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PubMed2002

Airway responsiveness to inhaled acetaldehyde in subjects with allergic rhinitis: relationship to methacholine responsiveness.

BACKGROUND: Asthmatic subjects have an exaggerated airway response to inhaled acetaldehyde, but no information is available on airway responsiveness to this bronchoconstrictor agent in subjects with allergic rhinitis. OBJECTIVE: The aim of this study was to determine the effect of inhaled acetaldehyde on lung function in nonasthmatic subjects with allergic rhinitis. METHODS: A total of 78 adults (43 subjects with allergic rhinitis, 16 asthmatics and 19 healthy subjects) were challenged with increased concentrations of acetaldehyde and methacholine. The response to each bronchoconstrictor agent was measured by the provocative concentration required to produce a 20% fall in FEV(1) (PC(20)). RESULTS: The geometric mean PC(20) acetaldehyde value for asthmatics was 35.5 mg/ml compared with 67.6 mg/ml in subjects with allergic rhinitis and with 80.0 mg/ml in healthy subjects (p < 0.001). The PC(20) acetaldehyde values in the allergic rhinitis group were also significantly lower than in the healthy control group (p = 0.04). All of the subjects with allergic rhinitis and increased responsiveness to acetaldehyde showed airway hyperresponsiveness to methacholine, but 9 patients with hyperresponsiveness to methacholine failed to respond to acetaldehyde. CONCLUSIONS: We conclude that subjects with allergic rhinitis are less responsive to inhaled acetaldehyde than asthmatic subjects, but more than healthy controls. Furthermore, only approximately half the patients with allergic rhinitis and airway hyperresponsiveness to methacholine exhibit bronchoconstriction with inhaled acetaldehyde, thus suggesting that airway hyperresponsiveness to methacholine may not be the sole factor leading to bronchoconstriction in response to acetaldehyde.

Acetaldehyde↗
PubMed2001

Asthma, rhinitis, and skin test reactivity to aeroallergens in families of asthmatic subjects in Anqing, China.

In industrialized countries with a Western lifestyle, sensitization to perennial aeroallergens is strongly associated with asthma, whereas sensitization to seasonal aeroallergens is closely related to allergic rhinitis. Little is known, however, about the relation between skin test reactivity to aeroallergens and either asthma or rhinitis in mainland China. We studied 10,009 members of 2,544 families in Anqing (China) that were selected on the basis of physician-diagnosed asthma in at least two siblings. Generalized estimating equations were employed to study the association between skin test reactivity to aeroallergens and either asthma or rhinitis. After adjustment for age, sex, intensity of smoking, skin test reactivity to other aeroallergens, and household correlations, sensitization to dust mite was an independent predictor of both asthma (OR = 1.3, 95% CI = 1.1 to 1.5, p = 0.008) and rhinitis (OR = 1.3, 95% CI = 1.0 to 1.8, p = 0.04). Sensitization to mold was significantly associated with asthma (OR = 1.6, 95% CI = 1.1 to 2.3, p = 0.008), and sensitization to silk was an independent predictor of rhinitis (OR = 1.5, 95% CI = 1.1 to 2.2, p = 0.02). Although 46.9% of the study participants were sensitized to at least one allergen, only 3.5% of study subjects reported nasal symptoms consistent with rhinitis. Among asthmatic subjects, 6.2% reported nasal symptoms. Whereas sensitization to perennial aeroallergens was associated with asthma among families of asthmatic subjects in rural China, sensitization to silk was the strongest predictor of rhinitis in this population. Our findings also suggest that allergic rhinitis is far less common among asthmatic subjects in rural China than in asthmatic subjects in industrialized countries with a Western lifestyle.

Adolescent↗
PubMed2002

Exhaled nitric oxide and bronchial responsiveness to adenosine 5'-monophosphate in subjects with allergic rhinitis.

