Specific immunotherapy with mugwort pollen allergoid reduce bradykinin release into the nasal fluid

Abstract

IntroductionA pathomechanism of allergic rhinitis is complex. A neurogenic mechanism seems to play a significant role in this phenomenon.AimThe evaluation of influence of specific immunotherapy of mugwort pollen allergic patients on the bradykinin concentration in the nasal lavage fluid.Material and methodsThe study included 22 seasonal allergic rhinitis patients. Thirty persons with monovalent allergy to mugwort pollen, confirmed with skin prick tests and allergen-specific immunoglobulin E, underwent a 3-year-long allergen immunotherapy with the mugwort extract (Allergovit, Allergopharma, Germany). The control group was composed of 9 persons with polyvalent sensitivity to pollen, who were treated with pharmacotherapy. Before the allergen-specific immunotherapy (AIT) and in subsequent years before the pollen seasons, a provocation allergen test with the mugwort extract was performed, together with collection of nasal fluids, where bradykinin concentration was determined according to Proud method.ResultsThere were similar levels of bradykinin in both groups at baseline prior to therapy (AIT group: 584.0 ±87.2 vs. controls 606.3 ±106.5 pg/ml) and changes after allergen challenge 1112.4 ±334.8 vs. 1013.3 ±305.9 pg/ml as well. The bradykinin concentration in nasal lavage fluid after mugwort challenge in 1 year was lower in the AIT group (824.1 ±184.2 pg/ml vs. 1000.4 ±411.5 pg/l; p < 005) with a further significant decrease after the 2nd and 3rd year of specific immunotherapy. Significant reduction of symptoms and medications use was observed in hyposensitized patients.ConclusionsA decreased level of bradykinin as a result of AIT suggests that some of the symptomatic benefits of AIT may be related to the reduced release of bradykinin into nasal secretions. These values correlate with clinical improvement within the course of treatment.

Evaluation of substance P and bradykinin levels in nasal secretions of patients with nasal polyposis with and without sensitivity to non‐steroidal anti‐inflammatory drugs

“… 24 , 26 , 27 This connection is especially pronounced in patients with chronic inflammation of the nasal mucosa, as is the case with allergic rhinitis. 24 , 26 , 27 SP exhibits a number of effects. It stimulates vasodilation and extravasation of plasma in the lamina propria.…”

“…BK is a peptide with an important role in the stimulation and enhancement of inflammatory response in the nasal mucosa 7,26 . In patients with allergic rhinitis, mast cells, basophils, neutrophils, and eosinophils in the nasal mucosa produce and release cytokines and chemokines, and neuropeptides as of BK and SP 26 . Previous investigations indicate a significant increase of BK concentration in the nasal secretions of allergic rhinitis patients in the pollen season 27…”

“…Neurogenic mechanisms have very important role in the regulation of nasal function. The rich innervation of the nasal mucosa is functionally highly connected with the multitude of cells that participate in the immune response 24,26,27 . This connection is especially pronounced in patients with chronic inflammation of the nasal mucosa, as is the case with allergic rhinitis 24,26,27 .…”

“…7,26 In patients with allergic rhinitis, mast cells, basophils, neutrophils, and eosinophils in the nasal mucosa produce and release cytokines and chemokines, and neuropeptides as of BK and SP. 26 Previous investigations indicate a significant increase of BK concentration in the nasal secretions of allergic rhinitis patients in the pollen season. 27 The results of our study show higher concentrations of SP and BK in the nasal secretions of patients with NP, compared to subjects without nasal inflammation and these data are consistent with the results of a study by Compton et al 28 Among patients with NP, those with sensitivity to aspirin have higher concentrations of these neuropeptides than those who are not sensitive to NSAIDs.…”

“…BK is a peptide with an important role in the stimulation and enhancement of inflammatory response in the nasal mucosa. 7 , 26 In patients with allergic rhinitis, mast cells, basophils, neutrophils, and eosinophils in the nasal mucosa produce and release cytokines and chemokines, and neuropeptides as of BK and SP. 26 Previous investigations indicate a significant increase of BK concentration in the nasal secretions of allergic rhinitis patients in the pollen season.…”