Bronchial inflammation in seasonal allergic rhinitis with or without asthma in relation to natural exposure to pollen allergens.
BACKGROUND
Nasal inflammation in allergic rhinitis enhances bronchial Th2 driven inflammation and development of asthma. We assessed bronchial inflammation induced by natural allergen exposure during pollen season in patients with pollinosis with or without asthma to show the intensity of inflammation in asthma and rhinitis and possible persistence of inflammation in periods without allergen exposure.


METHODS
Sputum was induced in 52 patients with seasonal allergic rhinitis without asthma, 38 patients with seasonal allergic rhinitis and seasonal asthma and 23 healthy volunteers. Sampling was performed 6-8 weeks before the expected beginning of symptoms, during symptomatic period and 6-8 weeks after the end of symptoms. Sputum ECP was measured by means of chemi-luminiscent immunometric assay and sputum cell counts were assessed by classical staining and immunocytochemistry.


RESULTS
Sputum eosinophils were on the whole higher in both asthma and rhinitis compared to controls (p<0.001, p=0.003). The rise of eosinophils during pollen season compared with values out of pollen season was significant in asthma (classical staining) (p=0.014) and slightly apparent in rhinitis (immunocytochemistry) (p=0.073). The seasonal rise of sputum ECP was observed only in rhinitis (p=0.006).


CONCLUSIONS
Inflammation of the lower airway in patients with allergic rhinitis with and without asthma has been confirmed by means of both sputum eosinophil count and sputum ECP level. Persistent inflammation of lower airway in periods without allergen exposure was proven in seasonal asthma. This may have implications for the therapy of seasonal allergic rhinitis with and without asthma in terms of promoting long-term anti-inflammatory treatment.
Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University Prague, Czech Republic. Electronic address: panzner@fnplzen.cz.
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Panzner
Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University Prague, Czech Republic.
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Malkusová
Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University Prague, Czech Republic.
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Vachová
Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University Prague, Czech Republic.
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Liška
Department of Dermatology, Faculty of Medicine in Pilsen, Charles University Prague, Czech Republic.
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P
Brodská
Department of Respiratory Medicine, Faculty of Medicine in Pilsen, Charles University Prague, Czech Republic.
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Růžičková
National Institute of Public Health, Prague, Czech Republic.
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M
Malý
D000328:Adult; D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000150:complications / Q000276:immunology*; D001991:Bronchitis / Q000209:etiology / Q000276:immunology*; D004781:Environmental Exposure / Q000009:adverse effects; D004804:Eosinophils / Q000276:immunology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011058:Pollen / Q000276:immunology; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000276:immunology*; D012621:Seasons; D013183:Sputum / Q000276:immunology; D055815:Young Adult
D000485:Allergens
Allergic rhinitis; Asthma; Induced sputum; Pollen allergy