Quantitative cytology was performed in nasal secretions of normal control (NC), seasonal allergic rhinitis in season (SAR), perennial allergic rhinitis (PAR), chronic sinusitis with mucoid secretion (MS), and chronic sinusitis with mucopurulent secretion (MPS). The majority of inflammatory cells were neutrophils in NC, MS, and MPS; the majority were eosinophils in SAR and PAR. The concomitant appearance of inflammatory cells in nasal secretions was found, i.e., there were significant correlations between neutrophil and eosinophil counts in MPS, and between eosinophil and basophil counts in SAR. The eosinophil/neutrophil ratio was more than 0.1 in SAR and PAR, but the ratio was less than 0.1 in all NC, all MPS, and in 93% of MS; this indicates that 0.1 in eosinophil/neutrophil ratio is the critical value between allergic and nonallergic nasal diseases.

To explore the dynamics of the cellular response to natural allergen exposure, the authors of this study performed quantitative cytology in both the nasal secretions and nasal scrapings of 16 normal control subjects and 23 Japanese cedar pollinosis patients before and during the pollen season. In nasal scrapings, the number of metachromatic cells increased significantly during the pollen season, although there was no significant difference between the normal subjects and the preseason pollinosis patients. The cell differential count in the patients with pollinosis showed that lymphocytes were predominant in scrapings; however, the majority of inflammatory cells in the nasal secretions were neutrophils before the season and eosinophils during the season. The study findings suggest that the appearance of metachromatic cells in nasal scrapings is specific to the pollen exposure and that the cytology in nasal secretions is significantly different from that in nasal scrapings.

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