Infectious Rhinitis Research Articles

Diagnosis of Allergic Rhinitis

Rhinitis is divided into allergic and non-allergic rhinitis. Non-allergic rhinitis includes inflammatory rhinitis, such as non-allergic rhinitis with eosinophilia syndrome (NARES) and infective rhinitis, and non-inflammatory rhinitis, such as vasomotor rhinitis and idiopathic rhinitis. Allergic rhinitis is diagnosed based on the presence of allergen-specific IgE and the documentation of relationship between the allergen and symptoms in patients with typical rhinitis symptoms, such as rhinorrhea, nasal obstruction, itchiness and/or sneezing. Local allergic rhinitis can be considered for differential diagnosis. Allergic rhinitis should be differentiated from non-allergic rhinitis by using skin prick test, serum specific IgE test, nasal cytology and/or allergen nasal provocation test. Allergic rhinitis should be differentiated from structural nasal diseases, such as septal deviation and nasal polyps. Rhinitis is frequently accompanied by paranasal sinusitis, which should be recognized in clinical practice. Management strategies differ between allergic and nonallergic rhinitis. In addition to pharmacotherapy, allergen avoidance and allergen-specific immunotherapy can be tried in patients with allergic rhinitis. Thus, the exact diagnosis is very important for the effective treatment in allergic rhinitis. The diagnostic tests for allergic rhinitis are reviewed. (Korean J Med 2013,85:452-456)

THE IMPORTANCE OF EARLY ALLERGIC RHINITIS DIAGNOSIS IN THE PREVENTION OF IT’S COMPLICATIONS

Background. Determination of prevalence of allergic rhinitis in patients with an allergy in the practice of an allergist, identification of the range of sensitization to common allergens in patients of different age groups, demonstration of the early diagnosis importance. Materials and methods. Determination of specific IgE in serum by MAST-HLA panels (36 allergens, Russian Panel IV, Hitachi Diagnostics, USA) was performed for 610 patients with rhinitis. For 269 of them a comprehensive clinical examination including cytological, bacteriological and mycological study of nasal swab was carried out. Results. Allergic rhinitis was diagnosed in 55,9% of the patients, infectious rhinitis was found in 28,7%, non-allergic rhinitis with eosinophilia syndrome is set in 6,1% of individuals. IgE to pollen was present in 53,9% of cases, to house dust— in 45,0% to house dust mites — in 29,0%, to mold allergens — in 14,5%. The frequency of children sensitization com -pared with adults to dog’s epithelium was higher by 1,4 times, the cat’s epithelium — by 1,3 times, to cockroaches — by 1,8 times, to house dust mites — by more than 2-fold, to food — by 2—3-fold. The clinical case demonstrates the importance of early diagnosis of disease. The choice of medicines for treatment was discussed. Conclusion. Given that the debut of allergic rhinitis in most of the examined patients occurred in childhood, the early examination of allergy in children is reasonable for the purpose of adequate therapy.

Endoscopic Myringotomy and Ventilation Tube Insertion under Topical Anesthesia

Endoscopic Myringotomy and Ventilation Tube Insertion under Topical Anesthesia

Obinutuzumab (GA101) in Combination with FC or CHOP in Patients with Relapsed or Refractory Follicular Lymphoma: Final Results of the Phase I GAUDI Study (BO21000)

