H
H
Crampette
L
L
Senac
J-P
JP
Bousquet
J
J
Demoly
P
P
D000328:Adult; D029781:Cupressus / Q000276:immunology*; D004804:Eosinophils / Q000502:physiology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D017997:Leukotriene C4 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism*; D009299:Nasal Provocation Tests; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging*; D011058:Pollen / Q000276:immunology*; D014057:Tomography, X-Ray Computed
D018799:Intercellular Adhesion Molecule-1; D017997:Leukotriene C4; D007073:Immunoglobulin E