Asia Pac Allergy.  2012 Oct;2(4):248-255. 10.5415/apallergy.2012.2.4.248.

Differences in airway inflammation according to atopic status in patients with chronic rhinitis

• Kwon JW
• Kim TW
• Kim KM
• Jung JW
• Cho SH
• Min KU
• Kim YY
• Park HW

• KMID: 2397441
• DOI: http://doi.org/10.5415/apallergy.2012.2.4.248

Abstract

BACKGROUND
Chronic rhinitis is a heterogeneous group of diseases that cause nasal inflammation. And the nose may be a window into the lung in the concept of "one airway one disease."
OBJECTIVE
This study was conducted to evaluate differences between the different forms of chronic rhinitis in terms of lower airway inflammation.
METHODS
Patients that attended the allergy clinic and presented with moderate/severe persistent rhinitis symptoms for more than 1 year were enrolled. The patients with chronic rhinitis were classified into two groups (house dust mites [HDM]-sensitive allergic rhinitis [AR] or non-allergic rhinitis [NAR]) according to the presence of atopy, and additionally according to nasal polyposis and airway hyperresponsiveness, respectively. Medical records were reviewed and the mRNA expression levels of IL-5, IFN-γ, TGF-β1, IL-17A, and IL-25 were evaluated in induced sputum samples in each group.
RESULTS
Induced sputum samples of 53 patients were evaluated. Patients with NAR were significantly older than patients with HDM-sensitive AR (p < 0.05). Nasal polyposis was more prevalent in NAR patients than in HDM-sensitive AR patients (10.2% vs. 62.5%, p < 0.001). The expression levels of IL-17A mRNA were higher in NAR patients, regardless of the presence of airway hyperresponsiveness (p = 0.005).
CONCLUSION
These results suggest that patients with different forms of chronic rhinitis could have different inflammatory environments in their lower airway and NAR patients might have bronchial inflammation related to the elevated levels of IL-17A compared to HDM-sensitive AR patients.

Keyword

Rhinitis; Allergy; IL-17A; Nasal polyps; Sputum; Asthma

MeSH Terms

Asthma
Dust
Humans
Hypersensitivity
Inflammation*
Interleukin-17
Interleukin-5
Lung
Medical Records
Mites
Nasal Polyps
Nose
Rhinitis*
Rhinitis, Allergic
RNA, Messenger
Sputum
Dust
Interleukin-17
Interleukin-5
RNA, Messenger

Figure

• 

  Fig. 1 Cytokine mRNA in the induced sputum samples of HDM-sensitized AR and NAR patients. (A) HDM-sensitized AR patients (n = 45) and NAR patients (n = 8). (B) HDM-sensitized AR patients without AHR (n = 31) and NAR patients without AHR (n = 6).HDM, house dust mites; AR, allergic rhinitis; NAR, non-allergic rhinitis; AHR, airway hyperresponsiveness (PC20 ≤16 mg/mL).

• 

  Fig. 2 Cytokine mRNA in the induced sputum samples according to the presence of nasal polyposis. Induced sputum samples were evaluated in chronic rhinitis patients with nasal polyposis (n = 9) and without nasal polyposis (n = 44). Nasal polyposis (+), chronic rhinitis with nasal polyposis. Nasal polyposis (-), chronic rhinitis without nasal polyposis.

• 

  Fig. 3 Cytokine mRNA in the induced sputum samples according to the AHR. Induced sputum samples were evaluated in 16 patients with positive AHR and 37 patients with negative AHR; AHR, airway hyperresponsiveness (PC20 ≤ 16 mg/mL).

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