Abstract 270Obinutuzumab (GA101), the first type II, glycoengineered, humanized anti-CD20 monoclonal antibody in clinical development, has shown single-agent activity in Phase I and II studies in follicular lymphoma (FL), but no studies have so far examined the safety and activity of GA101 in combination with chemotherapy, or compared GA101 dose levels in large cohorts. This study evaluates the feasibility, safety and efficacy of GA101 in combination with standard chemotherapy regimens for FL at two different doses of GA101.Patients with relapsed or refractory FL (n=56) were stratified by chemotherapy regimen based upon prior treatment history (cyclophosphamide/doxorubicin/vincristine/prednisone [6–8 21 day cycles; n=28] or fludarabine/cyclophosphamide [4–6 28 day cycles; n=28]). Patients were then randomized to one of two GA101 dosing regimens: 1,600 mg on Days 1 and 8 of cycle 1 then 800 mg for subsequent cycles (1,600/800 mg) or 400 mg in all cycles (400/400 mg). These regimens represent a range of active doses in indolent lymphoma, based upon Phase I and II trials in which there were no dose-limiting toxicities. Responding patients were offered maintenance treatment for 2 years or until progression. The primary objective was safety, with response rate a secondary objective. Response was assessed at the end of induction using International Working Group response criteria (Cheson, et al. J Clin Oncol 1999), modified to classify unconfirmed complete response as partial response.Baseline characteristics were similar for both groups (G-CHOP and G-FC, respectively): median age 62.5 and 61.0 years; low-risk FLIPI 29% in both groups; median prior treatments (range) 1 (1–3) and 2 (1–6); bone marrow involvement 25% and 26%; Ann Arbor stage III–IV at study entry 64% and 82%. All patients (28/28) in the G-CHOP arm and 22/28 patients in the G-FC arm completed treatment. Reasons for withdrawal (G-FC arm) were neutropenia (n=3), rash (n=1), infection (n=1) and insufficient response (n=1). The most common AEs in both groups were infusion-related reactions (all grades: 64% G-CHOP; 79% G-FC; Grade 3/4: 7% G-CHOP; 7% G-FC), mostly during the first infusion. Grade 3 or 4 neutropenia was reported in 39% of G-CHOP patients and 50% of G-FC patients. Of 190 cycles of G-CHOP delivered, 11 cycles (6%) were delayed in 8 patients for neutropenia or infection (6 cycles delayed by 1 week; 5 cycles delayed by 2 weeks). Dose of any CHOP component was reduced in 29% of patients, in 5 patients for neuropathy and in 1 patient each because of neutropenia, infection and allergic rhinitis. In the G-FC group, 14 of 135 delivered cycles (10%) were delayed in 10 patients for hematologic toxicity or infections (10 cycles delayed by 1 week; 4 cycles delayed by 2 weeks). Nine of these patients also had a dose reduction in both cytostatic components of the regimen with a further patient having a dose reduction only, for an overall dose reduction in 36% of patients. Three deaths were reported following G-FC induction treatment (progressive disease, n=1; underlying Parkinson’s disease, n=1; and chronic obstructive pulmonary disease during maintenance, n=1), with none considered to be treatment-related. There was no evidence for increased toxicity with the 1,600/800 mg dose compared with the 400/400 mg dose of GA101. The overall response rate (ORR) at the end of induction was 96.4% in the G-CHOP group (39.3% complete response [CR]) and 92.9% in the G-FC group (50.0% CR) (Table). Data from the G-CHOP cohort were compared in a matched-pair analysis to the rituximab plus CHOP (R-CHOP) arm from study M39022 (EORTC 20981) in a similar patient population. Response rates to G-CHOP compared favorably with response rates to R-CHOP.Response rates at end of inductionResponse, n (%)G-CHOPG-FCOverall response27 (96.4)26 (92.9)Complete response11 (39.3)14 (50.0)Partial response16 (57.1)12 (42.9)Stable disease1 (3.6)0Progressive disease01 (3.6)Not assessed01 (3.6)In conclusion, GA101 can be combined safely with chemotherapy regimens used in the treatment of FL, and demonstrates a high level of activity compared with historical controls. G-CHOP could be delivered at the protocol-specified 3-weekly interval in most patients. G-FC in a more heavily pretreated population showed worse tolerability. Following these promising results, GA101 will be studied in combination with CHOP and other chemotherapies in a randomized Phase III study against the standard of care, R-CHOP. Disclosures:Cartron:Roche: Consultancy, Honoraria. Morschhauser:Roche: Honoraria; Celgene: Consultancy, Honoraria. Salles:Roche: Consultancy, Honoraria. Wenger:Roche: Employment. Asikanius:Roche: Employment. Wassner-Fritsch:Roche: Employment. Vitolo:Roche: Membership on an entity's Board of Directors or advisory committees.

