Comparing nasal secretion eosinophil count with skin sensitivity test in allergic rhinitis in Ibadan, Nigeria

OBJECTIVES: The aim of this prospective study was to assess the usefulness of nasal smear eosinophilia compared with a skin sensitivity test for the diagnosis of allergic rhinitis and to determine the degree of correlation between the tests. MATERIAL AND METHODS: Fifty patients with a clinical history suggestive of nasal allergy and 20 controls were studied. A range of allergens were used for the skin sensitivity test in both groups. Nasal smears were examined by light microscopy. RESULTS: A positive skin test reaction was demonstrated in 90% of the study population and 25% of the controls, whereas 76% of the patients and 15% of the controls demonstrated significant nasal smear eosinophilia. There was 66% correlation between the skin test and nasal eosinophilia, although this was not statistically significant (correlation coefficient -0.187 p = 0.193). This study does, however, demonstrate that both tests are sensitive for the diagnosis of allergic rhinitis, with sensitivities of 0.90 (95% CI 0.82-0.98) for the skin test and 0.76 (95% CI 0.64-0.88) for nasal eosinophilia. CONCLUSION: Both the skin-prick test and the nasal smear eosinophilia showed correlation with the clinical history, although the skin-prick test was more sensitive. No statistically significant correlation was demonstrable between the two tests.     

Comparing Nasal Secretion Eosinophil Count with Skin Sensitivity Test in Allergic Rhinitis in Ibadan,Nigeria

Objectives—The aim of this prospective study was to assess the usefulness of nasal smear eosinophilia compared with a skin sensitivity test for the diagnosis of allergic rhinitis and to determine the degree of correlation between the tests.

Material and Methods—Fifty patients with a clinical history suggestive of nasal allergy and 20 controls were studied. A range of allergens were used for the skin sensitivity test in both groups. Nasal smears were examined by light microscopy.

Results—A positive skin test reaction was demonstrated in 90% of the study population and 25% of the controls, whereas 76% of the patients and 15% of the controls demonstrated significant nasal smear eosinophilia. There was 66% correlation between the skin test and nasal eosinophilia, although this was not statistically significant (correlation coefficient–0.187 p = 0.193). This study does, however, demonstrate that both tests are sensitive for the diagnosis of allergic rhinitis, with sensitivities of 0.90 (95% CI 0.82–0.98) for the skin test and 0.76 (95% CI 0.64–0.88) for nasal eosinophilia.

Conclusion—Both the skin-prick test and the nasal smear eosinophilia showed correlation with the clinical history, although the skin-prick test was more sensitive. No statistically significant correlation was demonstrable between the two tests.     

Diagnostic significance of nasal eosinophilia in allergic rhinitis

Background  Nasal eosinophilia is one of the potential tests for substantiating the diagnosis of allergic rhinitis. Objective  The aim was to establish the validity of nasal eosinophilia in allergic rhinitis, to study it's various clinical correlates and interpret it in context of skin sensitivity pattern. Study Design  Prospective cased study. Setting  Hospital based. Patients  The patients were selected on the basis of history and clinical examination and were from the Himalayan region. Intervention  Diagnostic. Methods  The patients and the equal number of controls, were subjected to nasal smear for eosinophilia and intra-dermal skin tests to various allergeus. Results  Overall, eighty percent of nasal smears were positive in various degrees among the cases. Around eighty-eight percent of cases showed both smear and skin test positivity, thereby signifying a high degree of harmony among them and further validating and confirming the diagnosis of allergic rhinitis. Conclusion  Nasal eosinophilia was found to be a useful diagnostic test in allergic rhinitis, with a moderately high sensitivity and a high specificity.     

