Allergen-specific nasal provocation testing: review by the rhinoconjunctivitis committee of the Spanish Society of Allergy and Clinical Immunology.
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Specific nasal provocation testing (NPT) consists of eliciting a response from the nasal mucosa by controlled exposure to allergens. It is indicated in the diagnostic confirmation of allergic rhinitis and when discrepancies arise or difficulties exist in the assessment of a patient's medical history and the results of skin and/or serological tests. The technique is also applied to evaluate sensitivity to the allergen, the efficacy and safety profile of treatment, and in research on the pathophysiological mechanisms of nasal response to allergens. NPT also provides information on the etiology of occupational respiratory diseases of allergic origin. Although there have been many studies and publications on the use and standardization of bronchial provocation tests with allergen, few analyze specific NPT. In this review, the Rhinoconjunctivitis Committee of the Spanish Society of Allergy and Clinical Immunology discuss the methodology, monitoring, and assessment of allergen-specific NPT in order to provide a practical and up-to-date review of the technique. (+info)
Nasal PMN response to repeated challenge with endotoxin in healthy volunteers.
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Differential allergenicity of mature and immature pollen grains in Shasta daisy (Chrysanthemum maximum Ramond).
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Weed pollen grains belonging to the Asteraceae family contain a variety of allergens inducing type I and IV allergies in susceptible people. The aim of this research was to compare the allergenic properties of immature and mature Shasta daisy pollen grains (Chrysanthemum maximum Ramond) to define the potential role of the maturation process on the allergenicity of Asteraceae pollen grains. The immature (IP) and mature pollen (MP) grains were first studied by optical and scanning electron microscopand their protein contents were quantitatively and qualitatively analyzed. Pollen extracts were finally used to sensitize guinea pigs in order to obtain IP and MP specific antibodies. Nasal provocation tests using IP and MP crude extracts were also performed on pre-sensitized guinea pigs. The MP extract induced IgE and eosinophilia in blood and positive skin tests in sensitized guinea pigs. Moreover, high number of eosinophils was found in the nasal mucosa of MP sensitized guinea pigs. SDS-PAGE analysis of the IP and MP protein content showed seven and five apparent bands ranging from 7 to 66kDa respectively. According to immunoblot analysis, MP extract contained a single allergen of 66kDa. The overall results showed developmental processes of Shasta daisy pollen grains towards both morphological and molecular changes increasing their allergenic potency. (+info)
Mediator profiles in tears during the conjunctival response induced by allergic reaction in the nasal mucosa.
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BACKGROUND: The allergic reaction occurring primarily in the nasal mucosa can induce a secondary conjunctival response of an immediate (SICR), late (SLCR), or delayed (SDYCR) type in some patients with allergic conjunctivitis (AC). OBJECTIVES: To investigate the concentration changes of histamine, tryptase, eosinophil cationic protein (ECP), eosinophil-derived neurotoxin (EDN), leukotrienes (LTB 4, LTC4, LTE4), myeloperoxidase (MPO), interferon-gamma (IFN-gamma), and interleukins (IL-2, IL-4, IL-5) in tears during the SICR, SLCR, and SDYCR. METHODS: In 32 patients with AC, 11 SICR (p<0.01), 13 SLCR (p<0.001), and eight SDYCR (p<0.01) to nasal challenges with allergens (NPTs), the NPTs and 32 control tests with PBS were repeated and supplemented with the determination of these factors in tears. RESULTS: The SICRs were associated with significant concentration changes in tears (p<0.05) of histamine, tryptase, ECP, LTC4, and IL-4. The SLCRs were accompanied by significant changes in concentrations of histamine, ECP, LTB4, LTC4, MPO, IL-4, and IL-5. The SDYCRs were associated with significant concentration changes in tears (p<0.05) of LTB4, MPO, IFN-gamma, and IL-2. No significant changes in these factors were recorded in tears during the 32 PBS controls (p>0.1) or in the ten control patients (p>0.1). CONCLUSIONS: These results provide evidence for causal involvement of nasal allergy in some patients with AC, inducing secondary conjunctival response of immediate (SICR), late SLCR, or delayed SDYCR type, associated with different mediator, cytokine, and cellular profiles in the tears, suggesting involvement of different hypersensitivity mechanisms. These results also emphasize the diagnostic value of nasal allergen challenge combined with monitoring of the conjunctival response in some patients with AC. (+info)