Pathogenesis of Allergic Rhinitis

  • Niels Mygind
  • Ronald Dahl
Chapter

Abstract

Allergic rhinitis is a well-defined disease. Especially seasonal allergic rhinitis is well suited for studies of pathogenesis and pathophysiology, as there are plenty of patients and as allergen challenge, outside the pollen season, can produce an experimental disease state with inflammation in the nasal mucous membrane. In addition, the nose is easily accessible for direct inspection, sampling of secretions and lavage fluids, and brush and mucosal biopsies. In recent years many researchers have taken advantages of these possibilities, and as a consequence, our knowledge of the pathogenesis and pathophysiology of allergic rhinitis has increased considerably (1–3).

Keywords

Mast Cell Allergic Rhinitis Nasal Mucosa Allergy Clin Immunol Pollen Season 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Naclerio RM, Baroody FM, Kagey-Sobotka A, Lichtenstein LM (1994) Basophils and eosinophils in allergic rhinitis. J Allergy Clin Immunol 94: 1303–1309.CrossRefPubMedGoogle Scholar
  2. 2.
    Terada N, Konno A, Togawa K (1994) Biochemical proterties of eosinophils and their preferential accumulation mechanism in nasal allergy. J Allergy Clin Immunol 94: 629–642.CrossRefPubMedGoogle Scholar
  3. 3.
    Howarth PH (1995) The cellular basis for allergic rhinitis. Clin Exp Allergy 50 (Suppl 23): 6–10.Google Scholar
  4. 4.
    Proctor DF (1989) The upper respiratory tract. In: Fishman AP, ed. Pulmonary Diseases and Disorders. McGraw-Hill, New York, pp. 209–223.Google Scholar
  5. 5.
    Andersen I, Proctor DF (1982) The fate and effects of inhaled materials. In: Proctor DF, Andersen I, eds. The Nose: Upper Airway Physiology and the Atmospheric Environment. Elsevier, Amsterdam, pp. 423–455.Google Scholar
  6. 6.
    Strachan DP (1995) Epidemiology of hay fever: towards a community diagnosis. Clin Exp Allergy 25: 296–303.CrossRefPubMedGoogle Scholar
  7. 7.
    Eccles R (1995) Nasal airways. In: Busse WW, Holgate ST, eds. Asthma and Rhinitis. Blackwell, Oxford, pp. 73–79.Google Scholar
  8. 8.
    Lowenstein H, Mygind N (1978) Extraction and degradation of timothy pollen allergen during simulated in vivo conditions. Allergy 33: 238–240CrossRefPubMedGoogle Scholar
  9. 9.
    Chien YW, Su KSE, Chang S-F (1989) Nasal systemic drug delivery. Marcel Dekker, New York.Google Scholar
  10. 10.
    Persson CGA, Svensson C, Greif L, Andersson M, Wollmer P, Alkner U, Erjefält I (1992) The use of the nose to study the inflammatory response of the respiratory tract. Thorax 47: 993–1000.Google Scholar
  11. 11.
    Viegas M, Gomez E, Brooks J, Davies RJ (1989) Changes in mast cell numbers in and out of the pollen season. Int Arch Allergy Appl Immunol 82: 275–276.Google Scholar
  12. 12.
    Fokkens WJ, Godthelp T, Holm AF, Mulder PGH, Vroom TM, Rijntes E (1992) Dynamics of mast cells in the nasal mucosa of patients with allergic rhinitis and non-allergic controls. Clin Exp Allergy 22: 701–710.CrossRefPubMedGoogle Scholar
  13. 13.
    Fokkens WJ, Vroom TM, Rijntes E, Mulder PGH (1989) Fluctuation of the number of CD1a ( T6)-positive dendritic cells, presumably Langerhans cells, in the nasal mucosa of patients with isolated grass-pollen allergy before, during and after the grass-pollen season. J Allergy Clin Immunol 84: 39–43.Google Scholar
  14. 14.
