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Lipińska-Ojrzanowska A, Marcinkiewicz A, Walusiak-Skorupa J. Usefulness of Biomarkers in Work-Related Airway Disease. CURRENT TREATMENT OPTIONS IN ALLERGY 2017; 4:181-190. [PMID: 28680796 PMCID: PMC5488075 DOI: 10.1007/s40521-017-0121-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Determination of biomarkers may be useful in the surveillance of occupational exposure and workers' health. The possibility of predicting development/clinical course of specific disorders or current disease, diagnosing in early steps, and health condition monitoring is a real necessity. Various agents present in the workplace environment (or their metabolites) can be measured in samples possessed from human body (blood and urine, saliva, etc.). On the other hand, inhalant exposure may induce specific or non-specific, local or systemic, acute or chronic biological response expressed by synthesis or releasing specific or non-specific substances/mediators that also can be determined in blood, nasal and bronchial lavage or sputum, tear fluid, exhaled breath, etc. The least is known about genetic markers which may predict individual susceptibility to develop some work-related disorders under the influence of occupational exposure. Due to common exposure to inhalant agents at workplace, researches on biomarkers that allow to inspect the impact of exposure to humans' health are still needed. The authors of this article summarize the utility of biomarkers' determination in work-related airway diseases in a recent clinical approach.
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Affiliation(s)
- Agnieszka Lipińska-Ojrzanowska
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 8 St. Teresy, 91-348 Lodz, Poland
| | - Andrzej Marcinkiewicz
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 8 St. Teresy, 91-348 Lodz, Poland
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 8 St. Teresy, 91-348 Lodz, Poland
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Matsumoto FY, Gonçalves TRT, Solé D, Wandalsen GF. Specific Nasal Provocation Test with Dermatophagoides Pteronyssinus, Monitored by Acoustic Rhinometry, in Children with Rhinitis. Am J Rhinol Allergy 2017; 31:7-11. [DOI: 10.2500/ajra.2017.31.4392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Currently, the diagnosis of allergic rhinitis (AR) is arrived at predominantly by a clinical history and by systemic sensitization tests, but specific nasal provocation tests (NPT) may establish a better direct correlation between etiologic surveyed allergens and nasal symptoms. Objectives To standardize the specific NPT with one of the most important house-dust mites, Dermatophagoides pteronyssinus, monitored by acoustic rhinometry, in children and adolescents, and propose a simplified specific NPT to improve its clinical applicability as a diagnostic tool. Methods Sixteen controls (group 1) and 17 patients with an AR diagnosis sensitized to D. pteronyssinus (group 2) underwent a specific NPT with D. pteronyssinus. The acoustic rhinometry was performed after instillation of 0.15 mL of increasing concentrations of D. pteronyssinus (5000 BU/mL). The test was finalized after (1) instillation of the final concentration of D. pteronyssinus, or (2) after a 20% or more reduction in the volume of the first 5 cm of the nasal cavity (V5), or (3) a score of >3 in the symptoms questionnaire (a score from 0 to 7). A simplified specific NPT with two concentrations was proposed and implemented in a group of 10 patients with AR (group 3). Results At the end of the specific NPT, the median (range) variation in V5 was -5.7% (-9 to 4%) in the control group and -22.8% (-24 to -20%) in group 2. None of the patients in the control group and 88% of group 2 (15/17) showed positive specific NPT results. The simplified specific NPT triggered a positive response in 80% of patients in group 3, with median (range) V5 variation of -30.4% (-36 to -20%). Conclusion This protocol has been proven safe and useful to differentiate between children and adolescents with AR and controls. Concentrations of 1:1000 and 1:100 D. pteronyssinus were the best for use in simplified specific NPT, which made it simpler and faster, and expanded its clinical applicability.
