Nasal Obstruction is the Key Symptom in Hay Fever Patients

2005 ◽  
Vol 133 (3) ◽  
pp. 429-435 ◽  
Author(s):  
Giorgio Ciprandi ◽  
Cirillo Cirillo ◽  
Catherine Klersy ◽  
Gian Luigi Marseglia ◽  
Davide Caimmi ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Symptom Score ◽  
Nasal Obstruction ◽  
Pollen Season ◽  
Allergic Inflammation ◽  
Hay Fever ◽  
Nasal Airflow ◽  
Bronchial Challenge ◽  
Severe Grade

BACKGROUND: Allergic rhinitis is characterized by a Th2-dependent inflammation. Nasal obstruction largely depends on allergic inflammation. OBJECTIVE: The aim of this study was to evaluate the possible role of the symptom nasal obstruction in assessing patients with hay fever. METHODS: Fifty patients (mean age, 23.7 ± 4.9 years) with hay fever were evaluated both during and outside pollen season. All of them had moderate-severe grade of nasal obstruction. Total symptom score (TSS), rhinomanometry, nasal lavage, nasal scraping, spirometry, and methacholine bronchial challenge were performed in all subjects. RESULTS: During the pollen season, patients with severe nasal obstruction showed significantly higher values of TSS, IL-4, IL-5, IL-8, nasal eosinophils and neutrophils, and significantly lower values of nasal airflow, IFNγ, FEV1, FVC, and FEF 25-75 in comparison with patients with moderate nasal obstruction. Twenty (83%) patients with severe nasal obstruction showed bronchial hyperreactivity (BHR), whereas only 6 (25%) patients with moderate nasal obstruction had BHR. Outside the pollen season overlapping results were observed. CONCLUSIONS: This study provides evidence about the key role played by nasal obstruction in assessing patients with allergic rhinitis.

Nasal Obstruction in Patients with Seasonal Allergic Rhinitis: Relationships between Allergic Inflammation and Nasal Airflow

2004 ◽  
Vol 134 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Giorgio Ciprandi ◽  
Ignazio Cirillo ◽  
Andrea Vizzaccaro ◽  
Manlio Milanese ◽  
Maria Angela Tosca
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Obstruction ◽  
Seasonal Allergic Rhinitis ◽  
Allergic Inflammation ◽  
Nasal Airflow

Cytokines and Adhesion Molecules in Allergic Rhinitis

1998 ◽  
Vol 12 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Claus Bachert ◽  
Martin Wagenmann ◽  
Gabriele Holtappels
Keyword(s):  
T Cells ◽  
Allergic Rhinitis ◽  
Adhesion Molecules ◽  
Current Knowledge ◽  
Allergic Inflammation ◽  
Allergen Challenge ◽  
Activated T Cells ◽  
Viral Rhinitis

This review summarizes our current knowledge of nasal allergic inflammation based on studies of cytokines, chemokines, and adhesion molecules in allergic rhinitis. The article also includes some aspects of viral rhinitis. Due to artificial or natural allergen exposure, an increase in the number of eosinophils and basophils, mast cells, IgE-positive cells, macrophages, monocyte-like cells, Langerhans cells, and activated T-cells can be observed within the mucosa and on the mucosal surface. Mediators are known to be released in response to allergens, but do not seem to be adequate to initiate the cell recruitment. After antigen challenge, the release of proinflammatory and regulatory cytokines could be demonstrated, and TH2-type cytokine mRNA upregulation in allergic mucosa has been shown. Proinflammatory cytokines initiate an adhesion cascade and activate T-cells that create an “atopic” cytokine environment within the tissue, which also may be linked to the long-term selective recruitment of eosinophils. However, the acute selective migration of eosinophils after allergen challenge is not fully understood, nor is the role of chemokines in allergic and viral rhinitis. Allergic rhinitis clearly represents an inflammatory reaction.

scholarly journals Histology-Based Blood Leukocyte Profiling Reveals Parallel Th2 and Th17 Signatures in Seasonal Allergic Rhinitis

2020 ◽  
Author(s):  
Premkumar Siddhuraj ◽  
Franziska U Nordström ◽  
Prajakta Jogdand ◽  
Gayathri Elongovan ◽  
Michiko Mori ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Pollen Season ◽  
Immune Cell ◽  
Ex Vivo ◽  
Birch Pollen ◽  
Allergic Inflammation ◽  
Immune Alterations ◽  
Positive Method ◽  
Blood Leukocyte ◽  
Feasibility Test

