title: Nasal provocation of patients with allergic rhinitis and the hypothalamic-pituitary-adrenal axis.
abstract: 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.
authors: Allergy Clinical Research Center, Allergy Section, Attikon Hospital, University of Athens Medical School, Athens, Greece.
authors: Demetrios
authors: D
authors: Kalogeromitros
authors: E Katerini I
authors: EK
authors: Syrigou
authors: Michael
authors: M
authors: Makris
authors: Duraisamy
authors: D
authors: Kempuraj
authors: Nikolaos G
authors: NG
authors: Stavrianeas
authors: Magdalini
authors: M
authors: Vasiadi
authors: Theoharis C
authors: TC
authors: Theoharides
mesh_terms: 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*
chemical_list: D052179:Antigens, Plant