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Allergic reaction induced by pollen in the upper respiratory tract aff…

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Allergic reaction induced by pollen in the upper respiratory tract affects eosinophils and basophils in peripheral blood as well as in the lower respiratory tract
S Yonekura, Y Okamoto
 
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In Japan, Japanese cedar pollen (JCP) induces widespread pollinosis. However, asthma directly caused by JCP is rare because the large size of the pollen prevents its entry into the lower respiratory tract. JCP pollinosis frequently aggravates the symptoms of patients with concomitant asthma. We examined the effect of JCP on the allergic reaction in the nasal mucosa, in peripheral blood cells, and in the lower respiratory tract, using an experimental challenge chamber.

Methods

A total of 50 patients with JCP pollinosis who did not have any symptoms or a history of lower respiratory tract diseases was enrolled in this study. JCP exposure was performed using an experimental challenge chamber. Before and after JCP exposure, we examined blood parameters as well as physiological changes in the nasal mucosa and lower respiratory tract.

Results

All patients complained of nasal symptoms after JCP exposure, but no lower respiratory symptoms were observed. The blood eosinophil count significantly increased in most patients after two consecutive JCP exposures (p<0.0001), and the eosinophil cationic protein (ECP) titer also significantly increased (p<0.001). The average fractional exhaled nitric oxide (FeNO) titer significantly increased after pollen exposure (p<0.01). In 25 cases with a high level of FeNO, forced expiratory volume in 1 s (FEV1) tended to decrease (average volume before exposure, 2.68 L; after exposure, 2.59 L; p=0.08).

Conclusions

The allergic reaction induced by JCP in the upper respiratory mucosa can evoke a generalized allergic inflammatory response, including that in the lower respiratory tract.

 
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