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Affiliation(s)
- Fausto Yoshio Matsumoto
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Gustavo Falbo Wandalsen
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil
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Baek JH, Cho E, Kim MA, Lee SW, Kang YS, Sheen YH, Jee HM, Jung YH, Han MY. Response to Nonallergenic Irritants in Children With Allergic and Nonallergic Rhinitis. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2016; 8:346-52. [PMID: 27126728 PMCID: PMC4853512 DOI: 10.4168/aair.2016.8.4.346] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 07/29/2015] [Accepted: 12/04/2015] [Indexed: 12/16/2022]
Abstract
Purpose Nonallergenic irritants can aggravate the symptoms of rhinitis. We investigated the clinical responses of children with allergic rhinitis (AR) and nonallergic rhinitis (NAR) to nonallergenic irritants, and identified factors associated with these responses. Methods Children with chronic rhinitis (n=208) were classified as having AR or NAR based on the presence of aeroallergen-specific IgE. Healthy controls (n=24) were recruited for comparison. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines were used to classify patients, and their irritant score (0-21 points) and current symptom score (5-35 points) were measured. Subjects with irritant scores ≥3 and <3 were classified as having irritant and nonirritant rhinitis, respectively. Results The mean age of enrolled subjects was 6.8 years (range: 1.8-16.0 years). The AR and NAR groups had similar irritant scores (P=0.394) and proportions of subjects with irritant scores ≥3 (P=0.105). Irritant score correlated positively with symptom score (P=0.005), and the proportion of subjects with irritant scores ≥3 was greater in children with moderate-severe rhinitis than in those with mild rhinitis (P=0.046). Multiple logistic regression analysis indicated that the presence of atopic eczema increased the risk for sensitivity to a nonallergenic irritant (aOR=2.928, 95% CI 1.567-5.473, P=0.001). Conclusions Response to a nonallergenic irritant was useful for gauging the severity of rhinitis, but not for differentiating AR from NAR. AR and NAR patients with atopic eczema may increase nasal sensitivity to nonallergenic irritants.
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Affiliation(s)
- Ji Hyeon Baek
- Department of Pediatrics, College of Medicine, Hallym University, Hwaseong, Korea
| | - Eunhae Cho
- Department of Pediatrics, CHA University School of Medicine, Pocheon, Korea
| | - Mi Ae Kim
- Department of Medicine, CHA University School of Medicine, Seongnam, Korea
| | - Seung Won Lee
- Department of Pediatrics, CHA University School of Medicine, Pocheon, Korea
| | - Yu Sun Kang
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Youn Ho Sheen
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Hye Mi Jee
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Young Ho Jung
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea.
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Segboer CL, Holland CT, Reinartz SM, Terreehorst I, Gevorgyan A, Hellings PW, van Drunen CM, Fokkens WJ. Nasal hyper-reactivity is a common feature in both allergic and nonallergic rhinitis. Allergy 2013; 68:1427-34. [PMID: 24118053 DOI: 10.1111/all.12255] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2013] [Indexed: 01/09/2023]
Abstract
BACKGROUND Nasal hyper-reactivity is an increased sensitivity of the nasal mucosa to various nonspecific stimuli. Both allergic rhinitis (AR) and nonallergic rhinitis (NAR) patients can elicit nasal hyper-reactivity symptoms. Differences in the prevalence or type of nasal hyper-reactivity in AR and NAR patients are largely unknown. In this study, we quantitatively and qualitatively assessed nasal hyper-reactivity in AR and NAR. METHODS In the first part, an analysis of a prospectively collected database was performed to reveal patient-reported symptoms of hyper-reactivity. In the second part, cold dry air provocation (CDA) was performed as a hyper-reactivity measure in AR and NAR patients and healthy controls, and symptoms scores, nasal secretions and peak nasal inspiratory flow were measured. Comparisons were made between AR and NAR patients in both studies. RESULTS The database analysis revealed high hyper-reactivity prevalence in AR (63.4%) and NAR (66.9%). There were no differences between AR and NAR in terms of the number or type of hyper-reactivity stimuli. Hyper-reactivity to physical stimuli did not exclude a response to chemical stimuli, or vice versa. CDA provocation resulted in a significant increase in rhinitis symptoms and the amount of nasal secretions in AR and NAR patients, but not in controls. CONCLUSIONS We found no quantitative or qualitative differences in nasal hyper-reactivity between AR and NAR patients. It is not possible to differentiate NAR subpopulations based on physical or chemical stimuli.
