Nasal smear eosinophilia for the diagnosis of allergic rhinitis and eosinophilic non-allergic rhinitis

Crobach, M. J. J. S.; Hermans, J.; Kaptein, Ad A.; Ridderikhoff, J.; Mulder, J.

doi:10.3109/02813439608997081

Cited by 52 publications

(53 citation statements)

References 12 publications

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“…As a separate entity of chronic rhinitis, nonallergic rhinitis with eosinophilia syndrome (NARES) constitutes a rare nasal condition, although prevalence rates range from 2 to 14% among patients with chronic rhinitis [6]. Patients present typical symptoms of persistent rhinitis, mainly nasal blockage and rhinorrhea, but in vitro and in vivo tests fail to detect any sensitization [7].…”

Section: Introductionmentioning

confidence: 99%

Mediators and Cytokines in Persistent Allergic Rhinitis and Nonallergic Rhinitis with Eosinophilia Syndrome

Gröger

Klemens

Wendt

et al. 2012

Int Arch Allergy Immunol

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Background: Patients with nonallergic rhinitis with eosinophilia syndrome (NARES) show typical symptoms of persistent allergic rhinitis (PAR). The aim of the present study was to compare nasal cytokine patterns between NARES and PAR. Methods: Nasal secretions of 31 patients suffering from NARES, 20 patients with PAR to house dust mite and 21 healthy controls were collected using the cotton wool method and analyzed for interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor (G-CSF), interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1β (MIP-1β) by Bio-Plex Cytokine Assay as well as eosinophil cationic protein (ECP) and tryptase by UniCAP-FEIA. Results: NARES and PAR presented elevated levels of tryptase, while ECP was markedly increased solely in NARES compared to both the controls and PAR. Elevated levels of IL-1β, IL-17, IFN-γ, TNF-α and MCP-1 were found in NARES compared to the controls as well as PAR. MIP-1β was elevated in NARES and PAR, while IL-4, IL-6 and G-CSF showed increased levels in NARES, and IL- 5 was elevated in PAR only. Conclusions: In patients with NARES and PAR, eosinophils and mast cells appear to be the pivotal cells of inflammation, reflected by high levels of tryptase and ECP as well as IL-5 and GM-CSF as factors for eosinophil migration and survival. The elevated levels of proinflammatory cytokines in NARES may indicate the chronic, self-perpetuating process of inflammation in NARES which seems to be more pronounced than in PAR. IL-17 might be a factor for neutrophilic infiltration or be responsible for remodeling processes in NARES.

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Section: Introductionmentioning

confidence: 99%

Mediators and Cytokines in Persistent Allergic Rhinitis and Nonallergic Rhinitis with Eosinophilia Syndrome

Gröger

Klemens

Wendt

et al. 2012

Int Arch Allergy Immunol

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“…The number of eosinophils on nasal mucosa has been known as a marker of allergic inflammation in the nose for many years [21, 22, 24, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50]. Mediators from eosinophils, particularly eosinophil cationic protein, play a pivotal role in the pathogenesis of allergic rhinitis and are under intensive investigation [51, 52, 53, 54].…”

Section: Discussionmentioning

confidence: 99%

“…In the study in asymptomatic adult Pacific Islanders, the wheal size of house dust mite (HDM) SPT was associated with exhaled NO levels and nasal NO levels in HDM-sensitive subjects [20]. Previous studies showed that nasal smear eosinophilia represented a specific test for the diagnosis of allergic rhinitis, when patients with nasal polyposis and aspirin sensitivity and/or negative skin tests had been excluded [21, 22]. The relationship between nasal hyperreactivity, mediators and eosinophils in patients with perennial rhinitis showed that nasal hyperreactivity tested by histamine challenge was correlated with the percentage of eosinophils in nasal lavage fluid [23].…”

Section: Introductionmentioning

confidence: 99%

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

Klaewsongkram

Ruxrungtham²,

Wannakrairot³

et al. 2003

Int Arch Allergy Immunol

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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.

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“…All the slides were air dried and stained with Giemsa's stain as per standard method to observe the types of epithelial cells and inflammatory infiltrate including mast cells. Cytologically, rhinitis was classified as allergic when eosinophils and mast cells predominated, infective when polymorphs predominated and vasomotor when mast cells predominated the picture [6]. On a mixed picture presentation, it was classified as infective on top of the allergic type of rhinitis.…”

Section: Methodsmentioning

confidence: 99%

Clinicocytological Correlation in Establishing the Aetiology of Chronic Rhinitis

Gulati¹,

Goyal²,

Sen

et al. 2002

ORL

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Two hundred patients clinically diagnosed as having chronic rhinitis were provisionally grouped into allergic and non-allergic types of rhinitis on the basis of history, clinical examination, X-ray of the paranasal sinuses using the occipitomental view and other relevant investigations like differential and total leucocyte count. Whereas 158 cases were categorized into allergic rhinitis, 13 were diagnosed as suffering from vasomotor rhinitis, 25 from infective rhinitis and 4 patients from atrophic rhinitis. A nasal cytogram performed in all these cases showed allergic rhinitis in 107 cases, vasomotor rhinitis in 30 cases, infective on top of allergic rhinitis in 32 cases, common cold over allergic rhinitis in 3 cases, infective rhinitis in 20 cases, a non-infective non-allergic type in 4 cases and atrophic rhinitis in 4 cases. There was a good clinicocytological correlation; however, 30 patients clinically suspected to be having allergic rhinitis had an infective episode alone or on top of allergic rhinitis. Nasal cytology was thus found useful in modifying the treatment. It is a simple, easy and reliable investigation that can be done routinely in the out-patient department.

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Nasal smear eosinophilia for the diagnosis of allergic rhinitis and eosinophilic non-allergic rhinitis

Cited by 52 publications

References 12 publications

Mediators and Cytokines in Persistent Allergic Rhinitis and Nonallergic Rhinitis with Eosinophilia Syndrome

Mediators and Cytokines in Persistent Allergic Rhinitis and Nonallergic Rhinitis with Eosinophilia Syndrome

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

Clinicocytological Correlation in Establishing the Aetiology of Chronic Rhinitis

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