Safety and Tolerability of Combination Acyclovir 5% and Hydrocortisone 1% Cream in Adolescents with Recurrent Herpes Simplex Labialis

A Phase 3, open-label, multicenter study was conducted to assess the safety of the combination of 5% acyclovir and 1% hydrocortisone cream (AHC cream) in the treatment of recurrent herpes simplex labialis (HSL) in immunocompetent adolescents. Eligible subjects were aged 12 to 17 years and had a history of recurrent labial herpes with two or more episodes during the last 12 months. Subjects initiated treatment at the first signs or symptoms of a herpes recurrence-at the earliest prodromal phase and preferably before the presence of papules or vesicles. Subjects applied the cream topically five times per day for 5 days. Adverse events, categorization of recurrence (ulcerative or nonulcerative), and maximum lesion area (maximum area of an ulcerative lesion) were assessed. Of the 134 subjects analyzed for safety, 131 had data for categorization of recurrence at the post-treatment visit 3 ± 1 weeks after the last dose. Seventy-eight subjects (59.5%) had nonulcerative recurrences, and 53 (40.5%) had ulcerative recurrences. All 131 subjects reached the stage of normal skin, with no signs or symptoms, at the follow-up visit. The mean maximum lesion area in the 53 subjects with ulcerative herpes lesion was 39 mm(2). Five subjects reported five adverse events (secondary herpes labialis recurrences, n = 2; infectious rhinitis, n = 1; application site inflammation, n = 1; bronchial asthma, n = 1). All adverse events were of mild to moderate intensity. The results of this study demonstrate that the combination of AHC cream is well tolerated in the treatment of recurrent HSL in adolescents.

Nasal obstruction as a drug side effect

Nasal obstruction is a common symptom of various diseases, allergies, and structural deformities and a 'stuffy nose' is one of the most common reasons that patients seek a physician's aid. Drugs that affect the autonomic nervous system are also expected to have a vasoactive effect on the nose. Nasal obstruction in the absence of infectious rhinitis or allergic symptoms may be due to drug use. With the chronic use of a medication, nasal obstruction can change over time and can be underestimated. Very little is known about this topic and very few publications to date solely devoted to drug-induced rhinitis. To prevent complications, obvious nasal obstruction due to drug intake should be treated with appropriate medication(s) or surgical intervention(s).

Inverse association between Helicobacter pylori infection and allergic rhinitis in young Japanese

The prevalence of allergic disorders, including asthma, atopic dermatitis, and allergic rhinitis has been increasing, and the prevalence of Helicobacter pylori (H. pylori) infection has been decreasing. Chronic bacterial infection during childhood is reported to protect the development of allergic diseases. The aim of the present study was to identify whether H. pylori infection influences the prevalence of allergic rhinitis, which has become a serious social problem, especially in the developed countries. We initially investigated the association between the prevalence of H. pylori and pollinosis symptoms in 97 healthy volunteers. We had investigated the association between the serum H. pylori-immunoglobulin (Ig) G antibodies and specific IgE antibodies for pollen, mites, and house dust in 211 consecutive patients. There were 52.2% (36/69) of H. pylori-negative volunteers with allergic symptoms, which was significantly higher than H. pylori-positive volunteers (14.3%, 4/28, P < 0.05). The risk of pollinosis symptoms by H. pylori infection was 0.148 (95% confidence interval): 0.046-0.475, P < 0.05). The prevalence of H. pylori infection increased according to age, whereas that of specific IgE-positive patients gradually decreased. Among the IgE-positive patients, the prevalence of H. pylori-negative patients was significantly higher than H. pylori-positive patients who were younger in age (P < 0.05). H. pylori infection decreased the pollinosis effects, especially among the younger volunteers. However, the prevalence of pollinosis in patients who were 50 years or older were almost same between H. pylori-positive and H. pylori-negative patients; therefore, the recent increase of pollinosis might relate to not only H. pylori infection, but also change in social environment.

Studies on the etiology of infectious atrophic rhinitis in pigs in Bulgaria.