STUDY OBJECTIVES: To determine differences in exhaled nitric oxide (ENO) between subjects with allergic rhinitis with and without increased responsiveness to direct and indirect bronchoconstrictor agents. STUDY DESIGN: Cross-sectional study with the order of challenge tests randomized. SETTING: Specialist allergy unit in a university hospital. PATIENTS: Thirty-eight subjects without asthma with allergic rhinitis and 10 healthy nonatopic control subjects. MEASUREMENTS AND RESULTS: Participants were challenged with increasing concentrations of adenosine 5'monophosphate (AMP) and methacholine. ENO was measured with the single-exhalation method. A positive response to both bronchoconstrictor agents was detected in nine subjects with allergic rhinitis, whereas four subjects showed increased responsiveness to AMP but not to methacholine. The geometric mean (range) ENO values were significantly higher in subjects with allergic rhinitis with increased responsiveness to either methacholine or AMP than in subjects with normal responsiveness to both agonists: 51.3 parts per billion (ppb) [22.0 to 108.5 ppb] vs 25.1 ppb (5.7 to 102.9 ppb, respectively; p = 0.007) and healthy control subjects (11.2 ppb [5.0 to 31.9 ppb], p < 0.001). Subjects with allergic rhinitis with normal responsiveness to both agonists also had higher concentrations of ENO than healthy control subjects (p = 0.007). No correlation was found between ENO and either of the provocative concentrations of methacholine or AMP causing a 20% fall in FEV(1). CONCLUSIONS: In subjects without asthma but with allergic rhinitis, the presence of bronchoconstriction in response to methacholine or AMP is associated with increased ENO concentrations. However, elevated concentrations of ENO are detected even in subjects with allergic rhinitis without airway hyperresponsiveness. These results suggest that the presence of airway hyperresponsiveness is not the only factor that determines the increased NO levels detected in subjects with allergic rhinitis.

Adenosine Monophosphate↗
PubMed2004

Etiopathogenesis and management of perennial allergic rhinitis: a state-of-the-art review.

Perennial allergic rhinitis is an inflammatory disorder characterized by symptoms of nasal congestion, rhinorrhea, sneezing, and itching. The prevalence of allergic rhinitis is quite common and affects 20% or more of various populations. Some patients with allergic rhinitis are symptomatic only during the pollen season, while many others are allergic to multiple allergens including indoor allergens such as house dust mites, animal dander, cockroaches, and fungi, which lead to perennial symptoms. Immunoglobulin (Ig)-E is the proximate cause of perennial allergic rhinitis. Circulating IgE antibodies bind to the high affinity IgE receptor on mast cells and basophils. IgE antibodies, bound to the receptors crosslinked by allergen, initiate the secretion of inflammatory mediators including histamine, leukotrienes, and cytokines. These mediators can induce both acute and chronic changes that result in symptoms of allergy. Many therapies are approved for the treatment of allergic rhinitis including intranasal corticosteroids, antihistamines with or without decongestants, and nasal cromolyn sodium (sodium cromoglicate). Allergen avoidance is the mainstay of therapy for many patients but is not always practical. For those patients who have not responded to appropriate medications, allergen specific immunotherapy may also be effective.A number of studies with omalizumab have shown that it is effective in the treatment of seasonal allergic rhinitis induced by pollen such as ragweed and birch pollen. Omalizumab is a molecularly cloned humanized monoclonal antibody inhibiting human IgE. It binds specifically to the region of the IgE molecule that binds to the IgE receptor on the mast cell or basophils. Because omalizumab cannot bind IgE molecules that are already bound to the surface receptors on mast cells and basophils, it does not stimulate secretion of mediators from these cells. Omalizumab does not appear to stimulate an immune response against itself. It rapidly reduces free serum IgE levels by over 95% when administered at therapeutic doses and also results in the reduction of IgE receptors on mast cells and basophils. The combined effects of reduction of both free IgE in serum and the receptor density on the mast cells or basophils results in decreased allergen-stimulated mediator release. Preliminary studies in the treatment of perennial allergic rhinitis supports omalizumab's efficacy and safety. The compound has been well tolerated. Aside from urticarial reactions, adverse effects appear to be minimal. Omalizumab is the first of several new immune-based specifically targeted molecules that may prove to be extremely valuable in the treatment of perennial allergic rhinitis, as it is often unresponsive to traditional therapies.

Antibodies, Anti-Idiotypic↗
PubMedDate not supplied

The effects of different levels of air pollution on atopy and symptoms of allergic rhinitis.

