title: Aggravation of airway inflammation and hyper-responsiveness following nasal challenge with Dermatophagoides pteronyssinus in perennial allergic rhinitis without symptoms of asthma.
abstract: BACKGROUND
  House dust mites are the most prevalent allergen causing sensitizations in patients with rhinitis and asthma in China. We aimed to investigate the changes in both upper and lower airway inflammation and responsiveness following Dermatophagoides pteronyssinus (Der-p) nasal provocation test (NPT) in rhinitis patients.
  
  
  METHODS
  Study subjects included 15 nonasthmatic Der-p-sensitized rhinitis (AR) patients with airway hyper-responsiveness (AHR) (AR+AHR+), 15 AR patients without AHR (AR+AHR-), 15 healthy controls (HCs) with Der-p sensitization (HC+DP+), and 15 HC without Der-p sensitization (HC+DP-). All subjects underwent Der-p NPT. Visual analogue scale (VAS) scores of nasal symptoms, nasal lavage and nasal airway resistance (NAR) measurement, sputum induction, and forced expiratory volume in 1 second (FEV1 ) were performed. Airway responsiveness to histamine bronchoprovocation (PD20 -FEV1 ) and exhaled nitric oxide (FeNO) was determined.
  
  
  RESULTS
  NAR increased significantly in all subjects with the greatest effect seen in AR+AHR+ individuals. VAS increased in all subjects at 30 min and returned to baseline at 6 h, with significantly higher levels in AR+AHR+ and AR+AHR- subjects (P < 0.05). Eosinophils in nasal lavage fluid and sputum increased significantly after NPT in AR+AHR+ and AR+AHR- subjects (P < 0.001). FEV1 % and PD20 -FEV1 decreased and FeNO increased significantly after NPT only in AR+AHR+ subjects (P < 0.05). Nasal lavage eosinophil count was positively correlated with sputum eosinophil count and the level of FeNO and negatively correlated with FEV1 and PD20 .
  
  
  CONCLUSIONS
  House dust mite nasal provocation test induces and aggravates both upper and lower airway inflammation and hyper-responsiveness in patients with persistent allergic rhinitis without asthmatic symptoms.
authors.affiliation: State Key Laboratory of Respiratory Disease, Department of Allergy and Clinical Immunology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
authors.forename: W
authors.initials: W
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Respiratory Disease, Department of Allergy and Clinical Immunology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
authors.forename: M
authors.initials: M
authors.lastname: Xian
authors.affiliation: State Key Laboratory of Respiratory Disease, Department of Allergy and Clinical Immunology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Xie
authors.affiliation: State Key Laboratory of Respiratory Disease, Department of Allergy and Clinical Immunology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
authors.forename: J
authors.initials: J
authors.lastname: Zheng
authors.affiliation: State Key Laboratory of Respiratory Disease, Department of Allergy and Clinical Immunology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.|Guangdong Provincial Key Laboratory of Allergy & Clinical Immunology, Guangzhou Medical University, Guangzhou, China.
authors.forename: J
authors.initials: J
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000008:administration & dosage / Q000276:immunology*; D040002:Dermatophagoides pteronyssinus / Q000276:immunology*; D018450:Disease Progression; D004804:Eosinophils / Q000276:immunology / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000209:etiology*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D017817:Nasal Lavage Fluid; D009299:Nasal Provocation Tests; D009569:Nitric Oxide / Q000378:metabolism; D012129:Respiratory Function Tests; D012130:Respiratory Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D012221:Rhinitis, Allergic, Perennial / Q000150:complications* / Q000276:immunology*; D012882:Skin Tests; D013183:Sputum; D055815:Young Adult
chemical_list: D039741:Antigens, Dermatophagoides; D009569:Nitric Oxide
keywords: Dermatophagoides pteronyssinus; airway hyper-responsiveness; allergic rhinitis; eosinophils; nasal provocation test