Eosinophilia In Nasal Secretions Research Articles

Development of allergic rhinitis in early life: A prospective cohort study in high-risk infants.

Allergic rhinitis (AR) is the most common allergic disease in children. The development process of AR in early childhood, however, is not well understood. We prospectively investigated the process in regard to not only the nasal symptoms and sensitization but also the nasal cytology, in relation to recurrent wheeze in a high-risk cohort. Infants under 2years of age with atopic dermatitis (AD) and/or food allergy (FA) symptoms were recruited and followed prospectively for 2years. The phenotype of perennial AR was classified based on the presence/absence of (1) persistent nasal symptoms, (2) nasal eosinophils, and (3) HDM sensitization, the most common allergen for perennial AR in Japan. AR-like phenotypes were defined as positive for at least two of those three categories. High-risk recurrent wheezer was diagnosed based on the Japanese guidelines and Global Initiative for Asthma. Cox proportional hazards regression analyses for high-risk recurrent wheeze and the AR-like phenotype, adjusting for known covariate risk factors for asthma. A total of 299 children were enrolled, and 237subjects (78%) completed the 2-year observation. The prevalence of eosinophilia in nasal secretions increased from 18.5% to 69.9%, while HDM-specific IgE≥0.35kUA /L increased from 30.6% to 74.8%. AR-like phenotypes increased from 18.4% to 65.0%. The AR-like phenotype at 2years was associated with development of high-risk recurrent wheezer (HR 2.062; 95% CI 1.005-4.796). The prevalence of an HDM-related AR-like phenotype was markedly increased during infancy in infants with AD/FA and was associated with high-risk recurrent wheezer.

The efficiency of hypoallergenic space created with LG Puricare™ air purifier in the complex therapy of seasonal and perennial allergic rhinitis and bronchial asthma

Background. To evaluate the efficacy and tolerability of a hypoallergenic space created with the LG Puricare air purifier, in a closed hospital ward and at home in the complex treatment of patients with exacerbation of perennial and seasonal allergic rhinoconjunctivitis with or without asthma. Materials and methods. 70 patients with seasonal and perennial allergic rhinoconjunctivitis with or without asthma were involved in the open comparative, randomized, placebo-controlled study conducted in 2 stages. At the 1st stage, an assessment of the efficacy and tolerability of hypoallergenic space created with LG Puricare™ air purifier in the hospital was performed. At the 2nd stage, the same study was performed at home space. The primary endpoint of the study was the evaluation of the total symptoms score. Secondary endpoints were changes in the parameters of peripheral blood, eye, and nasal secretion eosinophilia, external respiration function, peak flowmetry parameters. An assessment of indoor allergens, pollen and mold spores concentration, determination of the number of particle matter and evaluation of microbial and fungal air contamination in the environment were also carried out. Results. A significant reduction of the concentration of airborne particles and mold spores was demonstrated. Disease severity score showed significant clinical improvement but no changes in the parameters of the external respiration function, eosinophilia of blood, eyes and nasal secretions. Conclusion. The use of LG Puricare™ air purifier is recommended as a part of complex therapy of patients with various allergic diseases.

To investigate the correlation of nasal secretions of eosinophils and lung function after the treatment of budesonide in the allergic rhinitis patients

Objective:To identify the relationship between nasal secretion eosinophilia and pulmonary function of patients with AR after treatment of intranasal budesonide.Method:Fifty patients with moderate to severe AR were selected, and compared to 50 normals, all had pulmonary function and nasal secretion of eosinophil number check, experimental group of AR received budesonide+loratadine treatment for 3 months, and then had lung function and nasal secretion eosinophil again, analysised the trends of change between two. Result:Eosinophils of AR patients was higher than its of control group (P<0.05), lung function index MMEF and nasal secretion eosinophilia of 50 AR patients had a negative relationship(r=-0.945，P<0.05).Treated with eosinophils the number of nasal secretion eosinophilia of AR decreased 10 + 5.6, the difference compared to the before of the treatment was statistically significant(P<0.05), compared to the normal control group was significant(P<0.05). After the treatment of budesonide, the trends of change between nasal secretion eosinophils and pulmonary function was a positive correlation(r=0.803,P<0.01). Conclusion:The higher the number of eosinophils in nasal secretions of patients with AR, the more obvious the decline of lung function. After the treatment with budesonide, the more eosinophils decreased in patients with AR, the more obvious the improvement of pulmonary function.

