Evidence of maxillary sinus inflammation in seasonal allergic rhinitis.
OBJECTIVE
Allergic rhinitis has been frequently associated with both acute and chronic sinusitis. Previous studies have shown an influx of eosinophils into the maxillary sinus after nasal challenge with allergen. The objective of this study was to determine, in humans, if the development of seasonal allergic inflammation, secondary to natural allergen exposure, leads to similar inflammation within the maxillary sinus.


METHODS
Prospective, longitudinal study. Setting. Academic medical center and research laboratory.


METHODS
Eighteen subjects were evaluated in and out of the ragweed allergy season using subjective measures (nasal symptoms, quality of life), nasal secretory response to methacholine challenge, and evaluation of biomarkers in nasal and sinus lavages.


RESULTS
The subjects became symptomatic during the season and reported worse quality of life and increased nasal reactivity to methacholine. The total number of eosinophils obtained by nasal lavage during the season (median= 35,691) was significantly higher compared with out of season (median = 2811, P ≤ .02). Similarly, there were significantly more eosinophils, albeit to a lesser magnitude, in the maxillary sinus during the season (median = 4248) compared with the out-of-season samples (median = 370, P ≤ .02).


CONCLUSIONS
The authors provide evidence that natural exposure to pollen during an individual's allergy season leads to both nasal and sinus inflammation, strengthening the association between allergic rhinitis and sinusitis. The mechanism of this inflammatory response needs to be elucidated.
Section of Otolaryngology-Head and Neck Surgery, The Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA. fbaroody@surgery.bsd.uchicago.edu
Fuad M
FM
Baroody
Samantha M
SM
Mucha
Marcy
M
deTineo
Robert M
RM
Naclerio
D000328:Adult; D031164:Ambrosia; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D004804:Eosinophils; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008137:Longitudinal Studies; D008297:Male; D015523:Maxillary Sinusitis / Q000150:complications* / Q000378:metabolism / Q000473:pathology*; D017817:Nasal Lavage Fluid / Q000166:cytology; D009299:Nasal Provocation Tests; D011788:Quality of Life; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications* / Q000378:metabolism / Q000473:pathology*
D015415:Biomarkers