Allergic rhinitis to grass pollen: Measurement of inflammatory mediators of mast cell and eosinophils in native nasal fluid lavage and in serum out of and during pollen season

Lorenzo, Gabriele Di; Mansueto, Pasquale; Melluso, M.; Candore, Giuseppina; Colombo, Alfredo; Pellitteri, Maria Esposito; Drago, Agata; Potestio, Marcella; Caruso, Calogero

doi:10.1016/s0091-6749(97)70281-1

Cited by 42 publications

(74 citation statements)

References 25 publications

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“…Clinical scores, SPTs, nasal lavages and blood drawing were performed between May and June, i.e. during the peak pollen season for grass and Parietaria [21, 22, 23]. In our climate, grass pollen is strictly a seasonal allergen, whereas HDM and Parietaria species are present throughout the year [21, 22, 23].…”

Section: Methodsmentioning

confidence: 99%

Measurement of Inflammatory Mediators of Mast Cells and Eosinophils in Native Nasal Lavage Fluid in Nasal Polyposis

Lorenzo¹,

Drago²,

Pellitteri³

et al. 2001

Int Arch Allergy Immunol

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Background: Nasal polyposis (NP) often coexists with asthma, rhinitis and sinusitis. Polyp histology typically shows chronic, eosinophilic inflammation. The inflammatory cell infiltrate generally includes eosinophils, lymphocytes, plasma cells and mast cells. Objective: To gain insight into the natural history of NP, we analysed mediator levels and leukocyte values in nasal fluids and eosinophil cationic protein (ECP), total IgE levels and eosinophils in the blood in several groups of both allergic and non-allergic patients with nasal polyps and in patients with allergic rhinitis (AR). Methods: Thirty-two patients with nasal polyps entered the study. As a control group, we studied 55 patients with AR, i.e. 20 patients with seasonal AR to grass pollen, 24 with AR sensitive to Parietaria and 11 with AR sensitive to house dust mite (HDM). Eighteen patients with nasal polyps were also allergic patients (8 were sensitive to Parietaria and 10 were sensitive to HDM), whereas 14 were non-allergic patients. Tryptase and histamine values were assayed in nasal fluids, whereas total IgE was determined in serum. ECP values were assayed both in nasal fluids and serum. Eosinophils were quantified both in the blood and nasal fluids. Results: Tryptase levels were significantly higher in the nasal lavages from patients with NP than in those from patients without NP (4.7 vs. 3.5 U/l, p < 0.001) and correlated with symptom scores (r_s = 0.42, p < 0.0001). The median levels of histamine in nasal fluids from patients with NP were also significantly higher than those observed in patients without NP (50.0 vs. 21.3 ng/ml, p < 0.001), but did not correlate with symptom scores. Finally, the median levels of ECP in nasal fluids from patients with NP were significantly higher than those observed in patients without NP (38.1 vs. 16.1 ng/ml, p < 0.001) and correlated with symptom scores (r_s = 0.38, p < 0.001). Analysis of variance showed that, among the variables studied, the presence of nasal polyps was the factor responsible for the higher levels of tryptase, histamine and ECP in nasal fluids. With regard to leukocyte counts in nasal fluids, no significant differences were observed between rhinitis patients with NP and those without NP. With regard to serum ECP and serum total IgE, no significant differences were detected between the two groups under study. Blood eosinophil levels in patients with NP were significantly higher than those observed in patients without NP (5.8 vs. 5.6, p = 0.002). Analysis of variance showed that both the presence of nasal polyps and the type of sensitisation were important. Considering the total symptom scores, no significant differences were observed between rhinitis patients with NP and those without NP. Conclusions: The present findings are consistent with the view that chronic eosinophil mucosal inflammatory disease in NP involves a self-sustaining mechanism, i.e. local release of inflammatory mediators, independent of allergen stimulation of nasal mucosa. Increased release of inflammat...