Summary Experiments were carried out to elucidate the etiology of infectious atrophic rhinitis in pigs. It was proved that the disease was contagious and might be caused by various microorganisms. The association of different bacteria as an etiologic factor was established in one case (Pasteurella multocida, Bacterium pyocyanewn, E. coli). In another case Bordettella bronchiseptica was isolated. A viral agent was also demonstrated in a case of atrophic rhinitis. In all cases the disease could be reproduced by experimental infecting of sucking pigs. On the other hand, experiments with laboratory animals (mice, guinea pigs and rabbits) proved that Bordettella bronchiseptica might well play an etiologic role. The viral agent isolated could be grown on chicken embryos and tissue cultures. Zusammenfassung Untersuchungen zur Atiologie der infektiosen-atrophischen Rhinitis bei Schweinen in Bulgarien Zur Klarung der Atiologie der infektiosen-atrophischen Rhinitis wurden Versuche an Schweinen vorgenommen. Es wurde nachgewiesen, das die Krankheit ansteckend ist und durch verschiedene Mikroorganismen hervorgerufen werden kann. Die Vergesellschaftung mehrerer Bakterienarten als atiologischer Faktor wurde in einem Falle festgestellt (Pasteurella multocida, Bact. pyocyaneum, Bact. coli). In einem anderen Fall wurde Bordetella bronchiseptica isoliert. Auch ein Virus-Agens wurde in einem Falle von atrophischer Rhinitis gefunden. In allen Fallen konnte die Erkrankung durch experimentelle Ubertragung auf Saugferkel reproduziert werden. Andererseits zeigten Versuche mit Mausen, Meerschweinchen und Kaninchen, das Bordetella bronchiseptica durchaus eine atiologische Rolle spielen kann. Das isolierte Virus-Agens konnte auf Huhnerembryonen und Gewebekulturen vermehrt werden. Resume Etudes sur l'edologie de la rhinite atrophique infectieuse du porc en Bulgarie Des experiences furent entreprises sur des porcs, afin d'elucider l'etiologie de la rhinite atrophique infectieuse. Nous avons demontre que la maladie est infectieuse et qu'elle peut etre provoquee par differents microorganismes. Dans un cas, nous avons observe comme facteur etiologique une association de plusieurs especes de bacteries (P. multocida, Bact. pyocyaneum, Bact. coli). Dans un autre cas, nous avons isole Bordetella bronchiseptica. Un agent viral a ete egalement decele dans un cas de rhinite atrophique. Dans tous les cas, la maladie a pu etre reproduite experimentalement sur des procelets. D'autre part, des experiences sur souris, cobayes et lapins demontrent que Bordetella bronchiseptica peut tres bien jouer un role etiologique. On parvient a une propagation de l'agent viral sur embryons de poulet et culture de tissu. Resumen Estudios sobre la etiologia de la rinitis atrofica infecciosa en los cerdos de Bulgaria Para elucidar la etiologia de la rinitis atrofica infecciosa se efectuaron experimentos en cerdos. Se demostro que la enfermedad es contagiosa y que puede ser producida por diversos microorganismos. La asociacion de diversas especies bacterianas como factor etiologico se comprobo en un caso (Pasteurella multocida, Bact. pyocianeum, Bact. coli). En otro caso se aislo Bordetella bronchiseptica. Tambien se hallo un agente virico en un caso de rinitis atrofica. En todos los casos se pudo reproducir la enfermedad mediante transmision experimental a lechones. Por otro lado, los ensayos con ratones, cobayas y conejos aclarecieron que Bordetella bronchiseptica bien puede jugar un papel etiologico. El agente virico aislado se logro multiplicar en embriones de polio y en culturas histicas.

Stertor in the newborn due to congenital nasal pyriform aperture estenosis: case series

Stertor is a noise generated by the disturbance of the air flow passing through the nose. Its main cause -in newborns and infants- is inflammatory or infectious rhinitis. Congenital, neoplastic, traumatic or iatrogenic causes are less frequent. Congenital stenosis of the pyriform aperture is a rare etiology of nasal obstruction in the neonates. Early diagnosis and appropriate treatment are essential because of their exclusive nasal breathing. Suspicion might arise when a difficulty or even an impossibility to pass a probe of 2.8 mm (K30 tube) through anterior nares, exists. Diagnosis should be confirmed by a computed tomography of the craniofacial massif. The therapeutic behavior will depend on the severity of symptoms. We describe our experience with nine patients with this condition whose surgical correction was successful.