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Affiliation(s)
- C. L. Segboer
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam the Netherlands
| | - C. T. Holland
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam the Netherlands
| | - S. M. Reinartz
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam the Netherlands
| | - I. Terreehorst
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam the Netherlands
| | - A. Gevorgyan
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam the Netherlands
| | - P. W. Hellings
- Department of Otorhinolaryngology; University Hospitals Leuven; Leuven Belgium
| | - C. M. van Drunen
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam the Netherlands
| | - W. J. Fokkens
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam the Netherlands
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Shusterman DJ, Tilles SA. Nasal Physiological Reactivity of Subjects with Nonallergic Rhinitis to Cold Air Provocation: A Pilot Comparison of Subgroups. Am J Rhinol Allergy 2009; 23:475-9. [DOI: 10.2500/ajra.2009.23.3348] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Noninfectious nonallergic rhinitis (NINAR) is characterized by self-reported hyperreactivity to nonspecific physical or chemical stimuli. The relationship between these two classes of triggers is not well established, however. We compared NINAR subjects with predominantly physical or chemical triggers versus normal controls with respect to subjective (symptomatic) and objective (obstructive) responses to cold, dry air challenge. Methods We studied 14 NINAR subjects and 10 normal controls. Exposures consisted of 15 minutes of cold dry air (0°C/5% RH) or warm moist air (25°C/50% RH) on two separate days a week apart. Subjects rated symptoms using visual analog scales and had their nasal airway resistance measured at baseline, immediately after, and at 15-minute intervals for 1 hour postexposure. Results The majority of NINAR subjects reported physical triggers as more troublesome than chemical. Immediately postprovocation, the mean net proportional change in nasal airway resistance from baseline was +0.18 in NINAR (physical), +0.05 in NINAR (chemical), and –0.01 in control subjects (NS). However, a pooled linear regression by number of physical triggers (0–5) revealed a 7.5% increase in cold air–induced nasal airway resistance per trigger reported (p < 0.05). Similarly, raising the criterion number of physical triggers from ≥1 to ≥2 also distinguished NINAR subjects from controls in a bivariate analysis. Conclusion Either considering self-reported physical triggers as a continuous scale (0–5) or requiring more physical triggers (≥ 2 rather than ≥1) to define NINAR successfully predicts objective nasal reactivity to cold air provocation.
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Affiliation(s)
| | - Stephen A. Tilles
- Department of Medicine, University of Washington, Seattle, Washington
- ASTHMA, Inc., Seattle, Washington
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Gelardi M, Russo C, Fiorella ML, Fiorella R, Canonica GW, Passalacqua G. When allergic rhinitis is not only allergic. Am J Rhinol Allergy 2009; 23:312-5. [PMID: 19490808 DOI: 10.2500/ajra.2009.23.3320] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND In clinical practice it can be observed that some patients with seasonal allergic rhinitis (AR) continue to have symptoms even when the exposure to allergens is expected to be low or absent. We studied the clinical and cytological characteristics of these atypical forms of (AR) in a large population of patients. METHODS Consecutive patients with symptoms of rhinitis and with positive skin test to pollens only were interviewed for the duration of symptoms, correlation with sensitization pattern, and presence of reactivity to nonspecific stimuli. All underwent rhinoscopy and nasal scraping for cytology. RESULTS Five hundred nineteen patients with AR were studied. Of these 519 patients 60 (11.5%) had an atypical or mixed form of rhinitis, with symptoms independent of the exposure and also elicited by nonspecific stimuli. These patients clearly differed from typical forms, especially for the nasal inflammation. They had a greater number of eosinophils and mast cells out of season (p < 0.05). Moreover, these atypical forms had, more frequently, asthma and eosinophilic polyps. CONCLUSION In approximately 12% of patients with AR, other mechanisms of inflammation seem to intervene. Nasal cytology can be helpful in discriminating these atypical forms.
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Affiliation(s)
- Matteo Gelardi
- Department of Otolaryngology II, University of Bari, Bari, Italy
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Moscato G, Vandenplas O, Van Wijk RG, Malo JL, Perfetti L, Quirce S, Walusiak J, Castano R, Pala G, Gautrin D, De Groot H, Folletti I, Yacoub MR, Siracusa A. EAACI position paper on occupational rhinitis. Respir Res 2009; 10:16. [PMID: 19257881 PMCID: PMC2654869 DOI: 10.1186/1465-9921-10-16] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Accepted: 03/03/2009] [Indexed: 01/15/2023] Open
Abstract
The present document is the result of a consensus reached by a panel of experts from European and non-European countries on Occupational Rhinitis (OR), a disease of emerging relevance which has received little attention in comparison to occupational asthma. The document covers the main items of OR including epidemiology, diagnosis, management, socio-economic impact, preventive strategies and medicolegal issues. An operational definition and classification of OR tailored on that of occupational asthma, as well as a diagnostic algorithm based on steps allowing for different levels of diagnostic evidence are proposed. The needs for future research are pointed out. Key messages are issued for each item.
