Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1999 Jan;54(1):33–36. doi: 10.1136/thx.54.1.33

Demonstration of bronchial eosinophil activity in seasonal allergic rhinitis by induced plasma exudation combined with induced sputum

L Greiff 1, M Andersson 1, C Svensson 1, M Linden 1, P Wollmer 1, C Persson 1
PMCID: PMC1745349  PMID: 10343628

Abstract

BACKGROUND—Patients with seasonal allergic rhinitis may develop bronchial hyperresponsiveness during the active disease period. Eosinophil activation may occur in the bronchial mucosa and may be reflected by increased sputum levels of eosinophil cationic protein (ECP), especially when ECP binding proteins such as α2-macroglobulin pass through the lamina propria and across the epithelium into the airway lumen. A study was therefore undertaken to determine histamine airway responsiveness (FEV1) and bronchovascular responsiveness (exudation of α2-macroglobulin) to histamine in subjects with seasonal allergic rhinitis, and to explore whether sputum ECP levels are increased by the use of induced exudation followed by induced sputum.
METHOD—Eleven patients with seasonal allergic rhinitis were examined before and during a birch pollen season. Sputum was induced by inhalation of 4.5% saline twice before and twice during the pollen season. Histamine inhalations were given before the second of each pair of sputum inductions at increasing concentrations until FEV1 was reduced by 20%. Sputum levels of α2-macroglobulin and ECP were determined as indices of bronchial exudation of plasma and activation of bronchial eosinophils, respectively.
RESULTS—Bronchomotor responsiveness increased during the pollen season (median difference in the reduction of FEV1 9% (95% confidence interval (CI) -3 to 26)) but histamine induced exudation of plasma was not increased. Baseline sputum levels of α2-macroglobulin and ECP did not increase. Histamine induced exudation of α2-macroglobulin was associated with increased sputum levels of ECP exclusively during the pollen season (median difference 8.2 ng/ml (95% CI 0.4 to 562.0)).
CONCLUSION—Bronchial hyperresponsiveness in seasonal allergic rhinitis may not be associated with bronchovascular exudative hyperresponsiveness. Sputum levels of ECP were increased only during the season, and only after induced exudation (potentially moving ECP to the mucosal surface). It is suggested that the combined method of induced exudation and induced sputum may significantly improve the yield of some markers of inflammation in sputum samples.



Full Text

The Full Text of this article is available as a PDF (135.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aubier M., Levy J., Clerici C., Neukirch F., Herman D. Different effects of nasal and bronchial glucocorticosteroid administration on bronchial hyperresponsiveness in patients with allergic rhinitis. Am Rev Respir Dis. 1992 Jul;146(1):122–126. doi: 10.1164/ajrccm/146.1.122. [DOI] [PubMed] [Google Scholar]
  2. Frigas E., Gleich G. J. The eosinophil and the pathophysiology of asthma. J Allergy Clin Immunol. 1986 Apr;77(4):527–537. doi: 10.1016/0091-6749(86)90341-6. [DOI] [PubMed] [Google Scholar]
  3. Henriksen J. M., Wenzel A. Effect of an intranasally administered corticosteroid (budesonide) on nasal obstruction, mouth breathing, and asthma. Am Rev Respir Dis. 1984 Dec;130(6):1014–1018. doi: 10.1164/arrd.1984.130.6.1014. [DOI] [PubMed] [Google Scholar]
  4. James K. Interactions between cytokines and alpha 2-macroglobulin. Immunol Today. 1990 May;11(5):163–166. doi: 10.1016/0167-5699(90)90067-j. [DOI] [PubMed] [Google Scholar]
  5. Pedersen P. A., Weeke E. R. Asthma and allergic rhinitis in the same patients. Allergy. 1983 Jan;38(1):25–29. doi: 10.1111/j.1398-9995.1983.tb00852.x. [DOI] [PubMed] [Google Scholar]
  6. Persson C. G., Erjefält J. S., Andersson M., Greiff L., Svensson C. Extravasation, lamina propria flooding and lumenal entry of bulk plasma exudate in mucosal defence, inflammation and repair. Pulm Pharmacol. 1996 Jun;9(3):129–139. doi: 10.1006/pulp.1996.0015. [DOI] [PubMed] [Google Scholar]
  7. Persson C. G., Svensson C., Greiff L., Anderson M., Wollmer P., Alkner U., Erjefält I. The use of the nose to study the inflammatory response of the respiratory tract. Thorax. 1992 Dec;47(12):993–1000. doi: 10.1136/thx.47.12.993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Peterson C. G., Venge P. Interaction and complex-formation between the eosinophil cationic protein and alpha 2-macroglobulin. Biochem J. 1987 Aug 1;245(3):781–787. doi: 10.1042/bj2450781. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Pizzichini E., Pizzichini M. M., Efthimiadis A., Dolovich J., Hargreave F. E. Measuring airway inflammation in asthma: eosinophils and eosinophilic cationic protein in induced sputum compared with peripheral blood. J Allergy Clin Immunol. 1997 Apr;99(4):539–544. doi: 10.1016/s0091-6749(97)70082-4. [DOI] [PubMed] [Google Scholar]
  10. Rak S., Löwhagen O., Venge P. The effect of immunotherapy on bronchial hyperresponsiveness and eosinophil cationic protein in pollen-allergic patients. J Allergy Clin Immunol. 1988 Sep;82(3 Pt 1):470–480. doi: 10.1016/0091-6749(88)90021-8. [DOI] [PubMed] [Google Scholar]
  11. Svensson C., Andersson M., Greiff L., Alkner U., Persson C. G. Exudative hyperresponsiveness of the airway microcirculation in seasonal allergic rhinitis. Clin Exp Allergy. 1995 Oct;25(10):942–950. doi: 10.1111/j.1365-2222.1995.tb00396.x. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES