Eosinophil Count in Nasal Mucosa Is More Suitable than the Number of ICAM-1-Positive Nasal Epithelial Cells to Evaluate the Severity of House Dust Mite-Sensitive Allergic Rhinitis: A Clinical Correlation Study

Abstract

Background: House dust mite (HDM)-sensitive allergic rhinitis is a perennial rhinitis with persistent nasal inflammation. Currently, there are no reliable parameters to monitor the severity of perennial allergic rhinitis. The purpose of this study was to evaluate correlations between clinical and laboratory parameters in patients with HDM-sensitive allergic rhinitis. Methods: We measured nasal symptoms, did the Dermatophagoides pteronyssinus (Der P) skin prick test (SPT), evaluated the Der P allergen nasal challenge threshold, and laboratory parameters [(1) inflammatory cell count from nasal mucosal scraping specimens: eosinophils and neutrophils and (2) immunocytochemistry: ICAM-1 expression on nasal epithelial cells] in 20 cases of HDM-sensitive allergic rhinitis and performed correlation tests between all parameters. Results: The wheal diameter induced by Der P SPT was significantly correlated with the Der P allergen nasal challenge threshold (p = 0.001). The number of eosinophils from nasal mucosal scrapping specimens was correlated with the ICAM-1 expression on nasal epithelial cells (p = 0.039), the number of neutrophils from nasal mucosal scrapping specimens (p = 0.001), and nasal stuffiness (p = 0.037) but did not correlate with total nasal symptom scores. Conclusion: Clinical symptoms of HDM-sensitive allergic rhinitis showed a poor correlation with inflammatory parameters. The eosinophil count in nasal mucosa is correlated with ICAM-1 expression and more suitable than ICAM-1 levels to evaluate the severity of HDM-sensitive allergic rhinitis. This study also supports the role of the SPT in the diagnosis of nasal allergy to HDM.

Inflammatory profiles in nasal mucosa of patients with persistent vs intermittent allergic rhinitis

“…Moreover, the findings for the significantly higher concentrations of serum and/or nasal total and specific IgE, ECP, IL‐5 and LTC4/D 4 /E 4 measured in patients with PER than in patients with IAR are at least concordant with the significantly higher symptom scores for nasal congestion, rhinorrhoea, sneezing and nasal itching noted for patients with PER than for patients with IAR in this study. This is particularly likely as a combination of mediators synthesized and released by activated eosinophils, and mast cells are known to be involved in the development of the symptoms of AR during both the early‐phase and the late‐phase reactions (3, 11–14, 24, 25).…”

“…from a variety of inflammatory cells (particularly mast cells, eosinophils and T‐lymphocytes) (3, 9, 10). There is increasing evidence of a correlation between allergen‐specific IgE, nasal mast cell/eosinophil numbers and/or their mediators and the severity of symptoms in seasonal (11, 12) and perennial allergic rhinitis (13, 14). Similarly, the role of the T‐lymphocytes, particularly the association between Th2 T‐cells and increased infiltration of the nasal mucosa with eosinophils, increased expression of cytokines influencing eosinophil and mast cell/basophil activity, and modulation of B‐cell activity in IgE isotype switching and synthesis is well documented in AR (3, 15).…”

Evidence‐based recommendations regarding the differential diagnosis and assessment of nasal congestion: using the new GRADE system

“…However, SPT and RAST seem poorly or not at all correlated with allergic symptom severity and clinical relevance (130,131). Although one study did show a slight significant correlation of the SPT with nasal congestion (132).…”

Phenotype-oriented immunotherapy of bronchial asthma

“…При введении аллергена во время АСИТ модулируются как врожденные, так и адаптивные иммунные ответы, что в конечном итоге приводит к клиническому улучшению. В инфильтрате снижается число лаброцитов [38,39], базофилов [40] и эозинофилов слизистой [41], а так же количество врожденных лимфоидных клеток типа 2 (ILC2) [42] и Th2-клеток [43,44] на периферии. АСИТ модулирует реакции дендритных клеток [45], что приводит к иммунному отклонению от Т-хелперного ответа 2 типа к ответу 1 типа, индукции IL-10, IL-35, TGF-β и генерированию регуляторных Т-клеток FoxP3+, повышению продукции IgG4-антител, что, в целом, способствует развитию аллергенспецифической иммунологической толерантности.…”