Abstract Background : Allergic rhinitis (AR) is one of the most common medical conditions in the westernized world. Recent data suggest AR to be far more immunologically complex than the archetypical allergic Th2-driven eosinophilic inflammation and new methodological approaches are needed to decode this complexity. Methods : This study explores a novel histology-based analysis of circulating leukocytes for detailed profiling of immune cells using routine clinical blood samples. In brief, leukocytes were purified with minimal ex-vivo artefacts, embedded into agarose-paraffin pellets and sectioned for cutting-edge immunohistochemistry-based immune cell profiling. Blood leukocyte mapping was performed in 16 patients with seasonal AR outside and during the birch pollen season. Results : Our methodological feasibility test confirmed that the > 5000 cross sectioned leukocytes typically present in a pellet section had well preserved morphology and cell marker epitopes, allowing for robust quantitative analysis of immune-stained slides. Blood leukocyte samples collected during the allergen season had statistically higher levels of markers for eosinophils, neutrophils, monocytes and CD8 lymphocytes compared to the off-season baseline. No change was observed for CD20 B-lymphocytes, total CD3 T cells and basophils. Subclassification of CD4+ T-helper cells demonstrated a parallel and significant expansion of Th2 and Th17 cells during the pollen season, while Th1 cells remained unchanged. Whereas absolute basophils numbers were unaltered, a significant increase of the basophil markers GATA2 and CPA3 was observed during the pollen season. Conclusions: Apart from representing a positive method feasibility validation, our study provides further evidence of complex and parallel Th2 and Th17 immune signatures in seasonal AR. Our data also forward GATA2 and basophil CPA3 as potential biomarkers for ongoing allergic inflammation. It is thus proposed that the present histology-based approach, with its broad applicability, represents a powerful tool for decoding systemic immune alterations and guide novel biomarker strategies for improved personalized medication.

Role of hematopoietic prostaglandin D synthase in biphasic nasal obstruction in guinea pig model of experimental allergic rhinitis

2011 ◽  
Vol 667 (1-3) ◽  
pp. 389-395 ◽  
Author(s):  
Daisuke Kajiwara ◽  
Hiroki Aoyagi ◽  
Kazuhiko Shigeno ◽  
Michinori Togawa ◽  
Katsunao Tanaka ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Guinea Pig ◽  
Nasal Obstruction ◽  
Pig Model ◽  
Prostaglandin D Synthase ◽  
Guinea Pig Model ◽  
Experimental Allergic

scholarly journals Nasal hyperreactivity and inflammation in allergic rhinitis

1996 ◽  
Vol 5 (2) ◽  
pp. 79-94 ◽  
Author(s):  
I. M. Garrelds ◽  
C. de Graaf-in't Veld ◽  
R. Gerth van Wijk ◽  
F. J. Zijlstra
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Manifestations ◽  
Allergic Inflammation ◽  
Inflammatory Cells ◽  
Hay Fever ◽  
Effector Cells ◽  
Plasma Exudation ◽  
History Of ◽  
Definition Of ◽  
Antigen Presenting

The history of allergic disease goes back to 1819, when Bostock described his own ‘periodical affection of the eyes and chest’, which he called ‘summer catarrh’. Since they thought it was produced by the effluvium of new hay, this condition was also called hay fever. Later, in 1873, Blackley established that pollen played an important role in the causation of hay fever. Nowadays, the definition of allergy is ‘An untoward physiologic event mediated by a variety of different immunologic reactions’. In this review, the term allergy will be restricted to the IgE-dependent reactions. The most important clinical manifestations of IgE-dependent reactions are allergic conjunctivitis, allergic rhinitis, allergic asthma and atopic dermatitis. However, this review will be restricted to allergic rhinitis. The histopathological features of allergic inflammation involve an increase in blood flow and vascular permeability, leading to plasma exudation and the formation of oedema. In addition, a cascade of events occurs which involves a variety of inflammatory cells. These inflammatory cells migrate under the influence of chemotactic agents to the site of injury and induce the process of repair. Several types of inflammatory cells have been implicated in the pathogenesis of allergic rhinitis. After specific or nonspecific stimuli, inflammatory mediators are generated from cells normally found in the nose, such as mast cells, antigen-presenting cells and epithelial cells (primary effector cells) and from cells recruited into the nose, such as basophils, eosinophils, lymphocytes, platelets and neutrophils (secondary effector cells). This review describes the identification of each of the inflammatory cells and their mediators which play a role in the perennial allergic processes in the nose of rhinitis patients.