Optimal drugs concentrations and doses for allergological diagnostics of perioperative drugs hypersensitivity reactions

Background. The study aimed to develop the optimal concentration and doses of drugs for examination of perioperative drug’s hypersensitivity reactions. Methods. The protocol of allergological examination included clinical, laboratory methods and tests in vivo: skin tests (prick-, intradermal, patch- test) with neuromuscular blockers, opioids, radiocontrast medias, colloids, hypnotics; patch-test with povidon-iodine, chlorhexidine; dosing provocative test (including investigation of blood, nasal secretion eosinophilia, serum tryptase measurements) with antibiotics, nonsteroid anti-inflammatory drugs, local anesthetics. 20 healthy volunteers were included in the study during 2 years (2010-2012) for estimating of the doses and concentrations of testing drugs. Results. Non irritating concentrations for skin tests (prick- and intradermal) with perioperative drugs have been estimated on healthy controls. No one of healthy controls had false positive tests and nonspecific histamine-release effects while testing in vivo. Increased tryptase level 1 h after and the level of blood eosinophilia and eosinophiliaof nasal secretion 6 hours after dosing provocation test with each drug were found to be statistically insignificant. Conclusions. Optimal concentrations and doses of drugs for allergological examination of perioperative drug’s hypersensitivity reactions were estimated.

Sprayable chitosan/starch‐based sealant reduces adhesion formation in a sheep model for Chronic sinusitis

Postoperative adhesion formation after endoscopic sinus surgery (ESS) remains a complication associated with high revision rates. This study determines the efficacy of a sprayable chitosan/starch-based sealant for reducing adhesions in an ESS sheep model for chronic sinusitis. Prospective, blinded, randomized controlled trial. Sheep (n = 14) with eosinophilic rhinitis (determined by the presence of eosinophilia in nasal secretions) underwent ESS with middle turbinectomies, standardized mucosal injuries created on the lateral nasal wall, and partial thickness wounds created around the ethmoid cell region. Surgery was performed bilaterally (28 nasal cavities). Animals were randomized into treatment with sprayable chitosan/starch-based sealant (n = 7, 14 nasal cavities) or no treatment (n = 7, 14 nasal cavities). Two animals in the treatment group expired due to anesthetic complications associated with the turbinectomies, leaving five animals (10 sites) that completed the study. Presence of adhesions was assessed by endoscopic evaluation at days 14 and 28 after initial surgery. Adhesion formation was confirmed via necropsy of sinus cavities at day 28 after initial surgery. Adhesions were observed in all seven control animals, resulting in an 86% (95% confidence interval [CI], 65-100) adhesion rate (12 of 14 sites). The five surviving treatment animals had a 10% (95% CI, 0-33) adhesion rate (one of 10 sites). Treatment with the sprayable chitosan/starch-based sealant resulted in a 76% reduction (95% CI, 32-100) of adhesions (P < .002). In this sheep model for chronic sinusitis, treatment with sprayable chitosan/starch-based sealant reduced adhesion formation by 76% after ESS (P < .002).

Clinical and inflammatory features of occupational asthma caused by persulphate salts in comparison with asthma associated with occupational rhinitis

The relationships between asthma and rhinitis are still a crucial point in respiratory allergy and have scarcely been analysed in occupational setting. We aimed to compare the clinical and inflammatory features of subjects with occupational asthma only (OA) to subjects with OA associated to occupational rhinitis (OAR) caused by persulphate salts. The clinical charts of 26 subjects diagnosed in our Unit as respiratory allergy caused by ammonium persulphate (AP), confirmed by specific inhalation challenge (SIC), were reviewed. Twenty-two out of twenty-six patients underwent pre-SIC-induced sputum challenge test (IS) and 24/26 underwent nasal secretion collection and processing. Twelve out of twenty-six patients received a diagnosis of OA-only and 14/26 of OAR. Duration of exposure before diagnosis, latency period between the beginning of exposure and asthma symptom onset, basal FEV(1), airway reactivity to methacholine and asthma severity did not differ in the two groups. Eosinophilic inflammation of upper and lower airways characterized both groups. Eosinophil percentage in IS tended to be higher in OAR [11.9 (5.575-13.925)%] than in OA-only [2.95 (0.225-12.5)%] (P = 0.31). Eosinophilia in nasal secretions was present both in subjects with OAR [55 (46-71)%] and in subjects with OA-only [38 (15-73.5)%], without any significant difference. Our results indicate that OA because of ammonium persulphate coexists with occupational rhinitis in half of the patients. Unexpectedly, rhinitis did not seem to have an impact on the natural history of asthma. The finding of nasal inflammation in subjects with OA-only without clinical manifestations of rhinitis supports the united airway disease concept in occupational respiratory allergy as a result of persulphates.

Eosinophilia and cell activation mediators in nasal secretions.

In rhinologic disorders such as polyposis or rhinitis, nasal cytology allows differentiation between patients according to the degree of eosinophilia in nasal secretions. The egress of eosinophil and/or neutrophil polymorphonuclears from the underlying mucosa might correlate with the release of soluble mediators of cell activation such as the chemokine IL-8, and such molecules of the innate immunity as the LPS-receptor CD14 or lysozyme. We assayed the levels of these three molecules in nasal secretions in correlation with cytologic findings and especially the degree of eosinophilia. Fifty-four patients from a prospective study of nasal secretions were enrolled in this work. They constituted two groups of 27 patients each, respectively, with or without more than 20% eosinophils in nasal secretions. Nasal secretions were collected by aspiration, weighed and diluted in a fixed amount of buffer. Classic cytologic analyses were performed on the pelleted cells and IL-8, sCD14, and lysozyme levels were assayed in the cell-free supernatants. Cytologic analyses included cell-enumeration in Neubauer's chambers, and differentials performed on May-Grünwald Giemsa-stained cytospins. ELISA tests were used to assay the levels of IL-8 and sCD14. Lysozyme concentrations were assayed in immuno-nephelometry. Significantly lower levels of IL-8 and sCD14 were observed in patients with eosinophilia than in patients with a predominance of neutrophils, whereas no difference was observed in lysozyme concentrations. These data show that the egress of neutrophils in nasal secretions is associated with high levels of IL-8 and sCD14.

