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Ciprandi, G. et al.

Association between response to decongestion testing and sensitizations and allergic inflammation.

BACKGROUND: Rhinomanometry is used to measure nasal airflow, which is frequently impaired in allergic rhinitis ( AR). Decongestion testing consists of spraying an intranasal vasoconstrictor drug to evaluate recovery of nasal airflow. OBJECTIVE: To evaluate the relationships among type and number of sensitizations, nasal airflow recovery after topical vasoconstrictor drug use, and allergic inflammation. METHODS: A total of 123 patients (112 men and 11 women; mean +/- SD age, 22.9 +/- 5.7 years) were studied: 40 with perennial AR (PAR), 43 with mixed AR (MAR), and 40 with seasonal AR ( SAR). Patients with anatomic nasal defects were excluded. Total symptom scores (including nasal itching, sneezing, rhinorrhea, and nasal obstruction), sensitizations, nasal eosinophils, and cytokines (including interleukin 4 [IL-4], IL-5, and interferon-gamma) were evaluated. Electronic rhinomanometry and decongestion testing were performed in all the patients. RESULTS: After administration of a topical nasal vasoconstrictor agent, mean nasal airflow significantly increased from 471 to 580 mL/s (P < .001). In 12 patients (3 with PAR, 3 with MAR, and 6 with SAR), no increase was shown. Changes from baseline were different in the PAR, MAR, and SAR populations (PAR vs MAR, P < .001; PAR vs SAR, P < .001; and MAR vs SAR, P = .25). Type of sensitization (MAR, PAR, or SAR), concentration of eosinophils, and levels of IL-4, IL-5, and interferon-gamma were associated with nasal airflow recovery of at least 120 mL/s. CONCLUSIONS: This study provides the first evidence of a different response to decongestion testing taking into consideration the type of AR.[1]

References

Association between response to decongestion testing and sensitizations and allergic inflammation. Ciprandi, G., Cirillo, I., Klersy, C., Vizzaccaro, A., Tosca, M.A., Marseglia, G.L. Ann. Allergy Asthma Immunol. (2006) [Pubmed]

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