We evaluated the prevalence of symptoms of allergic rhinitis and atopy among two groups living in areas with different pollution levels. The study was conducted among high school students living in Bayrampaşa (polluted by SO2 and TSP) and Beykoz (unpolluted, residential area) in Istanbul (n = 386). Each subject filled out a standardized self-administered questionnaire. Atopic status was evaluated by skin-prick testing using eight different allergens. Also, anterior active rhinomanometry was performed to evaluate the symptoms objectively. Significantly higher prevalence rates for symptoms of allergic rhinitis were found in Bayrampaşa (22.8%) compared to Beykoz (6%). However, no significant difference was found for atopic status among the two groups. When we evaluated the atopic status of subjects with symptoms of allergic rhinitis between the two areas, the prevalence of atopic students was found to be relatively higher in the unpolluted area (BZ). This difference was not statistically significant. Within the atopic population, subjects complaining of symptoms of allergic rhinitis were significantly more frequent in the polluted area (BP), suggesting that air pollution causes an increase in symptoms of allergic rhinitis in the atopic population, but this is not significantly higher than the increase in symptoms of allergic rhinitis of the total study group. Our results suggest that pollutants exert irritant effects on mucous membranes of the population in general rather than aggrevating symptoms in predisposed individuals. Smoking was more frequent in the unpolluted area. Exposure to parental smoking in childhood and heating systems in houses were evenly distributed. Household crowding was lower in Beykoz. Rhinomanometric measurements among the two groups did not show significant difference. Multiple logistic regression models estimating the role of each risk factor independently showed significant odds ratio associated with residence in Bayrampaşa for symptoms of allergic rhinitis (OR = 4.6, 95% CI = 9.0-2.3). In conclusion, this study suggests that outdoor pollution has adverse effects on the symptoms of allergic rhinitis, while it has no effect on the prevalence of atopy in Istanbul in the 1990s.

Adolescent↗
PubMed1999

Economic outcomes of a targeted intervention program: the costs of treating allergic rhinitis patients.

OBJECTIVES: To determine the annual costs of treating allergic rhinitis patients in a managed care environment and to assess the effect of a treatment intervention program on direct and indirect costs. DESIGN: Two arms of an economics study were designed to calculate annual costs of treating allergic rhinitis in Lovelace Health Systems. Direct and indirect costs were also reviewed for patients participating in an intervention program designed to improve patient outcomes during the 1996 fall allergy season. PATIENTS AND METHODS: Annual medical costs of treating allergic rhinitis within the Lovelace system were reviewed using a patient database. A total of 7936 patients with allergic rhinitis symptoms were identified in the database using a case-finding algorithm. An equal number of patients without allergy conditions were selected for the comparison group. In addition to calculating annual costs of treating allergic rhinitis, direct and indirect costs were reviewed for patients participating in a rhinitis intervention program to determine differences in cost between the treatment and control groups. An intervention group of 247 patients was selected to receive care at clinics randomized to use practice guidelines to improve treatment, while 255 patients were treated in the control group clinics, which did not alter treatment practices. RESULTS: Annual expenditures were nearly $2 million more for the allergic rhinitis group than for the control group. In the intervention study, treatment and control groups expended the same in direct costs, but the intervention group showed a trend toward decreased indirect costs. CONCLUSION: Costs of allergic rhinitis are not trivial to a managed care organization; a specifically designed intervention program shows potential for minimizing the costs associated with the ailment.

Anti-Allergic Agents↗
PubMed2002

[Rhinitis in patients with cystic fibrosis].

The author presents material of 110 cystic fibrosis patients, 81 with typical clinical features and 29 with atypical phenotype. Based on clinical examination and nasal cytological smears infective chronic nonspecific rhinitis (n = 80), infective acute rhinitis (n = 16), perennial allergic rhinitis (n = 4), nonalergic rhinitis with eosinophilia (n = 2), and moreover 19 patients with nasal polyposis, and 8 patients without nasal symptoms were distinguished. Infective chronic nonspecific rhinitis and infective acute rhinitis were present in typical and atypical cystic fibrosis patients with similar frequency but in patients with atypical phenotype perennial allergic rhinitis and nonalergic rhinitis with eosinophilia were observed more frequently. Nasal polyposis was associated with typical cystic fibrosis phenotype, and with two "severe" mutations.