ASTHMA PHENOTYPES: Wheezy Infants and Wheezy Children

ASTHMA PHENOTYPES: Wheezy Infants and Wheezy Children

Autonomic reflexes and non-allergic rhinitis.

Functions traditionally ascribed to the nose include warming, humidification, and filtration of inspired air prior to its passage to the lower respiratory tract. The nose thus conditions inspired air, making it suitable for pulmonary gas exchange. In order to carry out these functions, the nose is subject to a complex series of reflexes mediated via the autonomic nervous system. The effector tissues are the nasal blood vessels and glands. Perennial non-allergic rhinitis may be divided into two types based on the presence or absence of eosinophilia in nasal secretions. Much circumstantial evidence suggests that non-eosinophilic non-allergic rhinitis (NENAR) may be a disease of autonomic imbalance. In a series of studies carried out at the University of Liverpool, patients with perennial non-allergic rhinitis, and NENAR in particular, were found to have qualitative and quantitative abnormalities in their nasal response to various stimuli as manifested by changes in nasal patency. The nasal response to axillary pressure is much reduced in NENAR patients compared with normal controls, and the normal decrease in nasal resistance in response to standing is abrogated. Isometric exercise has little effect in normal subjects, but those with NENAR demonstrate an increase in nasal resistance. A similar effect is seen in response to the cold pressor test. Of great importance for therapy is the effect of topical fluticasone propionate in patients with NENAR. Treatment normalizes the damaged nasal reflexes seen in this condition, whereas placebo has no effect. However, abnormalities in other non-nasal autonomic reflexes (systemic parameters) are not affected by treatment.

Hypereosinophilic Syndrome with a Rapidly Fatal Course in a Saudi Child

Hypereosinophilic Syndrome with a Rapidly Fatal Course in a Saudi Child

Response of the nonaliergic rhinitis with eosinophilia (HARES) syndrome to 4% cromolyn sodium nasal solution

A double-blind, parallel, multiple-dose drug trial was perforated on 23 adult patients with nonallergic rhinitis with eosinophilia (HARES) syndrome. All patients were characterized clinically as having perennial nasal symptoms of sneezing paroxysms, profuse watery rhinorrhea, and pruritus of the nasopharyngeal and conjunctiva( mucosa, with minimal nasal obstruction to airflow. They had nasal secretion eosinophilia, negative prick or intradermal immediate skin tests, negative serum RAST results to common inhalant allergens, negative methacholine bronchoprovocation challenges, and normal total eosinophil counts and total serum IgE levels. Twelve patients received a 4% cromolyn sodium nasal solution and/I patients received a matching placebo administered six times daily. for 8 wk. Daily symptom scores for itchy nose, runny nose, 'stuffy nose, itchy eyes, itchy throat, mouth breathing, postnasal drainage, sneezing, and nose blowing were recorded by the patients. Eye, ear, nose, and throat (SENT) examinations were performed weekly by one of the investigators, and blood samples for CBC and chemistries were obtained at the start and termination of the study. Chemistries and blood counts showed no adverse effects of the drug. No important differences between the drug and placebo groups were noted in either the .symptom scores or SENT examinations of the two groups. We conclude that 4% cromolyn sodium nasal solution is of no benefit in the treatment of patients with the HARES syndrome.

The epidemiologic relationship of clinical nasal allergy to eosinophils and to goblet cells in the nasal smear

Three hundred and fifty-four Vancouver primary school children were studied. Half had a hearing loss and half were control subjects with normal hearing. A trained nonmedical interviewer presented a precoded questionnaire of allergy symptoms to their mothers, and a pediatric allergist examined the children's noses for signs of allergy. Two nasal smears were made from each and were numbered consecutively. One was stained by Hansel's and the other by Papanicolaou's method. A technician scored the former positively if there were 10 eosinophils per high power field in any 2 high power fields and the latter positively if 6 goblet cells were found in the entire slide. There was a highly significant association between clinical evidence of nasal allergy and a nasal secretion eosinophilia. No significant association could be found between clinical evidence of nasal allergy and goblet cells or between eosinophils and goblet cells. The presence of goblet cells does not appear to help in making the diagnosis of nasal allergy in children.

Comparative study of simultaneous blood and nasal secretion eosinophilia in children with allergic diseases.

Comparative study of simultaneous blood and nasal secretion eosinophilia in children with allergic diseases.