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Affiliation(s)
- Gianna Moscato
- Allergy and Immunology Unit, Fondazione 'Salvatore Maugeri', Institute of Care and Research, Scientific Institute of Pavia, Pavia, Italy
| | - Olivier Vandenplas
- Service de Pneumologie, Cliniques de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | | | - Jean-Luc Malo
- Center for Asthma in the Workplace, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche-Pneumologie, Montreal, Quebec, Canada
| | - Luca Perfetti
- Allergy and Immunology Unit, Fondazione 'Salvatore Maugeri', Institute of Care and Research, Scientific Institute of Pavia, Pavia, Italy
| | | | - Jolanta Walusiak
- Department of Occupational Diseases, Institute of Occupational Medicine, Lodz, Poland
| | - Roberto Castano
- Center for Asthma in the Workplace, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche-Pneumologie, Montreal, Quebec, Canada
| | - Gianni Pala
- Allergy and Immunology Unit, Fondazione 'Salvatore Maugeri', Institute of Care and Research, Scientific Institute of Pavia, Pavia, Italy
| | - Denyse Gautrin
- Center for Asthma in the Workplace, Hôpital du Sacré-Coeur de Montréal, Centre de Recherche-Pneumologie, Montreal, Quebec, Canada
| | - Hans De Groot
- Department of Allergology, Erasmus MC, Rotterdam, The Netherlands
| | - Ilenia Folletti
- Occupational Medicine, Terni Hospital, University of Perugia, Perugia, Italy
| | - Mona Rita Yacoub
- Allergy and Immunology Unit, Fondazione 'Salvatore Maugeri', Institute of Care and Research, Scientific Institute of Pavia, Pavia, Italy
| | - Andrea Siracusa
- Occupational Medicine, Terni Hospital, University of Perugia, Perugia, Italy
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Moscato G, Vandenplas O, Gerth Van Wijk R, Malo JL, Quirce S, Walusiak J, Castano R, De Groot H, Folletti I, Gautrin D, Yacoub MR, Perfetti L, Siracusa A. Occupational rhinitis. Allergy 2008; 63:969-80. [PMID: 18691299 DOI: 10.1111/j.1398-9995.2008.01801.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The present document is the result of a consensus reached by a panel of experts from European and nonEuropean countries on Occupational Rhinitis (OR), a disease of emerging relevance, which has received little attention in comparison to occupational asthma. The document covers the main items of OR including epidemiology, diagnosis, management, socio-economic impact, preventive strategies and medicolegal issues. An operational definition and classification of OR tailored to that of occupational asthma, as well as a diagnostic algorithm based on steps allowing different levels of diagnostic evidence, are proposed. The needs for future research are pointed out. Key messages are issued for each item.
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Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8-160. [PMID: 18331513 DOI: 10.1111/j.1398-9995.2007.01620.x] [Citation(s) in RCA: 3002] [Impact Index Per Article: 187.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Asthma/therapy
- Child
- Global Health
- Humans
- Prevalence
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
- World Health Organization
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Affiliation(s)
- J Bousquet
- University Hospital and INSERM, Hôpital Arnaud de Villeneuve, Montpellier, France
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Kirmaz C, Degirmenci PB, Tunali D, Yuksel H. Lower respiratory tract complications during nasal provocation: nonspecific stimulant or specific allergen? Ann Allergy Asthma Immunol 2007; 98:524-32. [PMID: 17601264 DOI: 10.1016/s1081-1206(10)60730-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) is an allergic inflammatory disease in which allergen exposure leads to the appearance of symptoms in sensitized individuals because of histamine liberation from nasal mucosal mast cells. Comorbidity of this disease with allergic asthma is common. Therefore, the one airway one disease theory has been put forward. Lower respiratory tract provocation tests with both nonspecific (methacholine) and specific stimulants (allergen) have yielded positive results in nonasthmatic patients with AR. However, not enough research is available to demonstrate whether there is a response in the lower respiratory tract during nasal provocation tests (NPTs) performed to evaluate only nasal airway in these patients. OBJECTIVES To determine if the lower respiratory tract was affected as a result of NPTs with nonspecific and specific stimulants in nonasthmatic patients with AR and to determine the frequency of lower respiratory tract obstruction due to NPT with nonspecific and specific stimulants. METHODS Thirty-six participants were enrolled in the study between November 2005 and January 2006 (18 AR patients and 18 healthy control subjects). Patients underwent 2 sessions of NPT. The first session was performed with nasal methacholine as a nonspecific stimulant, and the second session was performed