title: Nasal histamine responses in nonallergic rhinitis with eosinophilic syndrome.
abstract: BACKGROUND
  Nonallergic rhinitis with eosinophilic syndrome (NARES) is persistent, without atopy, but with ≥25% nasal eosinophilia. Hypereosinophilia seems to contribute to nasal mucosa dysfunction.
  
  
  OBJECTIVE
  This analytical case-control study aimed at assessing the presence and severity of nonspecific nasal hyperactivity and at finding out whether eosinophilia may be correlated with the respiratory and mucociliary clearance functions.
  
  
  METHODS
  The symptom score was assessed in 38 patients and 15 controls whose nasal smear was also tested for eosinophils and mucociliary transport (MCT). Nonspecific nasal provocation tests (NSNPT) with histamine were also carried out, and total nasal resistance (TNR) was determined.
  
  
  RESULTS
  The symptom score of NARES after NSNPT were not significantly different from the control group, and there was poor or no correlation among the single symptoms and the differences studied for every nasal reactivity class. This correlation improved when using the composite symptom score. The most severe eosinophilia was observed in high reactivity groups, and it was correlated with an increase in TNR. MCT worsened as eosinophilia and nasal reactivity increased. Unlike controls, a significant correlation was observed between the increase in MCT and TNR.
  
  
  CONCLUSIONS
  In NARES, nonspecific nasal hyperreactivity is the result of epithelial damage produced by eosinophilic inflammation, which causes MCT slow down, an increase in TNR, and nasal reactivity classes, with possible impact on classification, prognosis, and treatment control.
authors: Rhinology and Immuno-Allergy Unit, Sense Organs Department, Otolaryngology Section, Rome "Umberto I" General Hospital, "La Sapienza" University, Rome, Italy.
authors: Giampietro
authors: G
authors: Zambetti
authors: Andrea
authors: A
authors: Ciofalo
authors: Raffaello
authors: R
authors: Romeo
authors: Pietro
authors: P
authors: Soldo
authors: Massimo
authors: M
authors: Fusconi
authors: Antonio
authors: A
authors: Greco
authors: Giuseppe
authors: G
authors: Magliulo
authors: Marco
authors: M
authors: de Vincentiis