Allergy Asthma Immunol Res.  2013 Jul;5(4):232-238. 10.4168/aair.2013.5.4.232.

Rhinitis Patients With Sputum Eosinophilia Show Decreased Lung Function in the Absence of Airway Hyperresponsiveness

• Yang MS
• Lee HS
• Kim MH
• Song WJ
• Kim TW
• Kwon JW
• Kim SH
• Park HW
• Chang YS
• Cho SH
• Min KU

• KMID: 2260317
• DOI: http://doi.org/10.4168/aair.2013.5.4.232

Abstract

PURPOSE
Sputum eosinophilia is observed frequently in patients with rhinitis. Sputum eosinophilia in patients with non-asthmatic allergic rhinitis has been suggested to be related to nonspecific airway hyperresponsiveness (AHR). However, the clinical significance of sputum eosinophilia in patients with non-asthmatic rhinitis without AHR has not been determined. We conducted a retrospective study examining the influence of sputum eosinophilia in patients with non-asthmatic rhinitis without AHR on pulmonary function and expression of fibrosis-related mediators.
METHODS
Eighty-nine patients with moderate-to-severe perennial rhinitis without AHR were included. All underwent lung function tests (forced expiratory volume in 1 second [FEV1] and forced vital capacity [FVC]), skin tests to inhalant allergens, methacholine bronchial challenge tests, and hypertonic saline-induced sputum to determine eosinophil counts. Sputum mRNA levels for transforming growth factor-beta (TGF-beta), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) were also examined. Patients were divided into two groups according to the presence of sputum eosinophilia (> or =3%, eosinophilia-positive [EP] and <3%, eosinophilia-negative [EN] groups).
RESULTS
FEV1 was significantly lower (P=0.04) and FEV1/FVC tended to be lower (P=0.1) in the EP group than in the EN group. In sputum analyses, the MMP-9 mRNA level (P=0.005) and the ratio of MMP-9 to TIMP-1 expression (P=0.01) were significantly higher in the EP group than in the EN group. There was no significant difference in TGF-beta mRNA expression between the two groups.
CONCLUSIONS
Sputum eosinophilia in patients with moderate-to-severe perennial rhinitis without AHR influenced FEV1 and the expression pattern of fibrosis-related mediators.

Keyword

Sputum; eosinophil; rhinitis; forced expiratory volume; matrix metalloproteinase-9

MeSH Terms

Allergens
Bronchial Provocation Tests
Eosinophilia
Eosinophils
Forced Expiratory Volume
Humans
Lung
Matrix Metalloproteinase 9
Methacholine Chloride
Respiratory Function Tests
Retrospective Studies
Rhinitis
Rhinitis, Allergic, Perennial
RNA, Messenger
Skin Tests
Sputum
Tissue Inhibitor of Metalloproteinase-1
Transforming Growth Factor beta
Vital Capacity
Allergens
Matrix Metalloproteinase 9
Methacholine Chloride
RNA, Messenger
Tissue Inhibitor of Metalloproteinase-1
Transforming Growth Factor beta

Figure

• 

  Fig. 1 Sputum eosinophil counts were negatively correlated with lung function parameters. Sputum eosinophil counts were negatively correlated with (A) FEV1 (β=-0.62, P=0.02), and (B) FEV1/FVC (β=-0.41, P=0.005) in the entire study population. Unfilled circles (○) represent individual subjects.

• 

  Fig. 2 Expression of fibrosis-related mediators was significantly higher in the eosinophilia-positive (EP) group than in the eosinophilia-negative (EN) group. (A) MMP-9 mRNA levels are expressed as normalized vs. GAPDH and were found to be significantly increased in the EP group (P=0.005) compared with the EN group. (B) MMP-9/TIMP-1 mRNA ratios were also significantly higher in the EP group (P=0.01) than in the EN group. Filled squares () represent mean mRNA levels, and vertical bars indicate standard deviations.

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