Aggravation of airway inflammation and hyper‐responsiveness following nasal challenge with <i>Dermatophagoides pteronyssinus</i> in perennial allergic rhinitis without symptoms of asthma

W, Wang; Xian, Ming; Xie, Yanqing; Zheng, Jinping; Li, J

doi:10.1111/all.12808

Cited by 21 publications

(18 citation statements)

References 31 publications

(29 reference statements)

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“… 36 37 38 In our previous work, we found that the nasal lavage eosinophil count correlated with sputum eosinophil count, FeNO, FEV1%, and PD 20 6 hours after NPT. 15 Similarly, in the current study, we found that sputum eosinophil count was significantly correlated with nasal lavage eosinophil count in non-AIT subjects both at baseline and after 6 hours of NPT. However, there was no correlation between upper and lower eosinophilic inflammation in AIT subjects at any AIT time point, regardless of whether measurements were taken before or after 6 hours of NPT.…”

Section: Discussionsupporting

confidence: 82%

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Effect of Dermatophagoides pteronyssinus Immunotherapy on Upper and Lower Airway Eosinophilic Inflammatory Response to Nasal Allergen Challenge

Huang

Qin

et al. 2020

Allergy Asthma Immunol Res

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Purpose It remains unknown whether allergen-specific immunotherapy (AIT) could attenuate airway inflammatory response triggered by allergen exposure. Methods We performed Dermatophagoides pteronyssinus ( Der-p ) nasal provocation tests (NPTs) in allergic rhinitis (AR) and/or asthma patients without AIT (non-AIT), or at 16, 52, 104, or 156 weeks after Der-p AIT. Rhinitis and asthma visual analog scale (VAS; VAS of nasal symptoms [VAS-NS], VAS of asthma symptoms), the rhinoconjunctivitis quality of life questionnaire (RQLQ), nasal lavage, sputum induction, fractional exhaled nitric oxide (FeNO), nasal airway resistance, pulmonary function, and airway hyperresponsiveness were performed before and after NPT. Results Non-AIT subjects demonstrated significantly higher VAS-NS before and after NPT compared to AIT subjects ( P < 0.05). NPT response was positive in 14 (100%) non-AIT, 7 (70%) 16 weeks-AIT, 6 (60%) 52 weeks-AIT, 6 (60%) 104 weeks-AIT, and 2 (20%) 156 weeks-AIT subjects. The NPT grade significantly correlated with AIT duration and baseline RQLQ score ( r = −0.561, P < 0.001 and r = 0.525, P < 0.001, respectively). Sputum and nasal lavage eosinophil count, and FeNO in non-AIT subjects were significantly increased 6 hours after NPT ( P < 0.05). AIT subjects did not change their sputum or nasal lavage eosinophil count before and after NPT. Subjects with 156 weeks-AIT demonstrated significantly lower levels of sputum and nasal lavage eosinophil count before and after NPT when compared with non-AIT patients ( P < 0.05). Sputum eosinophil counts positively correlated with nasal lavage eosinophil counts at baseline and 6 hours after NPT ( r = 0.719, P = 0.006 and r = 0.823, P < 0.001, respectively) in non-AIT patients. Conclusion Our results show that AIT can attenuate both upper and lower airway immune response to nasal allergen exposure in patients with AR and/or asthma.

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Section: Discussionsupporting

confidence: 82%

“… 14 We have previously reported that NPT can increase lower airway eosinophilic inflammation in AR patients without asthma symptoms. 15 Although it is reported that the nasal response to NPT is attenuated after AIT, it remains unknown whether it could decrease lower airway inflammation triggered by NPT.…”

Section: Introductionmentioning

confidence: 99%

Effect of Dermatophagoides pteronyssinus Immunotherapy on Upper and Lower Airway Eosinophilic Inflammatory Response to Nasal Allergen Challenge

