Baroody FM, deTineo M, Naclerio RM. Unilateral nasal allergic reactions increase bilateral sinus eosinophil infiltration. J Appl Physiol 115: 1262-1267, 2013. First published August 22, 2013 doi:10.1152/japplphysiol.00547.2013We have previously shown that unilateral nasal challenge with antigen causes an increase in the number of eosinophils in the ipsilateral maxillary sinus. Here we aimed to determine whether there was an eosinophil response in the contralateral maxillary sinus after unilateral nasal challenge with antigen. Twenty subjects with a history of seasonal allergic rhinitis and a positive nasal challenge to ragweed or grass allergens were studied outside of their allergy season. Catheters were placed in both maxillary sinuses and the subjects were challenged with antigen via the left nostril. The subjects recorded nasal symptoms before and after each allergen challenge and hourly for 8 h afterward. We performed nasal lavages of the nose and sinuses at the same time as symptoms were recorded. The lavages were analyzed for the number of eosinophils and levels of albumin. Subjects showed a symptomatic response to challenge accompanied by an influx of eosinophils into the nose and increased vascular permeability. The number of eosinophils increased in both maxillary sinuses. The total change from diluent in eosinophils during the late phase response was higher in the ipsilateral maxillary sinus (median ϭ 8,505; range ϭ 0 -100,360) compared with the contralateral sinus (median ϭ 1,596; range ϭ Ϫ13,527-93,373; P ϭ 0.03). We conclude that eosinophils increase in both maxillary sinuses after unilateral nasal challenge. We speculate that a central neurologic reflex initiated in the nose by the nasal challenge contributes to the bilateral eosinophil response in the maxillary sinuses. We further speculate that, since there are more eosinophils in the ipsilateral compared with the contralateral maxillary sinus, there is also an axonal reflex into the ipsilateral maxillary sinus that contributed to the eosinophil response. maxillary sinus; nasal allergen challenge; eosinophils THE NOSE IS RICHLY INNERVATED by sensory fibers from the second division of the trigeminal nerve and sympathetic and parasympathetic fibers that pass through the sphenopalatine ganglion. Whereas the sympathetic fibers merely pass through the ganglion, the parasympathetic fibers synapse sending efferent fibers to the nasal cavity, the paranasal sinuses, and the eye (2).Numerous neural reflexes originating inside and outside the nose affect nasal pathophysiology. The nasonasal reflex results from stimulation of one nasal cavity with a stimulus such as allergen or histamine. It produces a bilateral secretory response with the contralateral response being blocked by topical atropine administration (8, 3). Stimulation of the nose with allergen also induces bilateral ocular symptoms, the nasal ocular reflex (4). The nasal cycle, the process by which airway resistance of the two nasal cavities fluctuates in a cyclic manner, also involves neural m...