Role of Nasal Cytology

Nasal cytology represents a valid method in the differential diagnosis of allergic and non-allergic nasal diseases, as it is simple, safe, non-invasive, cost-effective, and easy to perform both in the medical and paediatric office. In particular, through cytological investigation it is possible to diagnose a group of “non-allergic infective rhinitis” that still today constitutes a vague aspect of the clinical-diagnostic-therapeutic approach to eosinophilic non-allergic rhinitis (NARES), non-allergic rhinitis mast cell (NARMA), neutrophilic non-allergic rhinitis (NARNA), and eosinophil-mast cell non-allergic rhinitis (NARESMA). Preventive treatment of nasal diseases, when guided by rhinocytograms, leads to a favorable clinical and time-dependent outcome. These advantages are reflected in a better quality of life and in a reduction in National Health Service costs, without chronic evolution of the disease to complications.

Methodology of the inflammation level evaluation in nasalsecretions

The questions of local nasal inflammation typical for allergic and infectious rhinitis are discussed. These proteins appear in nasal cavity in the beginning of the disease earlier than in the blood. That's why it is necessary to collaborate new non - invasive methods of new markers diagnostics of local inflammation.

Failure to identify an association between serologic or molecular evidence of Bartonella infection and idiopathic rhinitis in dogs

To determine whether infection with or exposure to Bartonella spp was associated with idiopathic rhinitis in dogs. Case-control study. 44 dogs with idiopathic nasal discharge and 63 age- and weight-matched control dogs without nasal discharge and no clinical signs of bartonellosis. Procedures-Serum was tested for antibodies against Bartonella henselae and Bartonella vinsonii subsp berkhoffii with indirect fluorescent antibody assays. Blood was tested for Bartonella DNA with a PCR assay. Results of the antibody and PCR assays were negative for all 44 dogs with idiopathic nasal discharge. One control dog had antibodies against B henselae; a second control dog had positive PCR assay results. We did not detect a significant association between assay results and group designation. The present study failed to confirm an association between idiopathic rhinitis and exposure to or infection with Bartonella spp in dogs. Findings do not rule out the possibility that Bartonella infection may cause nasal discharge in some dogs, but the failure to find any evidence of exposure to or infection with Bartonella spp in dogs with idiopathic nasal discharge suggested that Bartonella infection was not a common cause of the disease.

Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2LEN paper

Nonallergic rhinitis (NAR) can be defined as a chronic nasal inflammation which is not caused by systemic IgE-dependent mechanisms. It is common and probably affects far more than 200 million people worldwide. Both children and adults are affected. However, its exact prevalence is unknown and its phenotypes need to be evaluated using appropriate methods to better understand its pathophysiology, diagnosis and management. It is important to differentiate between infectious rhinitis, allergic/NAR and chronic rhinosinusitis, as management differs for each of these cases. Characterization of the phenotype, mechanisms and management of NAR represents one of the major unmet needs in allergic and nonallergic diseases. Studies on children and adults are required in order to appreciate the prevalence, phenotype, severity and co-morbidities of NAR. These studies should compare allergic and NAR and consider different age group populations including elderly subjects. Mechanistic studies should be carried out to better understand the disease(s) and risk factors and to guide towards an improved diagnosis and therapy. These studies need to take the heterogeneity of NAR into account. It is likely that neuronal mechanisms, T cells, innate immunity and possibly auto-immune responses all play a role in NAR and may also contribute to the symptoms of allergic rhinitis.

