title: Inflammatory and oxidative stress biomarkers in allergic rhinitis: the effect of smoking.
abstract: BACKGROUND
  Accumulating evidence confirms the presence of pan-airway inflammation in allergic rhinitis patients. Smoking is known to affect the asthmatic airway inflammation. However, no study has evaluated the impact of smoking on airway inflammation of allergic rhinitis patients.
  
  
  OBJECTIVE
  The aim of the present study was to evaluate the impact of smoking on inflammatory and oxidative stress biomarkers in patients with seasonal allergic rhinitis, using non-invasive methods for sample collection.
  
  
  METHODS
  Forty patients with seasonal allergic rhinitis (20 smokers and 20 non-smokers) and 30 healthy subjects (15 smokers and 15 non-smokers) were recruited for the study during pollen season. All subjects were submitted to measurement of the fraction of exhaled NO (FeNO), exhaled breath condensate (EBC) collection, nasal lavage collection, pre- and post- bronchodilation spirometry and metacholine bronchial challenge testing. pH, leukotriene B(4) (LTB(4)) and 8-isoprostane were determined in EBC and nasal lavage samples.
  
  
  RESULTS
  Patients with allergic rhinitis presented higher LTB(4) and 8-isoprostane levels in nasal lavage (P<0.0001 for both comparisons), with no significant differences between smokers and non-smokers. Patients with allergic rhinitis also presented higher LTB(4) levels and lower pH in EBC (P<0.001 and P=0.004, respectively), with prominent differences between smokers and non-smokers (P<0.0001 and P=0.003, for LTB(4) and pH, respectively). A significant correlation between nasal lavage and EBC LTB(4) values was observed (r(s)=0.313, P=0.048).
  
  
  CONCLUSIONS
  Patients with allergic rhinitis present increased LTB(4) and 8-isoprostane in their nasal cavity, however, with no significant differences between smokers and non-smokers. In contrast, smokers with allergic rhinitis present higher LTB(4) levels and lower pH in EBC, suggesting that these patients may be more susceptible to the deleterious effects of smoking, compared with non-smokers.
authors.affiliation: Respiratory Medicine Department, University of Thessaly Medical School, University Hospital of Larissa, Larissa, Greece. ktk@otenet.gr
authors.forename: K
authors.initials: K
authors.lastname: Tanou
authors.forename: A
authors.initials: A
authors.lastname: Koutsokera
authors.forename: T S
authors.initials: TS
authors.lastname: Kiropoulos
authors.forename: M
authors.initials: M
authors.lastname: Maniati
authors.forename: A I
authors.initials: AI
authors.lastname: Papaioannou
authors.forename: K
authors.initials: K
authors.lastname: Georga
authors.forename: S
authors.initials: S
authors.lastname: Zarogiannis
authors.forename: K I
authors.initials: KI
authors.lastname: Gourgoulianis
authors.forename: K
authors.initials: K
authors.lastname: Kostikas
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001944:Breath Tests; D015237:Dinoprost / Q000031:analogs & derivatives / Q000032:analysis / Q000378:metabolism; D004804:Eosinophils / Q000166:cytology; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007073:Immunoglobulin E / Q000097:blood; D007249:Inflammation / Q000378:metabolism*; D007975:Leukotriene B4 / Q000032:analysis / Q000378:metabolism; D008297:Male; D017817:Nasal Lavage Fluid / Q000737:chemistry / Q000166:cytology; D009569:Nitric Oxide / Q000032:analysis / Q000378:metabolism; D018384:Oxidative Stress; D006255:Rhinitis, Allergic, Seasonal / Q000097:blood / Q000378:metabolism*; D012907:Smoking / Q000009:adverse effects* / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D007975:Leukotriene B4; C075750:8-epi-prostaglandin F2alpha; D009569:Nitric Oxide; D007073:Immunoglobulin E; D015237:Dinoprost