Gonadotropin-releasing hormone analogs: update on new findings

Clinical trials are under way to investigate the optimal use of nafarelin. In one series of studies, the effect of nasal mucosal inflammation and the concomitant use of nasal decongestants on the nasal absorption of nafarelin was evaluated in women with perennial rhinitis. Neither rhinitis nor concomitant therapy with a long-acting nasal decongestant substantially affected the nasal absorption of nafarelin. Other clinical studies are investigating strategies for second treatment of endometriosis or to improve the safety profile of nafarelin. In one trial, a second 3-month treatment course with nafarelin in patients with recurrent symptoms of endometriosis provided substantial pain relief. In another trial, preliminary information indicates that the addition of norethindrone to nafarelin in patients with endometriosis attenuates bone density changes and menopausal symptoms associated with nafarelin treatment.

The relationship of IgE, skin-test, eosinophilia, eosinophil cationic protein and tumor necrosis factor production in allergic rhinitis

One hundred and twelve patients with allergic rhinitis (AR) were selected for this study. Sixty-one percent of the patients had elevated levels of total serum IgE (> 210 IU/ml) whereas 55% of them had eosinophilia. Skin-test reactivities to house dust mite and fungi allergens were positive in 86% of the patients, but this was correlated neither to levels of eosinophils and specific IgE to Dermatophagoides ptronyssinus (Dpt) and D. farinae (Df), nor with the levels of total IgE except in the skin-test highest-reactive group; they had significantly higher IgE level than the normal controls. Radioallergosorbent test (RAST) was 66% in those patients with high IgE levels and the major allergens were further identified by Quidel Allergen Screen assay as Dpt and Df. Serum ECP level was correlated with high, but not low, blood eosinophil numbers in patients with AR. Tumor necrosis factor (TNF) production from peripheral blood mononuclear cells culture by phytohemagglutinin (PHA) stimulation was suppressed in patients with AR with eosinophilia when compared with that of the normal controls. The symptom-triggering factors in patients with AR were primarily cold air, temperature change and the common cold. This suggests that factors other than the specific IgE response to house dust mite, skin-test reactivity and eosinophilia may also be important in the development of AR.

In vivo release of 15-HETE and other arachidonic acid metabolites in nasal secretions during early allergic reactions

The purpose of this study is to examine the "in vivo" release of 15-HETE and other arachidonic acid metabolites in nasal secretions following a challenge with "Dermatophagoides Pteronyssinus" in patients with allergic rhinitis and non-allergic controls. In addition, we examine the effects of a membrane stabilizer, such as sodium cromoglycate, on these metabolites. Thirteen allergic subjects and seven healthy controls are studied. 15-HETE, peptide leukotrienes, LTB4, PGD2, PGE2 and PGF2 alpha levels are evaluated before and after nasal challenge in sodium cromoglycate treated and untreated subjects. This study provides "in vivo" evidence that the pathophysiological responses to nasal antigen challenge could be related to the release of 15-HETE as well as other arachidonic acid metabolites, mainly arising from the lipoxygenase pathway.

Clinical and inflammatory responses to exogenous tachykinins in allergic rhinitis

Our purpose was to characterize the tachykinin receptor type involved in nasal obstruction to exogenous substance P in rhinitic patients. We also attempted to assess biochemical and cellular events associated with this response. Nasal challenges were performed in seven patients with allergic rhinitis. They received increasing doses (10 to 80 nmol) of substance P, of neurokinin A, of the N-terminal fragment of substance P, substance P(1-9), and of saline on 4 different days separated by 14 days. Nasal airway resistance (NAR) increased in a dose-dependent manner on substance P. Maximal increase reached 4.5-fold basal NAR. Response to neurokinin A was significantly lower (less than 2-fold basal NAR). No effect was observed on substance P(1-9) and saline. This order of activity [substance P much greater than neurokinin A greater than substance P(1-9) = saline] indicates an NK1 receptor-mediated mechanism inducing local vasodilation. No histamine release was found after any of the four challenges. Proteins significantly increased in nasal lavage fluid on both substance P and neurokinin A, whereas substance P(1-9) and saline had no effect. The percentage of albumin increased in nasal lavage fluid from 30 to 50% of total proteins on substance P and neurokinin A, indicating microvascular leakage. Polymorphonuclear cells significantly increased from 9 to 36% on substance P, from 13 to 49% on neurokinin A, and from 13 to 55% on substance P(1-9). Eosinophils increased in five patients on substance P (from 0.1 to 5% for the group), in three patients after neurokinin A, and in two after substance P(1-9).(ABSTRACT TRUNCATED AT 250 WORDS)

