Eosinophilic inflammation, remodeling of lower airway, bronchial responsiveness and cough reflex sensitivity in non-asthmatic subjects with nasal allergy.
BACKGROUND
It has been reported that nasal allergy influences the lower airway inflammation and functions. We elucidated whether nasal allergy would contribute to lower airway inflammation and functions.


METHODS
266 subjects aged 21-39 years were interviewed with special emphasis on history of asthma and nasal allergies (perennial allergic rhinitis (PAR) and seasonal allergic rhinitis (Japanese cedar pollinosis; PO)). Symptomatic subject was defined when nasal symptoms were present during a 3-week study period. Pulmonary function, provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 s (PC20), capsaicin cough threshold defined as capsaicin concentration eliciting 5 or more coughs (C5) and eosinophil percentage in hypertonic saline-induced sputum were measured.


RESULTS
Based on the interview, 232 subjects without asthma were divided into symptomatic (n = 25) and asymptomatic (n = 22) PAR, PO on-season (n = 15) and off-season (n = 36), and non-nasal allergy subjects (control) (n = 134). Sputum eosinophils were significantly greater in symptomatic PAR than another four groups (p < 0.01). FEV1/FVC ratio was significantly lower in PAR than control (p < 0.05). Maximum mean expiratory flow was lower in PAR than control (asymptomatic: p < 0.05, symptomatic: p = 0.06). C5 was not different among groups. PAR tended to have a lower PC20 compared to control (symptomatic: p = 0.078; asymptomatic: p = 0.086).


CONCLUSIONS
These results suggest that eosinophilic inflammation occurred in symptomatic period of PAR may contribute to development of lower airway remodeling and bronchial hyperresponsiveness. Reversely, PO may not be associated with lower airway eosinophilic inflammation or abnormal bronchial functions. Nasal allergy dose not influence the cough reflex sensitivity.
Hara
Johsuke
J
Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate School of Medicine, Kanazawa City, Ishikawa, Japan. hara@med3.m.kanazawa-u.ac.jp
Fujimura
Masaki
M
Myou
Shigeharu
S
Furusho
Shiho
S
Abo
Miki
M
Oribe
Yoshitaka
Y
Ohkura
Noriyuki
N
Herai
Yoriko
Y
Sone
Takashi
T
Waseda
Yuko
Y
Yasui
Masahide
M
Kasahara
Kazuo
K
D000328:Adult; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents / Q000494:pharmacology; D002211:Capsaicin / Q000494:pharmacology*; D003371:Cough / Q000503:physiopathology*; D004804:Eosinophils / Q000473:pathology; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male; D008450:Maximal Midexpiratory Flow Rate / Q000187:drug effects; D016210:Methacholine Chloride / Q000494:pharmacology*; D011014:Pneumonia / Q000473:pathology / Q000503:physiopathology*; D012123:Pulmonary Ventilation / Q000187:drug effects; D012018:Reflex / Q000187:drug effects; D012129:Respiratory Function Tests; D012221:Rhinitis, Allergic, Perennial / Q000503:physiopathology*; D006255:Rhinitis, Allergic, Seasonal / Q000503:physiopathology*; D012462:Saline Solution, Hypertonic / Q000494:pharmacology; D013183:Sputum / Q000166:cytology / Q000187:drug effects; D014797:Vital Capacity / Q000187:drug effects
D016085:Bronchoconstrictor Agents; D012462:Saline Solution, Hypertonic; D016210:Methacholine Chloride; D002211:Capsaicin