Nasal provocation of patients with allergic rhinitis and the hypothalamic-pituitary-adrenal axis.
BACKGROUND
Allergic rhinitis is a common problem involving activation of nasal mast cells and irritability. The hypothalamic-pituitary-adrenal (HPA) axis is stimulated in cases of emotional or environmental stress, and mast cells have been implicated in stress-induced immune responses.


OBJECTIVE
To investigate whether intranasal challenge of patients allergic to a single antigen would stimulate the HPA axis.


METHODS
Plasma corticotropin and cortisol levels were measured 20, 40, 60, 80, 100, and 120 minutes after intranasal antigen administration in healthy volunteers (n=3) and in patients with rhinitis who are allergic to Parietaria (n=10).


RESULTS
Mean +/- SD corticotropin levels were 24.43 +/- 14.38 pg/mL in patients compared with 8.83 + 5.02 pg/mL in controls, and this increase was statistically significant (P = .049). Patient cortisol levels also increased to a mean +/- SD of 8.87 +/- 4.90 pg/mL (at 40 minutes) compared with 4.36 +/- 1.72 pg/mL in controls (P = .11 due to 1 outlier). Compared with individual patient prechallenge levels, corticotropin levels increased in 7 patients and cortisol levels increased in 5 at 40 minutes.


CONCLUSIONS
These results suggest that allergic rhinitis may activate the HPA axis. A larger study with additional controls is required for definitive conclusions.
Kalogeromitros
Demetrios
D
Allergy Clinical Research Center, Allergy Section, Attikon Hospital, University of Athens Medical School, Athens, Greece.
Syrigou
E Katerini I
EK
Makris
Michael
M
Kempuraj
Duraisamy
D
Stavrianeas
Nikolaos G
NG
Vasiadi
Magdalini
M
Theoharides
Theoharis C
TC
D000293:Adolescent; D000328:Adult; D052179:Antigens, Plant / Q000276:immunology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000276:immunology*; D008875:Middle Aged; D009299:Nasal Provocation Tests; D032403:Parietaria / Q000276:immunology; D010913:Pituitary-Adrenal System / Q000276:immunology*; D011058:Pollen / Q000276:immunology; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology* / Q000503:physiopathology*
D052179:Antigens, Plant