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. 2006 Apr 27;25(10):942–950. doi: 10.1111/j.1365-2222.1995.tb00396.x

Exudative hyperresponsiveness of the airway microcirculation in seasonal allergic rhinitis

C SVENSSON 1,✉, M ANDERSSON 1, L GREIFF U ALKNER 2, C G A PERSSON 3
PMCID: PMC7188352  PMID: 8556565

Summary

Background Mucosal exudation of plasma is a non‐injurious, physiological response of the airway microcirculation to different inflammatory processes. The exudative response is similar in the nose and bronchi and exudation occurs in both allergic asthma and rhinitis. The educative response is a specific end‐organ function of the mucosal microcirculation that may be altered in airway diseases.

Objective This study examines the hypothesis of altered responsiveness of the superficial airway microcirculation to vascular permeability‐increasing challenges in sustained allergic inflammation.

Methods Fourteen patients with birch‐pollen induced allergic rhinitis were studied for 7 weeks during a Swedish birch‐pollen season. Nasal symptoms (itching, sneezing. blockage, and discharge) were recorded and the occurrence of pollen was determined. The plasma exudation response was examined by topical histamine challenges at the end (May) and well out of (December) the season. Challenge and lavage were carried out concomitantly using a‘nasal pool’ ‐device. The unilateral nasal cavity was filled for consecutive 10 minute periods with saline and two concentrations of histamine (80μg/ mL and 400μg/mL). The lavage fluid levels of different‐sized plasma proteins (albumin‐66 000 D. fibrinogen‐340000 D, and α 2‐macroglobulin‐725000D) were determined.

Results The pollen season was mild resulting in only minor nasal symptoms. Histamine produced exudation of all plasma proteins across the microvascular epithelial barriers with particularly strong correlation between the levels of albumin and α 2‐macroglobulin (r =0.98; P< 0.001). The exudative response to histamine was concentration‐dependent (P<0.05) and, furthermore, it was significantly greater late into the season compared with outside the pollen season (albumin: P < 0.05. tibrinogen: P<0.05. α 2‐macroglobulin: P<0.01).

Conclusion We conclude that histamine produced concentration‐dependent nasal airway exudation of bulk plasma in subjects with seasonal rhinitis and that this response is abnormally great during the pollen season. Whether angiogenesis or increased responsiveness of the mierovascular endothelium may explain this phenomenon now remains unknown. We suggest that a mierovascular exudative hyperresponsiveness may characterize allergic airway disease.

Keywords: allergic rhinitis, airway hyperresponsiveness, airway hyperreactivty, airway inflammation, histamine, plasma exudation, albumin, fibrinogen, α2‐macro‐globulin

