Abstract
BackgroundThe precise way in which allergen is handled by the nose is unknown. The objective of this study was to determine recovery of Der p 1 allergen following nasal administration and to determine whether Der p 1 can be detected in nasal biopsies after natural exposure and nasal challenge to allergen.Methods(1) 20 nonatopic non-rhinitics were challenged with Der p 1 and recovery was measured by ELISA in the nasal wash, nasal mucus and induced sputum up to 30 minutes. Particulate charcoal (<40 μm) served as control. (2) In 8 subjects (5 atopics), 30 to 60 minutes after challenge histological localisation of Der p 1 in the nasal mucosal epithelium, subepithelial mucous glands and lamina propria was performed. Co-localisation of Der p 1 with macrophages and IgE-positive cells was undertaken.Results(1) Less than 25% of total allergen was retrievable after aqueous or particulate challenge, most from the nasal mucus during 1-5 min after the challenge. The median of carbon particles recovered was 9%. (2) Prechallenge Der p 1 staining was associated with the epithelium and subepithelial mucous glands. After challenge there was a trend for greater Der p 1 deposition in atopics, but both atopics and nonatopics showed increases in the number of Der p 1 stained cells and stained tissue compartments. In atopics, increased eosinophils, macrophages and IgE positive cells co-localized with Der p 1 staining.ConclusionsDer p 1 allergen is detected in nasal tissue independent of atopic status after natural exposure. After challenge the nose effectively retains allergen, which remains mucosally associated; in atopics there is greater Der p 1 deposition and inflammatory response than in nonatopics. These results support the hypothesis that nasal mucus and tissue act as a reservoir for the inhaled Der p 1 allergen leading to a persistent allergic inflammatory response in susceptible individuals.
Highlights
It is increasingly recognised that host-environment interactions are important in the development and persistence of airway inflammation
Der p 1 allergen is detected in nasal tissue independent of atopic status after natural exposure
Fate of Intranasal Allergen nonatopics. These results support the hypothesis that nasal mucus and tissue act as a reservoir for the inhaled Der p 1 allergen leading to a persistent allergic inflammatory response in susceptible individuals
Summary
It is increasingly recognised that host-environment interactions are important in the development and persistence of airway inflammation. The majority of allergenic and non-allergenic particles enter the respiratory tract via the nasal cavity but there is incomplete data on how the nose interacts with these particles. Most insoluble particles over 4 microns in diameter are caught on the superficial gel layer of the mucous blanket, and swept backwards to the nasopharynx by mucociliary clearance [1]. Soluble materials dissolve into the periciliary or sol phase of the mucous blanket. There is incomplete information on how intranasal allergen is handled, its mechanisms of penetration into the epithelium, its interaction with epithelial cells and the cells of the immune system, such as dendritic cells and subsequently the elimination of allergen. The precise way in which allergen is handled by the nose is unknown. The objective of this study was to determine recovery of Der p 1 allergen following nasal administration and to determine whether Der p 1 can be detected in nasal biopsies after natural exposure and nasal challenge to allergen
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