Cystic Fibrosis↗
PubMed2002

[Does the presence of a pet at home influence the prevalence of asthma and rhinitis?].

INTRODUCTION: Recent epidemiological studies have shown an increase in the prevalence of asthma and allergic diseases. Among aetiological factors, the domestic environment and, in particular, pet ownership may be a part of it. The relationship between severity of asthma and pets is still unclear. The aim of this study was to evaluate the relationship of asthma and rhinitis prevalence in teenagers with pet ownership. PATIENTS AND METHODS: ISAAC I studied 3,303 teenagers (13-14 years old) in Bordeaux in 1994. They completed a written questionnaire about asthma, rhinitis, eczema and their domestic environment. Four groups (asthmatics, asthmatics with rhinitis, teenagers with only rhinitis and a control group without asthma and rhinitis) were studied. RESULTS: 4.6% had only asthma. 43.2% had only rhinitis. 10.3% had asthma and rhinitis, 41.7% had no allergic disease. 34.9% kept a cat and 79.4% allowed the cat to go inside. No difference was found between the four groups with regard cat, dog, bird or other pet ownership irrespective if the pet was kept in-doors or out doors. The prevalence of previous asthma was 45.8% and 50.3% for current asthma. No difference was found between the severity of asthma and pet ownership. CONCLUSIONS: This is an epidemiological study based on a written questionnaire. Furthermore there is no data on the presence of pets during the first year of life. However, our results suggest that pet ownership amongst asthma and rhinitis sufferers is not different to that in the group without allergic disease.

Adolescent↗
PubMed1999

[The effect of granule-rhinitis on allergic nasal mucosa].

OBJECTIVE: To investigate the effect of granule-rhinitis on allergic rhinitis. METHOD: Experimental guinea pigs with allergic rhinitis were treated with granule-rhinitis. During the total course of treatment, sneezing and nasal itching were observed and recorded and then compared quantitatively with those of the control groups. Histological changes of the nasal mucosa were observed. RESULT: The various symptoms of allergic rhinitis were obviously relieved in the treatment group. Granule-rhinitis reduced inflammatory cell infiltration, particularly decreased the number of mast cells and eosinophils in the superficial layers of the nasal mucosa, and reduced the release of mediators from mast cells. It diminished the vasodilatation in nasal mucosa. CONCLUSION: Granule-rhinitis is effective in the treatment of allergic rhinitis.

Animals↗
PubMed2003

[Nonspecific bronchial hyperreactivity in asthma patients with or without allergic rhinitis].

UNLABELLED: Bronchial hyperresponsiveness is the main pathophysiological feature of asthma. Eosinophilic inflammation of airway is one of main factors influencing bronchial hyperresponsiveness. The aim of the study was to evaluate bronchial responsiveness to methacholine and exercise of asthma patients with or without allergic rhinitis and to estimate relations between eosinophil count in nasal secretion and non-specific bronchial hyperresponsiveness. Ninety eight patients with mild or moderate asthma were examined. Seventy eight patients had mild allergic rhinitis. Patients were divided in two groups: asthma with rhinitis group (n=78) and asthma group (n=20). Bronchial responsiveness was tested with methacholine and exercise challenges. Allergic status was determined by skin prick tests, mean wheal size and eosinophil count in the blood and nasal secretion. Atopy was more frequent (p=0.001) and mean wheal size larger (p=0.002) in asthma with rhinitis group. No difference estimated on blood eosinophil count (p=0.125) between both groups. Nasal eosinophil count was higher in asthma with rhinitis group comparing with asthma group (p=0.001). Methacholine provocative dose (PD(20)) was lower and the slope of the dose-response curve higher in asthma with rhinitis group, but not statistically significantly: PD(20) 173.0+/-27.0 microg and 212.1+/-52.9 microg, accordingly, p=0.179; the slope of the dose-response curve - 23.6+/-1.6 and 20.7+/-2.5, p=0.219. Exercise-induce bronchoconstriction developed equally: to 46% patients (n=36) from asthma with rhinitis group and 45% patients (n=9) asthma group. No significant differences were found between maximal fall of FEV(1)after exercise (DeltaFEV (1)): 24.2+/-2.3% and 25.9+/-4.0%, accordingly, p=0,744; area under the curve (AUC(0-30)): 451.6 +/- 48.9 % x sec. and 484.0+/-111.0% x sec., p=0.777. No statistical significant correlations were evaluated between nasal eosinophilia and PD(20), the slope of the dose-response curve, DeltaFEV(1) and AUC(0-30). CONCLUSIONS: No significant differences were estimated on bronchial responsiveness to methacholine and exercise between asthma patients with or without allergic rhinitis. Eosinophil count in nasal secretion did not correlate with non-specific bronchial hyperresponsiveness.