Nasal provocation test with lysine-aspirin in diagnosis of nonallergic rhinitis with eosinophilia

Nonallergic rhinitis with eosinophilia is characterized by persistent nasal symptoms without allergy and by a marked eosinophil recruitment in the nasal cavities. The incidence of it is more than 15% among all types of rhinitis. A part of them is caused by nonsteroidal anti-inflammatory drugs hypersensivity. For this study 114 patients were selected on the basis of perennial rhinitis, the absence of allergy and with an eosinophil count higher than 10% of total leukocytes in nasal cytology. In all of them the nasal provocation test with lysine-aspirin was made. The clinical response was evaluated based on nasal symptoms (sneezes, itching, secretion and blockage). The nasal response was measured by acoustic rhinometry. The results of the test was positive in 19 cases, mostly in patients with nasal polyps, bronchial asthma and higher level of nasal eosinophilia (differences statistically significant). The count of nasal eosinophilia corresponded better with the decrease of nasal volume in acoustic rhinometry (r = 0,84) then with the clinical score (r = 0,52). The nasal challenge was well tolerated by almost all subjects. We conclude that the nasal challenge with lysine-aspirin is safe and can be helpful as a diagnostic test in patients with nonallergic rhinitis with eosinophilia.     

The effect of levocabastine and furosemide pretreatment on hyperreactive response after nasal provocation with hypotonic aerosol in subjects with allergic rhinitis

Patients with allergic rhinitis demonstrate hyperreactive response in distilled water nasal provocation, shown by significant increase in nasal airway resistance (NAR). Antihistamines, including topical antihistamine, levocabastine, reduce response in non-specific nasal provocation tests. Furosemide is a diuretic which reduces hyperreactivity in lower airways, but the mode of its action is not yet fully understood. In this study, we hypothesized that either levocabastine or furosemide pre-treatment in allergic rhinitis patients reduced response to nasal challenge with non-isotonic aerosol. To test the hypothesis, we measured the effect of pre-treatment with levocabastine and furosemide in topical application on suppression of hyperreactive response to distilled water nasal inhalation. Nasal resistance was measured, prior to and after the provocation, by active anterior rhinomanometry in two randomized groups of patients, according to pre-treatment, either by levocabastine or furosemide, 20 patients in each group, respectively. Nasal airflow resistance and level of hyperreactive response considering nasal eosinophilia were tested. Significant increase in nasal resistance following provocation was found at baseline conditions (without pre-medication); pre-treatment with levocabastine and furosemide has suppressed such response. Patients with positive nasal eosinophilia showed a significantly higher increase in nasal resistance compared to those with negative smears. Furosemide has shown significantly better protective effect on nasal resistance increase in patients with positive eosinophils nasal smears. Levocabastine and furosemide pre-treatment suppress hyperreactive response to distilled water nasal provocation. Comparison of resistances (pre-treatment vs. without) showed more protective effect of furosemide, measured on both better and worse patent side of nose, in contrast to levocabastine group for which it was shown only on better patent side prior to provocation. Protection of furosemide was significantly more pronounced in patients with significant nasal eosinophilia.     

Eosinophilia in nasal secretions compared to skin prick test and nasal challenge test in the diagnosis of nasal allergy.

This study was aimed to assess the usefulness of eosinophilia measurements in nasal smears (ENS) in the diagnosis of nasal allergy. Nasal smears were taken from 84 patients with histories suggestive of allergic rhinitis. The smears were stained by the Giemsa method and examined by light microscopy. Positive results were demonstrated in 69.2% of the samples. All the 84 patients also had a skin prick test (SPT); the perceniitage of correct correlation between ENS and SPT was 71.4%. Forty-two patients underwent nasal challenge test (NCT) and the percentage of correct correlation between ENS and NCT was 69%. Nine patients had negative SPT, but positive ENS. All were nasally challenged with 4 proving positive. This leaves 5 individuals (5.9% of the 84 studied) in the non-allergic rhinitis with eosinophilia category. Based on these findings, it is suggested that the assessment of eosinophils in nasal smears should be given more relevance and be more commonly used in the diagnosis of nasal allergy.     