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Section: Methodsmentioning

confidence: 99%

Measurement of Inflammatory Mediators of Mast Cells and Eosinophils in Native Nasal Lavage Fluid in Nasal Polyposis

Lorenzo¹,

Drago²,

Pellitteri³

et al. 2001

Int Arch Allergy Immunol

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“…Absolute peripheral b-eos counts were determined before ASI with a Technicon-H1 blood cell counter (Bayer, Leverkusen, Germany), with the normal range being 0.10 to 0.40 cells/10 23 mL. 17 …”

Section: Serum T-ige and S-ige Levelsmentioning

confidence: 99%

Evaluation of serum s-IgE/total IgE ratio in predicting clinical response to allergen-specific immunotherapy

Lorenzo

Mansueto

Pacor

et al. 2009

Journal of Allergy and Clinical Immunology

166

148

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Background: To date, no predictive tests for the clinical response to allergen-specific immunotherapy (ASI) are available. Therefore an in vivo or in vitro test would be of great value. Objective: We sought to evaluate pretreatment parameters used in diagnosing allergic rhinitis and determining serum specific IgE (s-IgE) levels, serum total IgE (t-IgE) levels, and blood eosinophil counts and to identify whether can be used to predict clinical improvement in monosensitized patients with allergic rhinitis with or without asthma treated with immunotherapy. Methods: We analyzed 279 patients who had undergone 4 years of ASI administered either by means of the subcutaneous immunotherapy (76 patients) or sublingual immunotherapy (203 patients) routes. Serum t-IgE and s-IgE levels, blood eosinophil counts, and serum s-IgE/t-IgE ratios were calculated and tested for correlation with clinical response to ASI. Receiver operating characteristic curves were determined. Predicted probabilities and predictive areas under the curve were calculated. Results: The clinical response to ASI was effective in 145 (52.0%) of 279 total patients, 42 (55.2%) of 76 patients treated with subcutaneous immunotherapy, and 103 (50.7%) of 203 patients treated with sublingual immunotherapy. A significant correlation was found between the serum s-IgE/t-IgE ratio and the clinical response to ASI, with high ratios (>16.2) associated with an effective response. The sensitivity and specificity of the area under the curve of the ratio were higher than those of serum s-IgE and t-IgE alone. Conclusion: The calculation of the serum s-IgE/t-IgE ratio for predicting the clinical response to ASI offers an advantage over measuring t-IgE and s-IgE levels in monosensitized patients for the following allergens: grass, Parietaria judaica,

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“…In AR the tissue recruitment of eosinophils is a hallmark of the natural history of the disease and of untreated allergic inflammation with nasal steroids (7,(27)(28). In NARES the cause of eosinophilia is unclear.…”

Section: Discussionmentioning

confidence: 99%

Clinical Importance of Eosinophil Count in Nasal Fluid in Patients with Allergic and Non-Allergic Rhinitis

Lorenzo

Mansueto

Pacor

et al. 2009

Int J Immunopathol Pharmacol

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Eosinophil count in nasal fluid (ECNF) was used to differentiate nasal pathologies. Receiver Operating Characteristic (ROC) curve analysis and the area under the curve (AVC) were performed to evaluate the ECNF's accuracy in distinguishing allergic rhinitis (AR) from non-allergic rhinitis (NAR). We also evaluated the accuracy of ECNF in recognizing patients with mild and severe symptoms of rhinitis and patients with ineffective and effective clinical responses to antihistamines. 1,170 consecutive adult patients with a clinical history of rhinitis were studied. ECNF's median in AR was 6.0 and 2.0 in NAR and the best cut-off value was> 3.0, AVC = 0.75. ECNF's median in AR with mild nasal symptoms was 3.0 and 7.0 with severe symptoms, and the best cut-off value was 4.0, AV C =0.90. ECNF's median in NAR with mild nasal symptoms was 2.0 and 8.5 with severe symptoms, and the best cut-off value was> The most common diagnostic tests for allergic rhinitis are the Skin Prick Test (SPT) and the determination of serum allergen-specific IgE. A less common diagnostic tool is nasal cytology. Nasal cytology is generally employed by subspecialists or in research, but does not play a role in the routine evaluation of rhinitis (1). The techniques for obtaining cells for cytology in lavage, or brushings, have not been standardized as the criteria for evaluating cell counts (2). Nasal lavage is the reference method among adult patients (3). Brushing was compared to lavage among adults by Juliusson et al. They found a strong correlation between the two methods regarding the percentage of eosinophils

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Allergic rhinitis to grass pollen: Measurement of inflammatory mediators of mast cell and eosinophils in native nasal fluid lavage and in serum out of and during pollen season

Cited by 42 publications

References 25 publications

Measurement of Inflammatory Mediators of Mast Cells and Eosinophils in Native Nasal Lavage Fluid in Nasal Polyposis

Measurement of Inflammatory Mediators of Mast Cells and Eosinophils in Native Nasal Lavage Fluid in Nasal Polyposis

Evaluation of serum s-IgE/total IgE ratio in predicting clinical response to allergen-specific immunotherapy

Clinical Importance of Eosinophil Count in Nasal Fluid in Patients with Allergic and Non-Allergic Rhinitis

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