    Okuda M, Sakaguchi Y, Suzuki F, Ohtsuka H, Kawabori S (1985) Ultrastructural heterogeneity of the basophilic cells in the allergic nasal mucosa. Ann Allergy 54: 152–157.PubMedGoogle Scholar
  15. 15.
    Enerbäck L, Pipkorn U, Olafsson A (1986) Intraepithelial migration of mucosal mast cells in hay fever: ultrastructural observations. Int Arch Allergy Appl Immunol 81: 289–297.CrossRefPubMedGoogle Scholar
  16. 16.
    Bentley M, Jacobson MR, Cumberworth V, et al. (1992) Immunohistology of the nasal mucosa in seasonal allergic rhinitis: increases in activated eosinophils and epithelial mast cells. J Allergy Clin Immunol 89: 877–883.Google Scholar
  17. 17.
    Juliusson S, Karisson G, Bachert C, Enerbäck L (1994) Metachromatic, IgE-bearing and tryptasecontaining cells on the nasal mucosal surface in provoked allergic rhinitis. Acta Pathologica Microbiologica et Immunologica Scandinavica 102: 153–160.Google Scholar
  18. 18.
    Otsuka H, Inaba M, Fujikura T, Kunitomo M (1995) Histological and functional characteristics of metachromatic cells in the nasal epithelium in allergic rhinitis: studies of nasal scrapings and their disperse cells. J Allergy Clin Immunol 96: 528–536.CrossRefPubMedGoogle Scholar
  19. 19.
    Connell TT (1969) Quantitative intranasal pollen challenges. J Allergy Clin Immunol 43: 33–44.Google Scholar
  20. 20.
    Bradding P, Feather IH, Wilson S, Bardin PG, Heusser CH, Holgate ST, Howarth PH (1993) Immunolocalization of cytokines in the nasal mucosa of normal and perennial rhinitis subjects. J Immunol 151: 3853–3865.PubMedGoogle Scholar
  21. 21.
    Sulukvelidze I, Conway M, Evans S, Djuric V, Dolovich J (1995) Perennial allergic rhinitis: clinical and nasal irrigation fluid findings. J Allergy Clin Immunol 95:191 (abstract).Google Scholar
  22. 22.
    Grq nborg H, Bisgaard H, Romeling F, Mygind N (1993) Early and late nasal symptom response to allergen challenge. Allergy 48: 87–93.Google Scholar
  23. 23.
    Wang D, Clement P, Smitz J, De Waele M, Derde M-P (1995) Correlations between complaints, inflammatory cells and mediator concentration in nasal secretions after nasal allergen challenge and during natural allergen exposure. Int Arch Allergy Immunol 106: 278–285.CrossRefPubMedGoogle Scholar
  24. 24.
    Bisgaard H, GrOnborg H, Mygind N, Dahl R, Lindqvist N, Venge P (1990) Allergen-induced increase of eosinophil cationic protein in nasal lavage fluid: effect of the glucocorticoid budesonide. J Allergy Clin Immunol 85: 891–895.CrossRefPubMedGoogle Scholar
  25. 25.
    Klementsson H (1992) Eosinophils and the pathophysiology of allergic rhinitis. Clin Exp Allergy 22: 1058–1064.CrossRefPubMedGoogle Scholar
  26. 26.
    Lim MC, Taylor RM, Naclerio RM (1995) The histology of allergic rhinitis and its comparison to cellular changes in nasal lavage fluid. Am J Respir Crit Care Med 151: 136–144.PubMedGoogle Scholar
  27. 27.
    Mygind N, Thomsen J (1973) Cytology of the nasal mucosa. Arch Klin Exp Ohr Nas Kehl Heilk 201: 123–129.CrossRefGoogle Scholar
  28. 28.
    Yang P-C, Okuda M, Pawankar R, Aihara K (1995) Electron microscopical studies of the cell population in nasal secretions. Rhinology 33: 70–77.PubMedGoogle Scholar
  29. 29.