with nasal Olea europaea extract as a specific stimulant. The control group underwent only nonspecific nasal provocation with methacholine. Basal nasal opening and nasal pressures were evaluated spirometrically by rhinomanometric measurements and basal respiratory function tests in both groups before methacholine nasal provocation. Whether or not nasal provocation was achieved, spirometric measurements were performed in all patients and controls after NPTs. RESULTS NPTs with methacholine resulted in a similar frequency of nasal provocation in the patient and control groups (P = .63). However, the mean methacholine dose was lower in patients with AR (P = .049). There was a decrease in parameters of asthma, including the ratio of forced expiratory volume in 1 second to forced vital capacity (P = .04), peak expiratory flow (P = .01), and forced expiratory flow between 25% and 75% (P = .004), as a result of NPTs with methacholine in the patient group. However, NPTs with allergen did not cause a change in lower respiratory tract obstruction criteria. CONCLUSIONS Lower respiratory tract obstruction can occur after NPTs with nonspecific stimulants; therefore, tests performed with specific allergens can be regarded as safer.
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Affiliation(s)
- Cengiz Kirmaz
- Division of Allergy and Immunology, Department of Internal Medicine, Celal Bayar University Medical Faculty, Manisa, Turkey.
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Sheahan P, McConn-Walsh R, Walsh M, Costello RW. Subjects with non-allergic non-infectious perennial rhinitis do not show nasal hyper-responsiveness to bradykinin. Eur Arch Otorhinolaryngol 2006; 264:33-7. [PMID: 17043856 DOI: 10.1007/s00405-006-0161-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2006] [Accepted: 07/19/2006] [Indexed: 10/24/2022]
Abstract
Symptoms in non-allergic non-infectious perennial rhinitis (NANIPER) are characteristically trigged by non-specific irritants. Hyper-responsiveness to cold dry air has been demonstrated in NANIPER. Bradykinin is a peptide involved in allergic inflammation. Neurally mediated hyper-responsiveness to bradykinin has been demonstrated in allergic rhinitis. The purpose of the present study was to investigate whether hyper-responsiveness to bradykinin is present in NANIPER. Normal subjects (n = 13) and subjects with NANIPER (n = 10) were subjected to a nasal bradykinin challenge protocol. Secretory responses were measured using filter paper disks, and congestive responses measured using acoustic rhinometry. Compared to normal subjects, with NANIPER had a greater secretory response to control challenge with Hartman's solution. On the other hand, the normal ipsilateral secretory and congestive response to bradykinin was absent in NANIPER. Subjects with NANIPER did not demonstrate any evidence of reflex responses to bradykinin, and no evidence of nasal hyper-responsiveness to bradykinin. Hyper-responsiveness to bradykinin is absent in NANIPER. These results suggest that autonomic hyporesponsiveness rather than neural hyper-responsiveness may be an important factor in the etiology of NANIPER.
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Affiliation(s)
- Patrick Sheahan
- Department of Otolaryngology-Head and Neck Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland.
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12
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Abstract
PURPOSE OF THE REVIEW The purpose of this review is to examine the role of acoustic rhinometry in clinical practice. Although acoustic rhinometry was first described for clinical use in 1989, it is not in common use today. Should we be using it? Yes. I think we should be using it more often. This review provides an update of the new standard for interpretation and expanded clinical uses. RECENT FINDINGS The most significant advances in the past year in this area have been the publication of standards for its clinical use. In addition, the repertoire of clinical problems that can be analyzed objectively with acoustic rhinometry has expanded to include turbinoplasty, sleep disorders, more types of cosmetic/reconstructive procedures, sinus surgery, vasomotor rhinitis, maxillofacial expansion procedures, and aspirin and methacholine challenge. (Its ability for pediatric disorders, such as adenoidectomy, has been reaffirmed.) Some case examples are included to demonstrate the utility of acoustic rhinometry for 'mixed' pathology. SUMMARY Acoustic rhinometry is a rapid, objective, painless, noninvasive technique for assessing nasal airway obstruction. Recently, standards have been developed that aid its expansion for clinical use. Expanded clinical applications include sleep disorders, cosmetic/reconstructive and maxillofacial disorders, sinus and turbinate procedures, and pediatrics. Acoustic rhinometry should be utilized to improve our ability to practice evidence-based medicine in rhinology.