Allergic rhinopathy: Magic Lite SQ Allergy Screen Inhalant and CAP-FEIA SX1--comparison of two allergen-specific screening tests in serum]

Although total IgE determination in the diagnosis of allergic rhinitis has been proposed for screening, specific tests seem to be more efficient. In this study, Magic Lite SQ Allergy Screen Inhalant (ML) and CAP-FEIA Phadiatop (CF) were compared in serum in a group of 101 patients with allergic rhinitis (41 women, 60 men, mean age 31.4 years, range 7-69) and 37 controls (17 women, 20 men, mean age 38.3 years, range 6-68). All patients were suffering from nasal disease. The diagnosis based on case history, skin prick test, total and specific IgE determination and nasal challenge tests. ML was found to have a sensitivity of 96% and a specificity of 83.8% while CF achieved a sensitivity of 94.1% and a specificity of 94.6%. Efficiency was 92.8% for ML and 94.2% for CF. A positive predictive value of 94.2% for ML and of 97.9% for CF was calculated while the negative predictive value was 88.6% for ML and 85.4% for CF. It is concluded, that both ML and CF are suitable allergy screening tests able to give a 100% diagnostic security in combination with further examinations, especially regarding the case history.     

Signals through CD40 play a critical role in the pathophysiology of Schistosoma mansoni egg antigen--induced allergic rhinitis in mice

BACKGROUND: Interaction between CD40 and CD40L is thought to regulate immune responses in several allergic diseases. However, little is known about its in vivo role in the pathophysiology of allergic rhinitis. We sought to determine whether the lack of signals through CD40 affects the pathophysiology of allergic rhinitis using a murine model. METHODS: Wild type (WT) and CD40-deficient BALB/c (CD40-/-) mice were sensitized intranasally to Schistosoma mansoni egg antigen (SEA). After repeated sensitization, histamine responsiveness, serum antibody titer including immunoglobulin E (IgE), nasal eosinophilia, and cytokine production by nasal mononuclear cells were determined in each group. RESULTS: Intranasal sensitization with SEA in WT mice elicited a strong Th2 response including SEA-specific IgE production, nasal eosinophilia, and interleukin (IL)-4, and IL-5 production by nasal mononuclear cells after antigen challenge. Production of SEA-specific IgE and IgG1 was abolished in SEA-sensitized CD40-/- mice. These mice showed impaired nasal eosinophilia and displayed markedly reduced histamine-induced nasal hyperresponsiveness as compared with WT mice. Furthermore, reduced production of IL-4 and IL-5 by nasal mononuclear cells was seen in CD40-/- mice. CONCLUSION: These results show that signals through CD40 play a critical role in not only IgE production but also pathophysiology of allergic rhinitis such as nasal hyperresponsiveness and nasal eosinophilia.     

Rhinitis in patients with cystic fibrosis

The author presents material of 110 cystic fibrosis patients, 81 with typical clinical features and 29 with atypical phenotype. Based on clinical examination and nasal cytological smears infective chronic nonspecific rhinitis (n = 80), infective acute rhinitis (n = 16), perennial allergic rhinitis (n = 4), nonalergic rhinitis with eosinophilia (n = 2), and moreover 19 patients with nasal polyposis, and 8 patients without nasal symptoms were distinguished. Infective chronic nonspecific rhinitis and infective acute rhinitis were present in typical and atypical cystic fibrosis patients with similar frequency but in patients with atypical phenotype perennial allergic rhinitis and nonalergic rhinitis with eosinophilia were observed more frequently. Nasal polyposis was associated with typical cystic fibrosis phenotype, and with two "severe" mutations.     