    Donelly AR, Glass M, Minkwitz C, Casale TB (1995) The leukotriene D4-receptor antagonist, ICI 204,219, relieves symptoms of acute seasonal allergic rhinitis. Am J Respir Crit Care Med 151: 1734–1739.Google Scholar
  30. 30.
    Howarth PH, Harrison K, Lau L (1995) The influence of a 5-lipoxygenase inhibitor in allergic rhinitis. Int Arch Allergy Immunol 107: 423–424.CrossRefPubMedGoogle Scholar
  31. 31.
    Varney VA, Jacobson MR, Sudderick RM, et al. (1992) Immunohistology of the nasal mucosa following allergen-induced rhinitis. Am Rev Respir Dis 146: 170–176.PubMedGoogle Scholar
  32. 32.
    Pawankar RU, Okuda M, Okubo K, Ra S (1995) Lymphocyte subsets of the nasal mucosa in perennial allergic rhinitis. Am J Respir Crit Care Med 152: 2049–2058.PubMedGoogle Scholar
  33. 33.
    Calderon MA, Lozewicz S, Prior A, Jordan S, Davies RJ (1994) Lymphocyte infiltration and thickness of the nasal mucous membrane in perennial and seasonal allergic rhinitis. J Allergy Clin Immunol 93: 635–643.CrossRefPubMedGoogle Scholar
  34. 34.
    Durham SR, Ying S, Varney V, et al. (1992) Cytokine messenger RNA expression for IL-3, IL-4, IL-5, and GM-CSF in the nasal mucosa after local allergen provoction: relationship to tissue eosinophilia. J Immunol 148: 2390–2394.PubMedGoogle Scholar
  35. 35.
    Karlsson MG, Davidsson A, Viale G, Grazziani D, Hellquist HB (1995) Nasal messenger RNA expression of interleukins 2, 4 and 5 in patients with allergic rhinitis. Diagn Mol Pathol 4: 85–92.Google Scholar
  36. 36.
    Pawankar RU, Okuda M, Hasegawa S, et al. (1995) Interleukin-13 expression in the nasal mucosa of perennial allergic rhinitis. Am J Respir Crit Care Med 152: 2059–2067.PubMedGoogle Scholar
  37. 37.
    Kenney JS, Baker C, Welch MR, Altman LC (1994) Synthesis of interleukin-la, interleukin-6, and interleukin-8 by cultured human nasal epithelial cells. J Allergy Clin Immunol 93: 1060–1067.CrossRefPubMedGoogle Scholar
  38. 38.
    Lee B-J, Naclerio RM, Bochner BS, Taylor RM, Lim MC, Baroody FM (1994) Nasal challenge with allergen upregulates the local expression of vascular endothelial adhesion molecules. J Allergy Clin Immunol 94: 1006–1016.CrossRefPubMedGoogle Scholar
  39. 39.
    Terada N, Konno A, Fukasa S, et al. (1995) Interleukin-5 upregulates intercellular adhesion molecule-1 gene expression in the nasal mucosa in nasal allergy but not in nonallergic rhinitis. Int Arch Allergy Immunol 106: 139–145.CrossRefPubMedGoogle Scholar
  40. 40.
    Ciprandi G, Pronzato C, Ricca V, Bagnasco M, Canonica GW (1994) Evidence of intercellular adhesion molecule-1 expression on nasal epithelial cells in acute rhinoconjunctivitis caused by pollen exposure. J Allergy Clin Immunol 99: 738–746.CrossRefGoogle Scholar
  41. 41.
    Ciprandi G, Pronzato C, Ricca V, Passalacqua G, Bagnasco M, Canonica GW (1994) Allergen-specific challenge induces intercellular adhesion molecule 1 (ICAM-1 or CD54) on nasal epithelial cells in allergic subjects. Am J Respir Crit Care Med 1150: 1653–1659.Google Scholar
  42. 42.
    Greve JM, Davis G, Meyer AM, et al. (1989) The major human rhinovirus receptor is ICAM-1. Cell 56: 839–847.CrossRefPubMedGoogle Scholar
  43. 43.
