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Although histamine and methacholine challenge tests are commonly used to evaluate the hypersensitivity in allergicrhinitis, some controversies still remain to standardize the test. This study was designed to evaluate the usefulness of themethacholine challenge test for the evaluation of hyperreactivity in allergic rhinitis. Twenty three patients with perennialallergic rhinitis and 17 normal subjects were included in this study. All subjects underwent saline nasal challenge andmethacholine nasal challenge test with different doses (6 mg, 12 mg, 24 mg / in 0.5 ml of saline). We measured the nasalcavity volume by acoustic rhinometry in each step and counted the number of sneezes for 15 minutes. The volume of nasalsecretion was also measured by tissue paper method. Besides that, we compared the data between allergic patients with ashort (under 1 year) and long duration (more than 1 year). There were no differences in the frequency of sneezing andnasal volume change to each amount of methacholine in both groups. Nasal secretion increased after methacholine challengein both groups. However, the allergic group showed significant increase after the methacholine challenge of 12 mg comparedto the control group. And the volume of nasal secretion significantly increased in patients with a long duration. The nasalmethacholine challenge test can be used as a diagnostic tool to detect hyperreactivity in perennial allergic rhintis. The optimaldilution was 12 mg (in 0.5 ml of saline) for the nasal methacholine challenge test.
Background : and objective : Mahuangbujaseshintang(MBST) and soshihotang (SST) have been used for treatment of chronic disease of respiratory tract. It is necessary to clarify the mechanism of anti-allergic effects and to standardize the extracts. Materials and methods : The effects of MBST and SST were evaluated on histamine release in rat mast cells ex vivo. Several hours after administration of the extracts. Mast cells were stimulated by DNP-ascaries and histamine contents were measured. Time course structural change of the cells was examined by dynamic study. In order to evaluate the effect of the extracts on the nasal patency. Acoustic rhinometry was performed after administering of leukotriene D4 to both nasal cavities of guinea pig(GP). We examined the effects of the extracts with double-blind study, and also studied change of nasal patency after challenge of antigen by acoustic rhinometry in patients with allergic rhinitis. Results : MBST at 4 hr and SST at 3 hr after oral administration remarkably inhibited histamine release from rat mast cells in a dose-dependent manner. MBST-treated GPs failed to show bi-phasic phenomena which indicated to reduce nasal volume at the time of early and late phases in allergic inflammation. Both groups of patients who took MBST and SST for 1 week or 2 weeks showed significant decreased symptom severity index (SSI) from treatment week 2 (p$lt;0.05). The percent volume change after challenge of the antigen was decreased in 31 patient who took the extracts for 2 weeks. Conclusion : We can conclude that the herb medicine of MBST and SST may be effective for allergic rhinitis. (J Asthma Allergy Clin Immunol 20: 619-626, 2000)
That mast cells play a role in acute allergic inflammation by releasing various inflammatory mediators, including histamine,leukotrienes (LT), such as LTC4 and LTD4, and prostaglandins (PG), such as PGD2, is well known. Additionally, mast cellscontribute to the development of allergic inflammation also through the release of multifunctional cytokines. The incidence ofintraepithelial mast cells (IEMC) is found to be greater in nasal mucosa exposed to an allergen, and the cells are thought to play animportant role in producing the immediate allergic reaction. Lamina propira mast cells (LPMC) are known to be the dominantsource of TH2 cytokine and are responsible for development of the late phases of an allergic reaction They may upregulate theexpression of adhesion molecules on the endothelial cells and induce basophil and eosinophil recruitment. Based on these considerationit can be proposed that mast cell is a initiating cell of allergic reaction in target organ and IEMC and LPMC havecapacity to make major contribution to both immediate or late phase reaction of allergic rhinitis.
Acoustic reflections have been used in adult human to determine nasal cavity dimension in terms of cross sectional area as a function of the distance from nostril. In order to measure nasal cavity dimensions in guinea pigs, we modified equipment for use in human by decreasing sound tube dimension, increasing sampling frequency, and applying a special nosepiece. The percent change of volume (VOL) from the nostril to 2cm into the nasal cavity showed significant reduction at 30 minutes and 6 hours after instillation of LTD₄ in guinea pigs. However the guinea pig instilled saline did not show any change in VOL. This result indicated that leukotriene was an potent mediator to induce nasal obstruction of late reaction in guinea pig.
The mucus secretion of airway glands is known to be controlled by the various autonomic neurotransmitters such as noradrenalinand acetylcholine. However, a recent study suggests that non-adrenergic, non-cholinergic (NANC) nerves may contributeto the secretory activity of glands. Substance P (SP) has been proposed as a neurotransmitter of the NANC nervoussystem. SP is present within nerve fibers innervating the airway mucosa and is known to be released from sensory nerves via anaxonal reflex. SP activity is controlled by neutral endopeptidase (NEP) which degrades SP. In this study, we evaluated theeffects of NEP inhibitor (thiorphan) and substance P on nasal mucosa and histamine on the nasal mucosa in healthy males. Inthe thiorphan-substance P experimental group, the nasal volume decreased after nebulization of substance P in proportion to theconcentration of histamine. In the thiorphan-substance P experimental group, the frequency of sneezing increased in proportionto the concentration of histamine, but there was no increased frequency of sneezing from thiorphan, SP and normal saline. Theresults of this study suggest that axonal reflexes can play a role in the pathogenesis of nasal mucosal hypersensitivity andneurogenic inflammation.