Tap water nasal irrigation in adults with seasonal allergic rhinitis: a randomized double-blind study

Saline nasal irrigation is effective in the treatment of seasonal allergic rhinitis, and sodium chloride itself has no antiallergic effects. The mechanism of saline nasal irrigation depends mainly on washing away allergens and inflammatory mediators induced by allergic reactions. Tap water has the same washing effects as saline. In this study, it was investigated if tap water nasal irrigation was effective in the treatment of seasonal allergic rhinitis. Sixty-four patients diagnosed with seasonal allergic rhinitis were enrolled. Patients were randomized to tap water nasal irrigation group and non-tap water nasal irrigation group for treatment. Patients of both groups were treated with desloratadine. Treatment outcomes were measured using allergic rhinitis Quality of Life (QoL) survey was completed at baseline and after 3 weeks of therapy. There were statistically significant differences in QoL scores between tap water nasal irrigation group and non-tap water nasal irrigation group. The tap water nasal irrigation group had better QoL scores than the non-tap water nasal irrigation group. Tap water nasal irrigation can be a valuable adjuvant therapy for patients with seasonal allergic rhinitis.     

Nasal hyperreactivity to methacholine measured by acoustic rhinometry in asymptomatic allergic and perennial nonallergic rhinitis

This study was carried out to assess nasal response to different doses of methacholine and to evaluate the diagnostic possibilities of this test. Thirty-seven patients with allergic rhinitis induced by pollen (out of season), 16 with nonallergic rhinitis, and 25 normal subjects were evaluated. After provocation with saline, increasing doses of methacholine, ranging from 0.5 to 16 mg/mL, were applied. Nasal obstruction was assessed by acoustic rhinometry 10 minutes after each dose, the minimum cross-sectional area and the nasal volume in both fossae were obtained. Ipratropium bromide was applied after the last dose of methacholine to evaluate reversibility. After methacholine challenge with 0.5, 1, 2, and 4 mg/mL there was a statistically significant decrease (p < 0.05) in nasal area and volume in a dose-dependent manner in patients with allergic and nonallergic rhinitis in comparison with controls. A ROC (receiver-operating characteristic) analysis showed that a decrease in nasal volume > or = 20% at methacholine concentration of 2 mg/mL is able to predict the presence of rhinitis (positive predicted value 93%, negative predicted value 79%) in 75% of subjects. The clinical relevance of this finding suggests that patients with symptomatic nonallergic rhinitis or even asymptomatic patients with allergic rhinitis out of pollen season present a nasal hyperreactivity to methacholine, and that a decrease of nasal volume > 20% by acoustic rhinometry after challenge with methacholine at 2 mg/mL is able to discriminate these patients from normal subjects. This method seems to be a suitable tool in the diagnosis of rhinitis.     

白细胞介素12基因治疗小鼠变应性鼻炎的实验研究

目的探讨鼻腔局部应用EB病毒(Epstein-Barrvirus,EBV)质粒载体介导的白细胞介素12(interleukin-12,IL-12)基因治疗对变应性鼻炎炎症反应的调节作用。方法将36只6～8周雄BALB/C实验小鼠随机分为变应性鼻炎组、IL-12基因治疗组和正常对照组,每组12只。以BALB/c小鼠经卵清蛋白(ovalbumin,OVA)免疫建立变应性鼻炎模型,用阳离子脂质体包裹EBV质粒载体介导的IL-12表达质粒(pGEG.mI-L12)形成混合物EBV/lipoplex,于激发前鼻腔局部滴入后,观察小鼠变应性症状的改善情况,并检测该基因在3组实验鼠鼻黏膜局部的表达情况以及对鼻黏膜炎性细胞和Th2细胞因子的影响。结果基因治疗组小鼠鼻黏膜中IL-12mRNA阳性细胞数量明显高于变应性鼻炎组,差异有统计学意义(P<0.01);基因治疗组小鼠鼻黏膜中IL12阳性细胞数量明显高于变应性鼻炎组(P<0.05);变应性鼻炎组鼻黏膜中嗜酸粒细胞、肥大细胞和IL5阳性细胞比例显著高于基因治疗组和正常对照组(P<0.01);变应性鼻炎组外周血中总IgE含量显著高于正常对照组和基因治疗组(F=1216.21,P<0.01)。结论鼻腔局部应用EBV/lipoplex后,pGEG.mIL-12能够在鼻黏膜中高效地表达,能明显抑制鼻腔的变应性反应。EBV/lipoplex有望成为变应性鼻炎免疫治疗一种新的方法。     