    Jacobi H, Stahl-Skov P, Bindslev-Jensen C, Prtorius C, Weeke B, Mygind N. Histamine and tryptase in nasal lavage fluid following challenge with allergen and methacholine. Clin Exp Allergy (in press).Google Scholar
  44. 44.
    Wang D, Clement P, Smitz J, Derde M-P (1994) Concentrations of chemical mediators in nasal secretions of patients with hay fever during natural allergen exposure. Acta Otolaryngol (Stockh) 114: 552–555.CrossRefGoogle Scholar
  45. 45.
    Simons FER (1993) Antihistamines. In: Mygind N, Naclerio RM, eds. Allergic and Non-allergic Rhinitis: Clinical Aspects. Munksgaard, Copenhagen, pp. 123–136.Google Scholar
  46. 46.
    Tos M (1982) Distribution of mucus producing elements in the respiratory tract. Eur J Respir Dis 64 (Suppl 128): 269–279.Google Scholar
  47. 47.
    Mygind N (1993) Hypersecretion in the airways. In: Andrews P, Widdicombe J, eds. Pathophysiology of the Gut and Airways. Portland, London, pp. 47–57.Google Scholar
  48. 48.
    Persson CGA, Pipkorn U (1990) Pathogenesis and pharmacology of asthma and rhinitis. In: Mygind N, Pipkorn U, Dahl R, eds. Rhinitis and Asthma: Similarities and Differences. Munksgaard, Copenhagen, pp. 275–288.Google Scholar
  49. 49.
    Brofeldt S, Mygind N, S¢rensen CH, Readman AS, Marriott C (1986) Biochemical analysis of nasal secretions induced by methacholine, histamine, and allergen provocation. Am Rev Respir Dis 133: 1138–1142.PubMedGoogle Scholar
  50. 50.
    Mygind N, Weeke B, Ullman S (1974) Quantitative determination of immunoglobulins in nasal secretion. Int Arch Allergy Appl Immunol 49: 99–107.CrossRefGoogle Scholar
  51. 51.
    Konno A, Togawa K, Fujiwara T (1983) The mechanisms involved in onset of allergic manifestations in the nose. Eur J Respir Dis 64 (128): 155–166.Google Scholar
  52. 52.
    Cauna N, Hinderer KH, Manzetti GW, Swansson EW (1972) Fine structure of nasal polyps. Ann Otol Rhinol Laryngol 81: 41–58.PubMedGoogle Scholar
  53. 53.
    Brooks CD, Karl KJ, Francom SF (1993) Effect of vasoconstrictor pre-treatment on obstruction, secretion and sneezing after nasal challenge with threshold and suprathreshold allergen doses. Rhinology 31: 165–168.PubMedGoogle Scholar
  54. 54.
    Wihl J-A, Petersen BN, Petersen BN, Gundersen G, Bresson K, Mygind N (1985) Effect of the non-sedative H1-receptor antagonist astemizole in perennial allergic and nonallergic rhinitis. J Allergy Clin Immunol 75: 720–772.CrossRefPubMedGoogle Scholar
  55. 55.
    Secher C, Kirkegaard J, Borum P, Maansson A, Osterhammel P, Mygind N (1982) Significance of H 1 and H2 receptors in the human nose. J Allergy Clin Immunol 70: 211–218.CrossRefPubMedGoogle Scholar
  56. 56.
    Rak S, Jacobson MR, Sudderick RM, et al. (1994) Influence of prolonged treatment with topical corticosteroid (fluticasone propionate) on early and late phase nasal responses and cellular infiltration in the nasal mucosa after allergen challenge. Clin Exp Allergy 24: 930–939.CrossRefPubMedGoogle Scholar
  57. 57.
    Mygind N, Lund V (1996) Topical corticosteroid therapy of rhinitis. Clin Immunother 5: 122–136.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Niels Mygind
  • Ronald Dahl

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