References

  • 1. Persson CGA. Plasma exudation in the airways: Mechanisms and function. Em Respir J 1991; 4:1268–74. [PubMed] [Google Scholar]
  • 2. Persson CGA. Svensson C, Greiff L et al The use of the nose to study the inflammatory response of the respiratory tract. Thorax 1992: 47:993–1000. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3. Svensson C. Andersson M. Persson CGA et al Albumin, bradykinin and eosinophil cationic protein on the nasal mucosal surface in patients with hay fever during natural allergen exposure. J Allergy Clin Immunol 1990; 85:828–33. [DOI] [PubMed] [Google Scholar]
  • 4. Erjefält I, Persson CGA. Inflammatory passage of plasma macromolecules into airway wall and lumen. Pulin Phanmacol 1989: 2:93–102. [DOI] [PubMed] [Google Scholar]
  • 5. Åkerlund A. Greiff L. Andersson M et al Mucosal exudation of fibrinogen in coronavirus‐induced common colds. Acta Otolaryngol(Stockh) 1993; 113:642–8. [DOI] [PubMed] [Google Scholar]
  • 6. Svensson C, Baumgarten CR, Pipkorn U, Persson CGA. Reversibility and reproducibility of hislamine induced plasma leakage in nasal airways. Thorax 1989: 44:13–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7. Raphael GD. Meredith SD. Baraniuk JN. Kaliner MA. Palhophysiology of allergic rhinitis. I. Assessment of the sources of protein in methacholine‐induced nasal secretions. Am Rev Respir Dis 1989; 139:791–800. [DOI] [PubMed] [Google Scholar]
  • 8. Greill L. Svcnsson C. Andersson M, Persson CGA. Effects of topical capsicain in seasonal allergic rhinitis. Thorax 1995: 50:225–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9. Greiff L. Wollmer P. Erjefält I. et al Effects of nicotine on the human nasal mucosa. Thorax 1993:48:651–5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10. Persson CGA. Krjetält I. Guslafsson B. Luts A, Subepithelial hydrostatic pressure may regulate plasma exudation across the mucosa. Int Arch Allergy Appl Immunol 1990; 92:148–53. [DOI] [PubMed] [Google Scholar]
  • 11. Gustafsson B. Pcrsson CGA. Asymmetrical effects of increases in hydrostatic pressure on macromolecular movement across the airway mucosu. A study in guinea‐pig trachael lube preparations. Clin Exp Allergy 1991; 21:121–6. [DOI] [PubMed] [Google Scholar]
  • 12. Salomonsson P. Grönneberg R. Gilliam H et al Bronchial exudation of bulk plasma at allergen challenge in allergic asthma Am Rev Rcspir Dis 1992; 146:1535–42. [DOI] [PubMed] [Google Scholar]
  • 13. Svensson C. Grönneberg R, Andersson M et al Allergen challenge‐induced entry of α 2‐macroglobulin and tryptase into human nasal and bronchial airways. J Allergy Clin Immunol 1995; in press. [DOI] [PubMed] [Google Scholar]
  • 14. Grciff L, Andersson M. Åkerlund A et al Microvascular exudative hyperresponsiveness in human coronavirus‐induced common cold. Thorax 1994:49:121–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15. Greiff L, Pipkorn U. Alkner U. Persson CGA. The nasal pool‐device applies controlled concentrations of solutes on human nasal airway mucosa and samples its surface exudations/secretions. Clin Exp Allergy 1990; 20:253–9. [DOI] [PubMed] [Google Scholar]
  • 16. Thorell JI, Johansson BG. Enzymatic iodination of poly‐peplides to high activity. Biochim Biophys Acta 1971: 251:363–9. [DOI] [PubMed] [Google Scholar]
  • 17. Erjefält I. Luts A. Persson CGA. The appearance of airway exudation‐ and absorption‐tracers in guincapig tracheo‐bronchial lymph nodes. J Appl Physiol 1993; 74:817–24. [DOI] [PubMed] [Google Scholar]
  • 18. Erjefält I. Persson CGA. Allergen, Bradykinin. and capsaicin increase outward but not inward macromolecular permeability of guinea‐pig tracheobronchial mucosa. Clin Exp Allergy 1991; 21:217–24. [DOI] [PubMed] [Google Scholar]
  • 19. Greigff L. Willmer P. Pipkorn U. Persson CGA. Absorption of 51Cr‐EDTA across the human nasal mucosa in the presence of topical histamine. Thorax 1991: 46:630–2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20. Greifi L, Wollmer P, Svensson C. Andersson M. Persson CGA. Elfecls of seasonal allergic rhinitis on airway mucosal absorption of chromium‐51 labelled EDTA. Thorax 1993; 48:648–50. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21. Majchel AM. Proud D. Freidhoff L et al The nasal response to histamine challenge: effect of the pollen season and inmunotherapy. J Allergy Clin Immunol 1992; 90: 85–91. [DOI] [PubMed] [Google Scholar]
  • 22. James K. Interactions between cytokines and α 2‐macro‐globulin. Immunol Today 1990; 11:163–6. [DOI] [PubMed] [Google Scholar]
  • 23. Bonner JC, Brody AR. Cytokine‐binding proteins In: Kelley J. ed. Cytokincs of the Lung, New York : Marcel Dekker Inc. 1992: 459–89. [Google Scholar]
  • 24. Linden M. Greiff L. Andersson M et al Nasal cytokines in common cold and allergic rhinitis, Clin Exp Allergy 1995; 25: 166–72. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25. Persson CGA. Airway epithelium and microcirculation. Eur Respir Rev 1994:4:352–62. [Google Scholar]
  • 26. Boulet LP, Cartier A, Thomson NC et al Asthma and increases in nonallergic bronchial responsiveness from seasonal pollen exposure. J Allergy Clin Immunol 1983: 71:399–406. [DOI] [PubMed] [Google Scholar]
  • 27. Löwhagen O. Rak S. Modification of bronchial hyperrcaetivity after treatment with sodium cromoglycate during pollen season. J Allergy Clin Immunol 1985; 75: 460–7. [DOI] [PubMed] [Google Scholar]
  • 28. Mandonini E. Briatico‐Vangosa G. Pappacoda A et al Seasonal increase of bronchial reactivity in allergic rhinitis. J Allergy Clin Immunol 1987; 79:358–63. [DOI] [PubMed] [Google Scholar]
  • 29. Corren J. Adinoff AD. Buchmeier AD. Irvin CG. Nasal beclomethasone prevents the seasonal increase in bronchial responsiveness in patients with allergic rhinitis and asthma. J Allergy Clin Immunol 1992; 90:250–6. [DOI] [PubMed] [Google Scholar]
  • 30. Hutt G, Wick H. Bronchiallumen und Atemwiederstand, Z Aerosol Forsch Ther 1956: 5:131–40. [Google Scholar]
  • 31. Pcrsson CGA. Role of plasma exudation in asthmatic airways. Lancet 1986; 2:1126–9. [DOI] [PubMed] [Google Scholar]

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