Adult↗
PubMedDate not supplied

Important aspects in management of allergic rhinitis: compliance, cost, and quality of life.

Allergic rhinitis is a highly prevalent, chronic condition. Physicians trained in the care of patients with allergic rhinitis focus on the main management points, which include environmental control, appropriate pharmacologic treatment, and allergen immunotherapy. There are other important aspects in caring for patients with allergic rhinitis that are equally important in achieving the best outcomes for sufferers of allergic rhinitis. Compliance is essential in getting optimal medical management. Issues such as failure to take and improper use of medications as prescribed can lead to dissatisfaction in controlling symptoms. Cost issues must be addressed in management. This condition extracts a high indirect cost due to work absenteeism and school absence. Cost-effective management is fundamental in the proper care of allergic rhinitis. Last, quality of life issues should be considered in the care of the patient with allergic rhinitis. In allergy-specific questionnaires, subjects with allergic rhinitis consistently report lower quality of life than nonallergic controls. Untreated patients are embarrassed and frustrated by their allergy symptoms. Atopic individuals consistently exhibit significant declines in cognitive processing, psychomotor speed, verbal learning, and memory during allergy season. Physicians should consider compliance, cost, and quality of life issues in each and every patient with allergic rhinitis.

Health Care Costs↗
PubMed2004

Point prevalence of allergic rhinitis among Saudi children.

BACKGROUND: Study of allergic rhinitis (AR) has only recently started in Saudi Arabia. No estimate of the actual percent of the population suffering from AR, especially children, is available. OBJECTIVE: To study the prevalence of AR in children in the Kingdom of Saudi Arabia, the association with hearing impairment (HI) and bronchial asthma. METHODS: An epidemiological survey was carried out using a modified "International study of asthma and allergies in childhood" (ISAAC) questionnaire for rhinitis phase1. The children with allergic history were subjected to allergy work up. Ten thousand children were surveyed and the clinical history of rhinitis (sneezing, rhinorrhea, irritation, nasal blockage) during the past 12 months was recorded. In total, 9540 children with complete data were interviewed. Demographic characteristics including age, sex, parents' relation, and family history were noted and an Ear, Nose and Throat (ENT) examination and hearing screening was performed. RESULTS: We identified 2529 children with rhinitis (prevalence 26.51%), 25.66% of them with physician diagnosed asthma. Laboratory tests were performed on blood samples from 304 children. A skin prick test with relevant allergens was performed on those aged 6 to 15 years: 61.8% had positive results to one or more allergens, compared to 23.75% in a non-rhinitis control group. HI was found in 450 (17.8%) of the rhinitis group compared to 791 (12.7%) among the non-rhinitis group. CONCLUSIONS: Compared with previous studies in Saudi Arabia, this survey showed higher rates of allergic disease. HI was also found to be higher among rhinitis children. This could be attributed to environmental, social or genetic factors.

Allergens↗
PubMed2005

[Assessment of quality of life in allergic rhinitis patients with Chinese version of SF-36].

OBJECTIVE: To evaluate the quality of life on allergic rhinitis patients and to evaluate the applying of Chinese version of the SF-36 questionnaire on allergic rhinitis. METHOD: From May 2004 to Jul 2004,150 allergic rhinitis patients completed the symptoms questionnaire and quality of life by Chinese version of the SF-36, 100 health completed the Chinese version of the SF-36. The demographic characteristics of allergic rhinitis group and health group were compared. RESULT: (1) Compared with health group, decrements are most pronounced in general health, role-emotional and role-physical dimensions in mild allergic rhinitis patients; (2) compared with health group, there was a significant impairment in all QOL dimensions in patients with moderate to severe allergic rhinitis patients. Especially in general health, role-emotional and social function dimensions. CONCLUSION: The allergic rhinitis patients experience significant impair in QOL,the Chinese version of SF-36 Health Survey Scales may be a useful measurement of allergic rhinitis patients.

