The Effects of Allergen-Induced Nasal Provocation on Pulmonary Function in Patients with Perennial Allergic Rhinitis

Small, Peter; Biskin, N

doi:10.2500/105065889782024384

Cited by 19 publications

(8 citation statements)

References 14 publications

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“…Our data demonstrating the existence of the AR induced by the allergic reaction originating initially in the nasal mucosa disagree with the findings of some investigators who were unable to confirm this clinical phenomenon [38, 40]. Another interesting aspect of our observations is the recording of various types of the secondarily induced AR which were not unavoidably associated with the NR.…”

Section: Discussioncontrasting

confidence: 57%

“…Studies of the relationship between the upper and lower airways in human subjects by means of the challenge technique are not numerous [8, 9, 11, 13, 17, 18,21,22,23,36,37,38,39,40], and those using challenge with allergen are but few [8, 13, 17, 18,21,22,23,36,37,38,39,40]. In some of these studies, the effects of nasal challenge with allergen on the bronchial responsiveness to histamine/methacholine have been investigated [18, 37, 38].…”

Section: Discussionmentioning

confidence: 99%

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Asthmatic Response Induced by Nasal Challenge with Allergen

Pelikán¹

2008

Int Arch Allergy Immunol

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Background: There is a link between the upper and lower airways. Allergic rhinitis and bronchial asthma may coexist, but they can also affect each other. Objective: To investigate the possibility of nasal allergy being able to induce a secondary asthmatic response (AR). Methods: In 82 asthmatics responding insufficiently to standard antiasthmatic therapy and demonstrating negative ARs to bronchial challenge with allergen, 82 nasal challenges with various inhalant allergens were performed by means of rhinomanometry in combination with spirometry (vital capacity and forced expiratory volume in 1 s). In 33 control subjects suffering from allergic rhinitis (n = 18) or bronchial asthma (n = 15) only, 33 nasal challenges with inhalant allergens were performed by rhinomanometry and supplemented with spirometry. Results: Of the 82 nasal challenges, 69 produced a positive nasal response (p < 0.01) and 13 were negative (p > 0.05). In 58 cases with a positive nasal challenge, a secondarily induced AR was recorded (p < 0.01). The following types of ARs were documented: 17 isolated immediate ARs (p < 0.01), 24 isolated late ARs (p < 0.01), 12 dual late ARs (immediate + late, p < 0.05 and p < 0.01, respectively) and 5 isolated delayed ARs (p < 0.05). Conclusions: (1) An allergic reaction occurring initially in the nasal mucosa can play an important role in bronchial asthma by inducing a secondary AR, and (2) nasal challenge with allergen performed by rhinomanometry in combination with lung function recording (e.g. spirometry) may then determine the possible need for additional intranasal antiallergic treatment and sparing of antiasthmatic drugs.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Asthmatic Response Induced by Nasal Challenge with Allergen

Pelikán¹

2008

Int Arch Allergy Immunol

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“…In 1 patient, forced ventilation also caused bronchoconstriction. Similarly, Small and Biskin [8] observed a significant drop in FEV) in 2 of 15 nasal allergen challenges performed in subjects with perennial rhinitis and asthma.…”

Section: Discussionmentioning

confidence: 99%

Asthmatic Reactions after Nasal Allergen Provocation

Baur

1996

Respiration

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Three bronchoconstrictive responses associated with acute rhinitis and occurring in two patients were observed among 400 nasal allergen challenges. Causative substances were birch pollen, Dermatophagoides pteronyssinus and HSA-conjugated pyromellitic dianhydride. Both subjects showed bronchial hyperreactivity and immediate-type sensitization to these allergens. It is concluded that bronchoobstruction nearly occurs in nasal allergen challenges. The underline pathophysiological mechanism remains unclear.

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“…Many agents, including silica particles [7], petrolatum packing [8], atomized histamine [9] and cold air [10], have been shown to cause immediate changes in lower airway function. However, some studies seem unable to detect lower airway obstruction immediate ly after nasal challenge with allergens [11][12][13][14]. A recent study failed to demonstrate any changes in lower airway function induced by nasal challenge with grass pollen, al though it may cause a several-fold increase in nasal resist ance [15].…”

Section: Introductionmentioning

confidence: 97%

“…In allergic rhinitis patients, the FEV, FEF25-75% and FVC before nasal provocation were 2.33±0. 14 fig. 1).…”

Section: Effect O F Nasal Challenge On Pulmonary Function and Airway mentioning

confidence: 99%

Relationship between Nasal Resistance and Airway Hyperreactivity following Nasal Provocation with <i>Dermatophagoides pteronyssinus</i> in Allergic Rhinitis

Tsai

Ho²,

Wang

1995

Int Arch Allergy Immunol

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To determine whether nasal allergic symptoms can cause bronchial hyperresponsiveness to methacholine, 30 subjects with allergic rhinitis (22 with allergic rhinitis and 8 with allergic asthmatic rhinitis) were studied. All subjects were skin test positive to Dermatophagoides pteronyssinus (DP) and underwent nasal allergic provocation with DP. After provocation, there was a severe nasal allergic reaction in the challenged nostril with a significant increase in nasal resistance both immediately and long (7 h) after DP exposure. There were no significant changes in the forced expiratory volume in 1 s and the forced expiratory flow rate between 25 and 75% of the forced vital capacity and in both allergic rhinitis and allergic asthmatic rhinitis patients. There was also no change in bronchial hyperresponsiveness to methacholine. The eosinophil counts, leukotriene B₄, leukotriene C₄and platelet-activating factor levels in nasal discharges also showed no differences in both groups of patients. Our studies suggest that nasal provocation with limited allergen is a safe diagnostic technique. However, the relationship between nasal resistance and airway hyperreactivity is not obvious in this study. The similar concentrations of nasal inflammatory mediators in both allergic rhinitis and allergic asthmatic rhinitis indicate that bronchial hyperreactivity is not solely due to nasal drainage of inflammatory mediators.

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The Effects of Allergen-Induced Nasal Provocation on Pulmonary Function in Patients with Perennial Allergic Rhinitis

Abstract: Fifteen patients with perennial allergic rhinitis responded intranasally to ragweed antigen challenge. Concomitant measurements of pulmonary function did not reveal a significant decrement onflow rates over a 30-minute period.

Cited by 19 publications

References 14 publications

Asthmatic Response Induced by Nasal Challenge with Allergen

Asthmatic Response Induced by Nasal Challenge with Allergen

Asthmatic Reactions after Nasal Allergen Provocation

Relationship between Nasal Resistance and Airway Hyperreactivity following Nasal Provocation with <i>Dermatophagoides pteronyssinus</i> in Allergic Rhinitis

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