Huang

Qin

et al. 2020

Allergy Asthma Immunol Res

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“…In patients with allergic rhinitis induced by mites, but without asthma, nasal provocation with the allergen produced a significant increase in blood, nasal secretions and induced sputum eosinophils, with a simultaneous worsening of the BHR to methacholine and pulmonary function . This fact adds further evidence for the existence of a pathophysiological connection between BHR and inflammation in rhinitis.…”

Section: Lower Airway Inflammatory Involvement In Rhinitismentioning

confidence: 75%

“…Inflammatory signs in the lower airway were demonstrated in patients with AR without concurrent asthma symptoms …”

Section: Lower Airway Inflammatory Involvement In Rhinitismentioning

confidence: 99%

Subclinical lower airways correlates of chronic allergic and non‐allergic rhinitis

Saranz

Lozano

et al. 2017

Clin Experimental Allergy

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The upper and lower airways behave as a physiological and pathophysiological unit. Subclinical lower airways abnormalities have been described in patients with rhinitis without asthma. These are expressed as bronchial hyperreactivity, abnormalities in lung function and bronchial inflammation, likely as a result of the same phenomenon with systemic inflammatory impact that reaches both the nose and the lungs, which for unknown reasons does not always have a full clinical expression. Patients with rhinitis are at increased risk of developing asthma; therefore, most authors suggest a careful clinical evaluation and monitoring of these patients, especially if symptoms related to inflammation in the lower airways are observed. Although current treatments, such as H1-antihistamines, intranasal steroids and allergen immunotherapy, are quite effective for the management of rhinitis, it is difficult to prove their capacity to prevent asthma among subjects with rhinitis. Evidence showing that the treatment of rhinitis has a favourable impact on indicators of bronchial hyperreactivity and inflammation among subjects that have no symptoms of asthma is more frequently described. In this review, we address the frequency and characteristics of lower airway abnormalities in subjects with rhinitis, both in paediatric and adult populations, their likely predictive value for the development of asthma and the possibilities for therapeutic intervention that could modify the risk of subjects with rhinitis towards presenting asthma.

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“…39 Another study demonstrated that HDM nasal challenge tests cause initiation and exacerbation of airway inflammation and hyper-responsiveness in both upper and lower airways in patients with persistent AR without asthmatic symptoms. 40 Climate change contributes to increases in chemical air pollutant and aeroallergen production and their distribution. 33,36,41,42 Climate change affects vegetation, resulting in changes in the start, duration, intensity, and distribution of allergenic pollen.…”

mentioning

confidence: 99%

Recent developments and highlights in allergic rhinitis

Meng

Wang

Zhang

2019

Allergy

125

105

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Allergic rhinitis (AR) is a disease with high prevalence all over the world and therefore needs to be thoroughly investigated and treated accordingly. The mechanisms underlying the pathology and treatment of AR have been widely studied, but many aspects remain unclear and warrant further investigations. This review presents an overview of recently published papers highlighting the risk factors, mechanisms, and treatment of AR. Additionally, recent studies discussing the role of single nucleotide polymorphism, DNA methylation, regulatory B cells, group 2 innate lymphoid cells, immunotherapy, and biologics in AR are also covered. K E Y W O R D Sallergic rhinitis, biologics, epigenetics, risk factors, treatment | 2321 MENG Et al.

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Aggravation of airway inflammation and hyper‐responsiveness following nasal challenge with Dermatophagoides pteronyssinus in perennial allergic rhinitis without symptoms of asthma

Abstract: 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.

Cited by 21 publications

References 31 publications

Effect of Dermatophagoides pteronyssinus Immunotherapy on Upper and Lower Airway Eosinophilic Inflammatory Response to Nasal Allergen Challenge

Effect of Dermatophagoides pteronyssinus Immunotherapy on Upper and Lower Airway Eosinophilic Inflammatory Response to Nasal Allergen Challenge

Subclinical lower airways correlates of chronic allergic and non‐allergic rhinitis

Recent developments and highlights in allergic rhinitis

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