Adolescent↗
PubMed1978

[Contamination and age as factors in the pathogenesis of atrophic rhinitis (author's transl)].

The relationship between contamination with Bordetella bronchiseptica or Pasteurella multocida and the age of the piglets on the one hand and the pathogenesis of atrophic rhinitis on the other, is discussed. Minimal disease-free piglets born and reared on farms on which pigs affected with clinical atrophic rhinitis were present, developed clinical atrophic rhinitis at the age of six weeks. Piglets born in the Central Veterinary Institute (CVI) of sows from herds including pigs affected with atrophic rhinitis and reared under normal CVI conditions, did not develop clinical atrophic rhinitis. These sows are believed to be factors of minor importance in the pathogenesis of clinical atrophic rhinitis in piglets. When minimal disease-free piglets were contaminated during the third or fourth week of life, a slight degree of foreshortening of the upper jaw was observed in three out of nine pigs, the carcase weights of these animals not differing markedly from those of normal swine. When they were contaminated at the age of eight weeks, clinical atrophic rhinitis did not appear. It is essential that young piglets should be protected against atrophic rhinitis during the first few weeks of life.

Age Factors↗
PubMedDate not supplied

Nasal mucociliary clearance in perennial rhinitis.

Mucociliary clearance is one of the homeostatic systems of the respiratory mucosa. Alterations in mucociliary clearance have been extensively studied in asthma, but less frequently in allergic rhinitis. In rhinitis, conflicting results have arisen: while some authors reported no change, others noticed a reduction in nasal mucociliary clearance. The aim of this study was to compare the nasal mucociliary clearance in allergic and non-allergic patients with perennial rhinitis and a healthy control group. One hundred and three patients and 14 healthy control subjects were studied. Nasal mucociliary clearance was assayed with the saccharin test modified with a food dye to add a visual parameter. Patients were divided into allergic and non-allergic rhinitis according to the presence of three of the following factors: total serum IgE above 180 KIU/L, positive skin prick tests to a battery of standardized allergens relevant to Uruguay, family and personal history of atopic diseases, and blood eosinophilia above 450 cells/mm3. The aspect of the nasal mucosa was not considered for categorizing the patients. Fifty-seven patients (29 males, mean age: 22.2 years) with allergic perennial rhinitis and 46 patients (15 males, mean age: 24.8 years) with non-allergic perennial rhinitis were compared with 14 controls (6 males, mean age: 35 years). A significant difference in nasal mucociliary clearance was observed between the three groups, with a mean of 8.8 minutes for the controls, 10.27 minutes for allergic rhinitis and 11.73 minutes for non-allergic patients. We suggest that the differences we observed were due to changes in the rheology of nasal mucus as a consequence of the underlying inflammatory process in rhinitis.

Adult↗
PubMedDate not supplied

Light and electron microscope study in allergic rhinitis patients (ARP) with or without bronchial hyperreactivity (BHR).

Little is known about the pathogenesis of bronchial hyperreactivity associated with allergic rhinitis. For this purpose, bronchial biopsies and bronchoalveolar lavage from 6 allergic rhinitis patients with bronchial hyperreactivity, 5 allergic rhinitis patients without bronchial hyperreactivity and 3 healthy, normoreactive control subjects were obtained by fiberoptic bronchoscope and investigated with light and transmission electron microscope. Varying degrees of morphological alterations were observed in all groups; however, the intensity of the epithelial shedding, goblet cells, basement membrane thickness, stromal collagenous fibers and smooth muscle cells appeared to be increased in allergic rhinitis patients with bronchial hyperreactivity. In the mucosa and submucosa, the numbers and activation of lymphocytes, neutrophils and macrophages were lower in allergic rhinitis patients with bronchial hyperreactivity than in the control group and in allergic rhinitis patients without bronchial hyperreactivity. In accordance with these findings, bronchoalveolar lavage showed increased numbers of lymphocytes and surface alterations of phagocytic cells in allergic rhinitis patients without bronchial hyperreactivity. As a result, we could not find evidence of inflammation accompanying bronchial hyperreactivity in allergic rhinitis patients.