Relationships between allergic inflammation and nasal airflow in children with seasonal allergic rhinitis

2005 ◽  
Vol 94 (2) ◽  
pp. 258-261 ◽  
Author(s):  
Giorgio Ciprandi ◽  
Maria A. Tosca ◽  
Gian Luigi Marseglia ◽  
Catherine Klersy
Keyword(s):  
Allergic Rhinitis ◽  
Seasonal Allergic Rhinitis ◽  
Allergic Inflammation ◽  
Nasal Airflow

Antihistamines as Allergy Drugs

2014 ◽  
Author(s):  
Jie Jack Li
Keyword(s):  
United States ◽  
Allergic Rhinitis ◽  
Immune System ◽  
Pollen Season ◽  
The United States ◽  
Hay Fever ◽  
Food Allergies ◽  
The United Kingdom ◽  
Ancient Times ◽  
Common Illnesses

Most blockbusters have at least one thing in common—they are all widely prescribed to treat common illnesses such as hypertension, high cholesterol, pain, ulcers, and depression. Allergies are another malady that afflicts more and more Americans. To many, allergies are no longer an inconvenience but a major annoyance with constant sneezing and itching. For them, an allergy medicine is often needed to relieve the symptoms. As a consequence, many antihistamine allergy drugs, especially nonsedating antihistamines, have become blockbuster drugs. Allergies are the sixth leading cause of chronic illness in the United States. More than 50 million Americans have allergies and spend in excess of $18 billion a year on medical treatment. The word allergy was coined by Austrian pediatrician Clemens von Pirquet in 1906. According to his definition, allergy was manifest in cases of serum sickness, hay fever, sensitivities to mosquito bites and beestings, and various idiosyncratic food reactions, as well as in individuals who had been exposed to, or successfully immunized against, common infectious diseases such as diphtheria and tuberculosis. Today, the word allergy is broadly associated with allergic rhinitis, asthma, hay fever, and food allergies. Allergies are the malady of civilization. In ancient times, allergies like hay fever and food allergies were virtually nonexistent. The first report of a case of allergy did not appear until the 1870s in Europe. The beginning of the 20th century saw a sharp rise in allergies. Nowadays, hay fever is so prevalent in the United Kingdom, that there are 1.4 to 1.8 million students who are drowsy from taking antihistamines. U.K. educational authorities even schedule the exams away from the peak of pollen season. In the United States, hay fever is the number-one chronic disease. Until we learn how to turn off the genes responsible for hay fever and asthma, these afflictions will remain among the most irritating of our existence. During evolution, humans developed the immune system to fight the real danger of foreign invaders like bacteria and viruses. It turns out that the human body has two types of responses toward tissue damage or infection.

Role of spirometry in detection of nasal obstruction

2013 ◽  
Vol 127 (3) ◽  
pp. 271-273 ◽  
Author(s):  
M Farhadi ◽  
H Ghanbari ◽  
F Izadi ◽  
E Amintehran ◽  
M S Eikani ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Quantitative Measurement ◽  
Airflow Obstruction ◽  
Upper Airway ◽  
Subjective Feeling ◽  
Common Symptom ◽  
Nasal Airflow ◽  
Physiological Evaluation ◽  
Definite Correlation

AbstractBackground:A subjective feeling of nasal airflow obstruction is a common symptom. An objective method for quantitative measurement of nasal airflow has long been desired. Rhinomanometry and acoustic rhinometry have been developed for anatomical and physiological evaluation of nasal obstruction. This study was designed to determine the usefulness of a portable spirometer in assessing upper airway obstruction.Methods:One hundred and ninety-six patients were assessed with nasal inspiratory spirometry to determine nasal airflow. All patients also underwent paranasal sinus computed tomography to determine anatomical abnormalities. Spirometry was performed on each nostril separately.Results:Sensitivity and specificity levels were high. This portable and easy to use device may be useful in respiratory assessment. Correlation between anatomical obstructions and subjects' complaints was statistically significant (p < 0.001), but no definite correlation between septal deviation severity and spirometric values was found.Conclusion:Portable spirometry is an objective and useful method of evaluating nasal obstruction, but needs more investigation to establish a standardised test.

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