Allergic rhinitis does not constitute a risk factor for obstructive sleep apnea syndrome

Obstructive sleep apnea syndrome (OSAS) is a condition characterized by recurrent episodes of obstruction of the upper airway. The aim of this study was to evaluate whether nasal obstruction due to allergic rhinitis constitutes a risk factor for OSAS. Patients (n = 119) presenting typical symptoms of sleep apnea were tested for OSAS using polysomnography. Additionally all patients were tested in vivo and in vitro (including nasal eosinophilic cationic protein) for allergic rhinitis. Examination for allergic rhinitis revealed that 88.3% of all patients had no allergic rhinitis, whereas only 11.7% were diagnosed as allergic. No significant differences in sleeping parameters were observed between allergic and non-allergic patients. Comparison of parameters indicative of relevant OSAS (apnea-hypopnea index [AHI] > 10) revealed that 60% of non-allergic patients had relevant OSAS, compared to only 50% of allergic patients. Investigation of allergic subgroups revealed similar results: no significant differences in sleeping parameters or elevated rates of relevant OSAS parameters were observed, especially in perennial allergic rhinitis due to house dust mites. No elevated rates of allergic rhinitis were observed in the studied cohort of patients suffering from sleep apnea or OSAS. Furthermore, no significant differences in sleeping behavior or polysomnography parameters were found on comparing allergic and non-allergic patients. In summary, our data rule out allergic rhinitis as a major risk factor for OSAS.     

Functional inferior turbinosurgery (FITS) for the treatment of resistant chronic rhinitis

CONCLUSIONS: Modified vidian neurectomy combined with inferior turbinoplasty provided an optimal surgical outcome as a treatment for intractable chronic rhinitis as evidenced by a relatively long-term follow-up. OBJECTIVE: The study was designed to determine the efficacy of submucosal reduction of the inferior turbinate and resection of the posterior nasal nerve for the treatment of resistant chronic rhinitis. PATIENTS AND METHODS: Fifty-six consecutive patients (37 males and 19 females; mean+/-SD age, 26+/-11 years) with resistant allergic rhinitis or nonallergic rhinitis with eosinophilia syndrome despite medical treatment. Symptomatic improvement including nasal obstruction, nasal discharge, sneezing, smell perception, and quality of life and objective evaluation of nasal airway resistance and nasal provocation test before and after surgery were investigated. RESULTS: The patients showed a remarkable improvement of > or = 80%, with the exception of two patients who had an approximately 50% reduction of the total symptomatic scores. Four of eight patients with anosmia subjectively improved whereas the other four patients felt unchanged. All patients who underwent rhinomanometry (n=15) and nasal provocation testing (n = 15) both before and after surgery showed a significant improvement. There were no intraoperative complications. Postoperative epistaxis occurred in one patient. One patient complained of a transient hypesthesia of the soft palate and dry eye. Nasal mucosal tears were observed in approximately 30% of the patients who otherwise showed no severe synechia or persistent crusting.     

Allergic Rhinitis does not Constitute a Risk Factor for Obstructive Sleep Apnea Syndrome

Obstructive sleep apnea syndrome (OSAS) is a condition characterized by recurrent episodes of obstruction of the upper airway. The aim of this study was to evaluate whether nasal obstruction due to allergic rhinitis constitutes a risk factor for OSAS. Patients (n = 119) presenting typical symptoms of sleep apnea were tested for OSAS using polysomnography. Additionally all patients were tested in vivo and in vitro (including nasal eosinophilic cationic protein) for allergic rhinitis. Examination for allergic rhinitis revealed that 88.3% of all patients had no allergic rhinitis, whereas only 11.7% were diagnosed as allergic. No significant differences in sleeping parameters were observed between allergic and non-allergic patients. Comparison of parameters indicative of relevant OSAS (apnea-hypopnea index [AHI] &gt; 10) revealed that 60% of non-allergic patients had relevant OSAS, compared to only 50% of allergic patients. Investigation of allergic subgroups revealed similar results: no significant differences in sleeping parameters or elevated rates of relevant OSAS parameters were observed, especially in perennial allergic rhinitis due to house dust mites. No elevated rates of allergic rhinitis were observed in the studied cohort of patients suffering from sleep apnea or OSAS. Furthermore, no significant differences in sleeping behavior or polysomnography parameters were found on comparing allergic and non-allergic patients. In summary, our data rule out allergic rhinitis as a major risk factor for OSAS.     