Adolescent↗
PubMed2004

Nasal mucosal immunoexpression of the mast cell chemoattractants TGF-beta, eotaxin, and stem cell factor and their receptors in allergic rhinitis.

BACKGROUND: Allergic rhinitis is characterized by the epithelial accumulation of cells, particularly mast cells and eosinophils. There is little information relating to the chemotaxins responsible for mast cell epithelial accumulation in this disease. OBJECTIVE: Expression of the mast cell chemoattractants TGF-beta, eotaxin, and stem cell factor and their receptors was investigated in tissue sections from biopsy specimens obtained from patients with naturally occurring allergic rhinitis. METHODS: Specific immunohistochemical staining was performed on thin sections of inferior turbinate biopsy specimens from patients with perennial and seasonal allergic rhinitis and, for comparison, from nonatopic and, where relevant, atopic healthy volunteers without rhinitis. Sequential staining of adjacent 2-microm sections was undertaken to colocalize TGF-beta receptors to mast cells. RESULTS: Evidence was found of significantly increased epithelial immunoreactivity for TGF-beta1, TGF-beta2, TGF-beta3, TGF-beta receptor I, TGF-beta receptor II, and TGF-beta receptor III in patients with perennial and seasonal allergic rhinitis compared with that seen in healthy control subjects. TGF-beta receptors I and II were found to colocalize to mast cells. Eotaxin epithelial immunoreactivity was significantly increased in the perennial group, although there were no corresponding disease-related differences found in relation to CCR-3 immunoreactivity at this site. There was no increase in stem cell factor immunoreactivity within the epithelium in naturally occurring disease. Significant correlations were found between epithelial immunoreactivity for TGF-beta1, TGF-beta2, TGF-beta receptor I, TGF-beta receptor II, and the number of epithelial mast cells. CONCLUSION: These findings of enhanced epithelial TGF-beta immunoreactivity in patients with rhinitis, the correlation with intraepithelial mast cell numbers, and the colocalization of TGF-beta receptors to mast cells suggest that the epithelial expression of TGF-beta might represent an important biologic process involved in either the recruitment or retention of mast cells within the epithelium in naturally occurring allergic rhinitis.

Adult↗
PubMed2006

Prevalence, classification and perception of allergic and nonallergic rhinitis in Belgium.

BACKGROUND: Allergic rhinitis (AR) and noninfectious, nonallergic rhinitis (NINA) are common disorders, which may prompt patients to seek medical help. METHODS: We performed a survey in a representative sample of the Belgian population (n=4959) with an overall prevalence of self-declared recent rhinitis symptoms of 39.3%. Detailed information on patients having experienced nasal symptoms over the past year was then obtained from a random sample of respondents (n=743). RESULTS: The adjusted prevalence was 29.8% for AR and 9.6% for NINA, respectively. According to the ARIA classification, there was significantly more 'persistent' symptomatology in the AR group (40.8%) than in NINA (23.5%) (P<0.001), and more 'moderate/severe' symptom intensity in AR (75.4%) than in NINA (53.1%) (P<0.001). Allergic rhinitis patients suffered from a greater number of symptoms than NINA patients (P<0.001). Asthma, skin and food allergy as co-morbidities were all found to be significantly more prevalent in the AR vs the NINA group (P<0.05 for all). The percentage of consulting patients (total: 66.8%), who subjectively perceived their rhinitis as moderate/severe, was 94.0%, whereas 75.6% of these patients were classified accordingly based on ARIA criteria. CONCLUSIONS: We found a high prevalence of self-declared rhinitis symptoms in the Belgian population, AR being about three times more prevalent than NINA. In addition, AR patients suffered from a greater number of symptoms and displayed a more 'persistent' and 'moderate-severe' ARIA profile than NINA. About 75% of patients seeking medical help suffer from 'moderate to severe' forms of rhinitis.

Adult↗