Effective Treatment of Smell Loss with Theophylline

While patients with smell loss in the US number in the millions there has been no effective method to either evaluate or treat the majority of them. These patients exhibit several causes for their loss including post viral infection, head injury and allergic rhinitis. Their semll loss has been measured objectively by psychophysical techniques and subjectively by quantitative evaluation of loss. We described the major biochemical defect causing these sensory losses‐decreased cAMP and cGMP in nasal mucus; this defect inhibits growth and development of olfactory receptor cells. To improve patients’ sensory loss we attempted to correct their observed biochemical defect by increasing cAMP and cGMP though use of the phosphodiesterase inhibitor theophylline which we gave orally to 309 patients at doses of 200–600 mg for 2–8 months. Psychophysical measurements of smell function improved in over 70%. Subjective responses improved in only 144 (47%); among these responders were 27% who improved 51% and 20% who improved 84%. 165 (53%) did not improve‐nonresponders‐ who improved 0.5%. Responders had significantly less severe smell loss than did nonresponders but there were no differences in age or blood levels of theophylline. These results indicate that patients with smell loss of several etiologies with this biochemical defect can be treated effectively with theophylline to improve smell fucntion.

The level of free hemoglobin, eosinophilic cationic protein and eosinophils in nasal secret in patients with allergic and infectious rhinitis

Background. Allergic rhinitis manifestates as the local inflammation with minimum pathophysiological disorders. Revealing of local inflammatory markers in nasal secret is actual problem. The aim: to detect the levels of free hemoglobin, eosinophilic cationic protein and eosinophils in nasal secret in patients with allergic rhinitis and infectious rhinitis. Materials and methods. 60 patients with allergic rhinitis and 30 patients with infectious rhinitis were observed. The diagnosis and severity of disease were rated in conformity with international standards. Results. Mean level of free hemoglobin in patients with allergic rhinitis was significantly higher in comparison with the group of infectious rhinitis and had compiled 55,9 mkg/ml and 6,1 mkg/ml. The quantity of eosinophils more than 10% was observed in 43,9% of cases in patients with allergic rhinitis and in 11,1% in patients with infectious rhinitis. Frequency of elevated level of eosinophilic cationic protein in patients with allergic rhinitis has made 87,9%, in comparison with infectious rhinitis where it corresponded to 28%. The highest sensitivity (87,9%) was found in method of definition of eosinophilic cationic protein. Method of free hemoglobin's definition was characterized by high parameter of correct diagnosis's probability - 97,3%. Conclusion. Methods of definition of eosinophilic cationic protein and free hemoglobin in nasal secret had possessed with the highest diagnostic efficiency.

Xylitol to Prevent Acute Otitis Media

To the Editors: We read with interest the clinical trial by Hautalahti, et al “Failure of xylitol given three times a day for preventing acute otitis media.”1 The authors report no effect on the incidence of acute otitis media (AOM) in children treated with xylitol three times daily compared with placebo, in contrast to their two previous clinical trials, which reported 20%–40% reductions in AOM among children treated with a similar total daily dose of xylitol divided five times daily.2,3 The authors explain the disparate findings on the basis of the reduced xylitol frequency, but we find a potentially more compelling explanation. In the current study, the authors’ definition of AOM as the primary outcome of interest required: (1) symptoms of “any respiratory symptoms (fever, cough, rhinitis, blocked nose, sore throat, earache, vomiting, diarrhea, nocturnal restlessness or lack of appetite)”; (2) the presence of middle ear effusion by tympanometry. This definition of AOM is imprecise in that it lacks any requirement for middle ear inflammation and would therefore misclassify episodes of otitis media with effusion (OME) as AOM.4 For example, a child with rhinitis (which could be due to a viral upper respiratory tract infection, environmental allergies, or vasomotor rhinitis) plus a serous middle ear effusion would be classified by the study as having AOM when such a child most likely has OME. Indeed, a child with diarrhea but no respiratory symptoms at all, and an incidental serous middle ear effusion would qualify as having AOM. Such nondifferential misclassification of the outcome biases towards the null and, especially since OME is much more common than AOM, could easily explain the study's null result. What makes this misclassification error all the more puzzling is that the same group of researchers used an appropriate definition of AOM in their 1998 xylitol trial, namely “The diagnosis of AOM required the finding of middle ear effusion in tympanometry (B- or C-curve), verified signs of inflammation in the tympanic membrane (emphasis added), and the presence of symptoms of acute respiratory tract infection (rhinitis, cough, conjunctivitis, sore throat, earache).”3 In summary, the trial by Hautalahti, et al demonstrates that xylitol given three times daily does not prevent OME in children. We believe that the question of whether xylitol given three times daily prevents AOM is still an open one. Louis Vernacchio, MD, MSc Allen A. Mitchell, MD Slone Epidemiology Center at Boston University Boston, MA