Prostaglandins, leukotrienes and perennial rhinitis

Prostaglandins and leukotrienes are implicated in conditions of both the upper and lower airways. In the former they are deranged in nasal polyposis, intrinsic rhinitis and allergic rhinitis while in the latter they are involved in the pathogenesis of asthma. The aim of the present study was to measure mucosal eicosanoid levels in the three types of rhinitis and compare with controls. In addition, the effect of topical steroids on eicosanoid levels in rhinitis was examined. The levels of prostaglandins E(2) (PGE(2)) and D(2) (PGD(2)) and of leukotrienes E(4) (LTE(4)) and B(4) (LTB(4)) were measured in nasal biopsies from the inferior turbinates of patients suffering from perennial rhinitis and a control group. Rhinitis patients were classified into three categories: perennial allergic rhinitis (PAR), non-allergic rhinitis with eosinophilia (NARES) and noneosinophilic non-allergic rhinitis (NENAR) on the basis of symptoms, secretion eosinophilia, nasal resistance and allergy testing. Patients with rhinitis were randomized into two groups. One received fluticasone propionate nasal spray (FPANS) and the other a placebo (PNS) over a period of six weeks prior to the biopsies. One hundred and one patients with PAR, NARES or NENAR were recruited sequentially and the control group consisted of 21 patients with no evidence of rhinitis but with nasal obstruction due to septal deviation. Untreated rhinitics had significantly lower levels of PGE(2), PGD(2) and LTE(4) than non-rhinitic controls. Six-weeks' treatment with FPANS significantly increased the levels of those eicosanoids in patients with PAR and NARES but they were still significantly below normal. Levels of LTB(4) in all three rhinitis groups were not significantly different from controls and treatment with topical steroids had no effect. Their findings are contrary to current thinking that increased levels of eicosanoids, in particular cysteinyl-leukotrienes, play an important role in the pathogenesis of chronic, non-infective upper airway inflammation.     

姜黄素对卵清蛋白致小鼠变应性鼻炎的治疗作用

目的研究姜黄素对卵清蛋白（ovalbumin,OVA）致变应性鼻炎（AR）小鼠的防治作用,探讨作用机制。方法 40只BAL-B/C小鼠随机分为正常对照组,AR模型组,地塞米松组和姜黄素组,共4组,每组10只。除正常对照组外,其余3组均使用OVA致敏并激发制备AR模型,模型建立后地塞米松组腹腔注射地塞米松（5 mg/kg）,姜黄素组腹腔注射姜黄素（0.6 mg/kg）,均为1次/d,持续7 d。AR模型组给予等量磷酸盐缓冲液（PBS）替代。评估小鼠鼻部症状,HE染色和免疫组化观察鼻黏膜炎症情况,ELISA检测血清白细胞介素4（interleukin-4,IL-4）、干扰素γ（interferon-gamma,IFN-γ）和OVA特异性IgE（specific IgE,sIgE）水平。结果与正常对照组相比,AR模型组小鼠鼻部症状明显,鼻黏膜可见大量嗜酸性粒细胞（eosinophils,Eos）浸润,组织间质水肿严重,IL-4表达增多。地塞米松组和姜黄素组小鼠鼻部症状均减轻,鼻黏膜组织中Eos局部浸润及鼻黏膜下组织间质水肿减少,鼻黏膜IL-4表达下调,血清IL-4浓度降低。此外,血清slgE浓度在姜黄素组小鼠中降低而地塞米松组小鼠未见下降,且地塞米松组小鼠血清IFN-γ降低。结论姜黄素可减少鼻黏膜Eos浸润,抑制IgE释放,其机制可能是通过抑制Th2细胞因子反应,从而达到治疗AR的作用。     

