Correlation of atopy and FeNO in allergic rhinitis an Indian study.

Background. Fractional exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation. Limited published data are available on the effect of atopy on FeNO in allergic rhinitis. Objectives. To investigate the relationship between atopy and FeNO in patients with allergic rhinitis. Methods. Patients with allergic rhinitis were assessed for atopy and exhaled breath analysis of nitric oxide. Atopy was assessed by skin prick testing (SPT) against 58 common aero-allergens; a wheal size of 3mm or more as compared to buffer saline was considered positive. Patients were labelled to be atopic if they had at least one positive SPT result. The measurement of FeNO level was done by using NIOX chemiluminescence analyser. Results. Forty-nine participants (26 males) aged between 8-50 years were studied and 31 of them were found to be atopic. The average value of FeNO in the subjects studied (n=49) was 26.0±22.7 parts per billion (ppb) with significantly higher values being observed in atopic group as compared to non-atopic group (34.2±24.3 versus 11.9±9.0 ppb; p<0 .05). Conclusion. As FeNO is a marker of lower airway inflammation, significantly higher FeNO levels in atopic allergic rhinitis patients suggest that it may be a predictor for onset of asthma in these patients.

Análise de citocinas pela RT-PCR em pacientes com rinite alérgica / RT-PCR cytokine study in patients with allergic rhinitis

Rinite alérgica é uma doença que decorre de um processo inflamatório da mucosa nasal conseqüente à reação de hipersensibilidade a alérgenos inalatórios e, eventualmente, alimentares. É mediada por IgE, envolvendo diferentes células, mediadores e citocinas. OBJETIVO: Avaliar as transcrições para as seguintes citocinas: IL-4, IL-5, IL-8 e IFN-gama, particularmente importantes no processo alérgico nasal, principalmente IL-4 e IL-5. Neste estudo, optou-se por avaliar os pacientes atópicos fora das crises alérgicas, com a finalidade de se conhecer as expressões das citocinas neste período. MATERIAL E MÉTODO: Realizou-se um estudo transversal e prospectivo, selecionando-se 30 pacientes, sendo 13 pacientes portadores de rinite alérgica paucissintomáticos e 17 pacientes não-atópicos. Os grupos foram selecionados através da história, do exame clínico otorrinolaringológico e do teste alérgico cutâneo - Prick Test. O perfil das citocinas foi pesquisado nos fragmentos de mucosa nasal, através da RT-PCR semiquantitativa, escolhida por apresentar boa reprodutibilidade e especificidade, utilizando-se como referência o gene da Beta-actina. RESULTADOS: Os valores de IL-5, IL-8, IFN-gama mantiveram-se homogêneos em relação ao grupo controle. A IL-4 apresentou diferença com significância estatística. CONCLUSÃO: Os pacientes alérgicos paucissintomáticos apresentaram normalização da expressão das citocinas na mucosa nasal à exceção de IL-4.

Allergic rhinitis is an inflammatory reaction of the nasal mucosa, in consequence of an IgE mediated hypersensitive reaction to inhaling allergens, involving different mediators and cytokine cells. AIM: The purpose of this study was to evaluate the transcriptions for IL-4, IL-5, IL-8 and IFN-gama, particularly important in the nasal allergy process, especially IL-4 and IL-5. For this study we decided to evaluate atopic patients who were free from allergic crises, with the purpose of knowing the cytokine expressions during this period. MATERIALS AND METHODS: Another prospective and transversal study was carried out, selecting 30 patients, 13 of these patients were pauci-symptomatic and 17 were non atopic. The groups were selected by means of a medical interview, an otolaryngologic clinical exam and allergy skin tests - Prick Test. The cytokines were investigated in fragments of the nasal mucosa, using RT-PCR - chosen because it has good reproducibility and specificity. RESULTS: IL-5, IL-8, IFN-gama cytokine values were kept homogeneous in relation to the control group. Only IL-4 presented significant statistic differences. CONCLUSION: Asymptomatic patients with allergic rhinitis presented with normalization of cytokine expression in the nasal mucosa, with exception of IL-4.

Detection of amino acids in human nasal mucosa using microdialysis technique: increased glutamate in allergic rhinitis.

Amino acids, the smaller basic biochemical units of neuropeptides, have not been evaluated in the nasal cavity. The purpose of this study was to measure the concentration of neurotransmitting amino acids of the central nervous system, glutamate, aspartate, serine, taurine (2-aminoethane sulfonic acid; a conditionally essential amino acids), and GABA (gamma-amino-butyric acid; an amino acid produced in the brain), in nasal mucosa of allergic rhinitis patients and normal controls using a microdialysis technique. A microdialysis probe appropriate for use on human nasal mucosa was developed using Cuprophan hollow fiber. Glutamate concentration in allergy group was significantly higher (p = 0.004) than in control group, while the concentrations of the other four amino acids showed no significant difference between the two groups. Our findings and review of the literature suggest that glutamate is one of the most potent neurotransmitters associated with the parasympathetic nerve in the nasal cavity, and that the microdialysis technique is useful in studying the pharmacokinetics in situ and local organ chemistry of the nasal cavity.