Relationship between Toxocara Seropositivity and Allergic Rhinitis

Allergic rhinitis is the most common chronic disease in the upper respiratory tract, requiring better diagnostic methodology to counteract its onslaught. The purpose of this study was to investigate the association between Toxocara seropositivity and allergic rhinitis. Sixty-four consecutive patients with allergic rhinitis and 61 healthy volunteers in the control group were included in this study. The diagnosis of allergic rhinitis was defined by positive epicutaneous prick test. The diagnosis of toxocariasis was established by IgG and specific IgE antibodies against Toxocara by ELISA method. All cases were examined for intestinal parasites also. The seropositive cases with Toxocara were reevaluated for symptoms and signs of toxocariasis. Higher toxocariasis seropositivity (ELISA IgG; 28.1%) rate was determined in the patients with allergic rhinitis and compared with the control groups (11.5%; p < 0.05). Specific IgE seropositivity (17.2%) was high for the patients with allergic rhinitis compared with the control group (3.3%; p < 0.05). Our results show that there was a possible causal relationship between Toxocara infection and allergic rhinitis. Patients with allergic rhinitis from a region with high prevalence for this parasitic infection should be evaluated for Toxocara infection.

Analysis of Plasmacytoid and Myeloid Dendritic Cells in Nasal Epithelium

The role of plasmacytoid dendritic cells (PDC), the major producers of alpha interferon upon viral infection, in the nasal mucosa is largely unknown. Here we examined the presence of PDC together with myeloid dendritic cells (MDC) in the nasal epithelia of healthy individuals, of asymptomatic patients with chronic nasal allergy, of patients undergoing steroid therapy, and of patients with infectious rhinitis or rhinosinusitis. Considerable numbers of PDC and MDC could be detected in the nasal epithelium. Furthermore, we demonstrate the expression of SDF-1, the major chemoattractant for PDC, in the nasal epithelium. PDC levels were significantly lower for patients with allergies than for healthy individuals. Interestingly, PDC and MDC were almost absent from patients who received treatment with glucocorticoids, while very high numbers of PDC were found for patients with recent upper respiratory tract infections. Our results demonstrate for the first time a quantitative analysis of PDC and MDC in the healthy nasal epithelium and in nasal epithelia from patients with different pathological conditions. With the identification of PDC, the major target cell for CpG DNA or immunostimulatory RNA, in the nasal epithelium, this study forms the basis for a local nasal application of such oligonucleotides for the treatment of viral infection and allergy.

Nasal Cytobrush Cytology

To evaluate the hyperchromatic supranuclear stria (SNS) in various types of rhinopathies.The study included 42 patients with rhinopathies and a control group consisting of 28 healthy adults. The rhinopathy group was categorized into 4 subgroups, including allergic rhinitis, infective rhinitis, vasomotor rhinitis and mixed group. Cytologic samples were obtained by cytobrush from the middle one third of the inferior turbinate.The hyperchromatic SNS was present in the majority of ciliated cells in a high percentage in the control group (91.7%), whereas in the pathologic group it was 40%. The difference is significant (p = 0.0000).Nasal cytology is a simple, reliable tool for the diagnosis of rhinopathies.

Techniques d’étude pharmacologique et clinique de l’obstruction nasale : application à la xylométazoline

Nasal obstruction, a prominent feature of rhinitis, may be quantified in humans by haemodynamic techniques (measuring local blood flux), static methods (measuring the geometry of nasal cavities) and dynamic methods (assessing the patency of nasal airways through the measure of resistance to air flow). These methods demonstrated the nasal decongestant activity of xylometazoline in healthy volunteers and rhinitis patients. Controlled double-blind studies established the clinical efficacy of xylometazoline in infectious and allergic (seasonal and perennial) rhinitis versus placebo and in comparison with various reference substances. The effects on nasal epithelium ciliary activity which are observed in vitro are modest and even less pronounced in vivo owing to dilution in situ and protective physiological processes.