Immunoblotting technique: a new accurate in vitro test for detection of allergen-specific IgE in allergic rhinitis

Allergic rhinitis is the most common manifestation of an atopic reaction to inhaled allergen. It accounts for 80% of rhinitis in children and 30% in adults. The objective of the study is to evaluate the presence of serum-specific IgE to a variety of common allergens using a new immunoblotting technique in order to detect the specific allergen causing allergic rhinitis. The study included 32 patients with allergic rhinitis (20 females and 12 males) with age ranging from 15 to 60 years. Measurement of specific IgE by immunoblotting technique was performed to patients with positive skin test. Overall diagnostic performance of immunoblot test in comparison to skin test in detection of all studied allergens showed 56.1% sensitivity, 100.0% specificity, 100.0% positive predictive value, 93.9% negative predictive value and 94.4% diagnostic accuracy. It may help in proper diagnosis and determination of the specific causative allergen through an easy and inexpensive way.     

The use of lipid containing nasal ointment for allergic rhinitis--a therapeutic option? A bicentric, prospective, open, randomised, controlled clinical study

BACKGROUND: Some 10-20% of the population suffer from allergic rhinitis. A recently discussed and interesting, albeit disputed therapy option is the use of a lipid-based nasal ointment. METHOD: To test the efficacy of this nasal ointment as an adjuvant therapy for allergic rhinitis, a two-centre, prospective, open, randomized, controlled clinical study was carried out. RESULT: In the study, 17 patients using the test agent were compared with 16 who did not. For the group using the test agent, before and after comparisons showed a significant (about 40%) improvement in the medium, relative total range of symptoms (Wilcoxon-Mann-Whitney U-test, P<0.01) based on the individual parameters of sneezing attacks, nasal itching, nasal secretion and nasal obstruction. In the control group, non-use of the test agent meant that the total range of symptoms remained unchanged. No side effects were recorded. CONCLUSION: The test agent used in our study contains a lipid fraction, in this case in the form of high purity, long chain hydrocarbons. By local application, a significant improvement of the total symptomatology was shown. The mechanism has not been clarified. Owing to the efficacy and low risk of side effects, this seems to be a promising adjuvant therapy for allergic rhinitis. The probetoric use of this nasal ointment as a supportive therapeutic option should be reviewed in further clinical studies.     

Chronic rhinitis in HTLV-1 carriers: a histopathologic study

The nasal histopathology of HTLV-1 carriers with chronic rhinitis is unknown.ObjectiveTo describe the histopathological features of HTLV-1 carriers with chronic rhinitis.Materials and MethodsBiopsies of nasal mucosa of ten HTLV-1 carriers with chronic rhinitis (eight patients with allergic rhinitis and two patients with non-allergic rhinitis) were studied using a light microscope. Samples from ten patients with allergic rhinitis not infected with HTLV-1 were used as controls.ResultsSubepithelial fibrosis was more pronounced in patients with allergic rhinitis infected with HTLV-1 (p=0.01), while the basement membrane thickness was greater in controls (p=0.03). There was a trend towards less eosinophilia and edema among those infected with HTLV-1, without statistical significance (p=0.2). For the lymphocytic infiltrate, there was no difference between infected and not infected patients with allergic rhinitis (p=1.0). Subepithelial fibrosis associated to moderate or small number of lymphocytes were found in the two HTLV-1 carriers with non-allergic rhinitis.ConclusionsThis study suggests HTLV-1 may modify the histopathology of allergic rhinitis, especially by promoting subepithelial fibrosis, and may be related to chronic non-allergic rhinitis with lymphocytic infiltrate.