Allergen-induced Specific and Non-specific Nasal Reactions Reciprocal Relationship and Inhibition by Topical Glucocorticosteroids

Abstract

The correlation between allergen-induced specific and non-specific (histamine) nasal reactions was studied, especially as regards topical glucocorticosteroid effects on the non-specific reactions. Thirteen patients with strictly seasonal allergic rhinitis participated. A nasal challenge with histamine and three increasing doses of allergen was performed on the first day. The patients were rechallenged 24 h later with the same histamine dose and the lowest allergen dose from the previous day. The same 2-day challenge was also performed after pretreatment for one week with budesonide in 8 of these patients. Symptom scores were recorded. The N-alpha-tosyl-l-arginine-methyl-esterase (TAME esterase) activity in nasal lavages was determined. The nasal symptoms and the TAME-esterase activity increased at rechallenge for both histamine and allergen, compared with the initial challenge. The mean (±SE) composite nasal symptom score after histamine increased from 3.5±0.49 to 4.9±0.35 (p<0.01) and after allergen from 1.62±0.3 to 3.2±0.5 (p<0.01) at rechallenge. Similar increases were recorded for the TAME-esterase activity. A close correlation between the allergen-induced increase in specific (allergen) and non-specific (histamine) reactivity was found (r=0.7, p<0.01, composite nasal symptom score). Treatment with topical glucocorticosteroids abolished the allergen-induced increase in both specific (p<0.001) and non-specific (histamine) p<0.01) nasal reactivity.

Key Words:

• allergen challenge
• allergic rhinitis
• histamine
• nasal lavage
• TAME-esterase