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MESH Headings
- Adult
- Aged
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Nasal Cavity/physiopathology
- Nasal Obstruction/diagnosis
- Nasal Obstruction/etiology
- Nasal Obstruction/physiopathology
- Nasal Obstruction/surgery
- Nose Diseases/diagnosis
- Nose Diseases/etiology
- Nose Diseases/physiopathology
- Nose Diseases/surgery
- Postoperative Complications/diagnosis
- Postoperative Complications/etiology
- Postoperative Complications/physiopathology
- Postoperative Complications/surgery
- Pulmonary Ventilation/physiology
- Plastic Surgery Procedures
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/physiopathology
- Rhinitis, Allergic, Perennial/surgery
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/physiopathology
- Rhinitis, Allergic, Seasonal/surgery
- Rhinometry, Acoustic
- Rhinoplasty
- Turbinates/surgery
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Affiliation(s)
- Jacquelynne P Corey
- University of Chicago Hospitals, 5841 S. Maryland Avenue, MC 1035, Illinois 60637, USA.
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13
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Lal D, Corey JP. Acoustic rhinometry and its uses in rhinology and diagnosis of nasal obstruction. Facial Plast Surg Clin North Am 2004; 12:397-405, v. [PMID: 15337107 DOI: 10.1016/j.fsc.2004.04.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Acoustic rhinometry is a tool that can aid in the assessment of nasal obstruction. The test is noninvasive, reliable, convenient, and easy to perform. Common clinical and practical uses of acoustic rhinometry for the rhinologic surgeon include assessment of"mixed" nasal blockage, documentation of nasal alar collapse, and preoperative planning for reduction rhinoplasty. Acoustic rhinometry can also be used to document the positive effect of surgery on nasal airway obstruction.
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Affiliation(s)
- Devyani Lal
- Section of Otolaryngology-Head and Neck Surgery, University of Chicago, 5841 South Maryland Avenue, MC 1035, Chicago, IL 60610, USA
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14
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Rudblad S, Andersson K, Bodin L, Stridh G, Juto JE. Nasal mucosal histamine reactivity among young students and teachers, having no or prolonged exposure to a deteriorated indoor climate. Allergy 2002; 57:1029-35. [PMID: 12358999 DOI: 10.1034/j.1398-9995.2002.23682.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND In a study performed in the spring of 1995, we found a significantly greater nasal mucosal histamine reactivity among teachers, who had worked for several years in a recently renovated moisture-damaged school, than in those in a control school. In the present study we investigated the students who begun their high-school studies at both schools in the autumn of 1995 and compared them with the teachers as regards mucosal reactivity, atopy and symptoms. METHODS Twenty-eight teachers in the target school, 18 teachers in the control school and 45 students from each school underwent a nasal histamine provocation test and a skin-prick test. They also answered a standardized questionnaire. RESULTS The teachers in both schools had more marked nasal mucosal histamine reactivity at the lowest provocation concentrations than the students. The histamine provocation curve of the target school teachers had consistently higher values than that of the students (P = 0.0001), but its slope and shape were similar (P = 0.15), while the slope of the provocation curve of the control school teachers was flatter. However, there was only a borderline significance in this respect compared to the students (P = 0.07). Teachers with a dry and crusty appearance of the nasal mucosa on anterior rhinoscopy reacted more strongly to histamine provocation than those without this finding (P = 0.0004). There was a significantly higher frequency of skin-prick test positivity (SPT+) among the students (P = 0.03). There were no significant differences in nasal mucosal histamine reactivity between atopic and non-atopic subjects out of pollen season. CONCLUSIONS Teachers had a significantly greater mucosal histamine reactivity than the students, whereas the latter had a significantly higher frequency of atopy. These results are compatible with an age-related pattern of mucosal reactivity. A crusty appearance of the nasal mucosa seems to predispose to an increase in histamine reactivity. There were no significant differences according to histamine reactivity between atopic and non-atopic subjects.
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Affiliation(s)
- S Rudblad
- Department of Otorhinolaryngology, Orebro University Hospital, SE-701 85 Orebro, Sweden
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15
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