[Allergic rhinitis nasal epithelial cell conditioned medium stimulates growth and differentiation of basophil/mast cell and eosinophil progenitors from atopic blood]

We examined the conditions, kinetics and cell sources for basophil/mast cell and eosinophil colony stimulating activity (CSA) production by nasal epithelial cells taken from house dust (HD) nasal allergic patients. Epithelial scrapings removed from HD nasal allergic patients were grown to confluence over 7 days as a monolayer of epithelial cells in medium supplemented with fetal calf serum (FCS) on collagen coated microwell plates. CSA in nasal epithelial cells conditioned medium (CM) was assessed with density-gradient separated, nonadherent peripheral blood mononuclear cells in 14-day and 21-day methylcellulose assays. In the 14-day methylcellulose assays, the number of Eo-type colonies in the presence of either 10% or 5% CM was significantly higher than the background number of Eo-type colonies (negative control). Comparison of Gm CSA among 1%, 5% and 10% CM with negative, revealed no significant differences. We also compared the Eo-type CSA in the presence of 10% significant differences. We also compared the Eo-type CSA in the presence of 10% CM in the 14-day methylcellulose assay with 21-day methylcellulose assay. There was no significant difference in the number of Eo-type colony between the 14-day and 21-day methylcellulose assays. We also examined the composition of the cells in the colonies in the 14-day and 21-day methylcellulose cultures. The percentage of metachromatic granule containing cells in a Eo-type colony in 14-day methylcellulose assay was significantly higher than in a Eo-type colony in 21-day methylcellulose assay.(ABSTRACT TRUNCATED AT 250 WORDS)

[Histamine metabolism in the nasal tissue of human and nasal hypersensitive guinea-pig]

Histamine (HA) is the most important mediator of nasal allergy and nasal hypersensitivity. To investigate HA metabolism, HA content and activities of its synthetic enzyme, histidine decarboxylase (HDC) and degrading enzymes, histamine-N-methyltransferase (HMT) and diamine oxidase (DAO) in nasal mucosa of human and toluene diisocyanate (TDI) sensitized guinea-pigs were measured. In human nasal mucosa and nasal polyps, HA content and HDC activity were 80-200 nmol/g tissue, 20-30 fmol/min/mg protein respectively. Among two degrading enzymes, HMT activity was 20-200 times higher than that of DAO. In the nasal mucosa of guinea-pigs, HA content was significantly increased by TDI sensitization, and was decreased immediately after TDI provocation. In 24 hours after provocation, HA content recovered to 80% of pre-provocation level. HDC activity increased by TDI sensitization significantly. Though HMT activity increased slightly by TDI sensitization and provocation, DAO activity was unchanged. The data suggest that, increase in turnover rate of HA is present in allergic nasal mucosa.

Elevated bronchoalveolar lavage fluid histamine levels in allergic asthmatics are associated with increased airway obstruction

Bronchoalveolar lavage (BAL) fluid was evaluated for histamine and tryptase levels in 61 samples (46 samples from 24 atopic asthmatics, seven samples from seven patients with allergic rhinitis, and eight samples from eight normal volunteers). Asthmatics and patients with allergic rhinitis had significantly higher BAL histamine than did normal subjects (169 +/- 22, 141 +/- 23, 42 +/- 6 pg/ml, respectively; p less than 0.05, both comparisons). BAL fluid tryptase levels were also higher in asthmatics and patients with allergic rhinitis than in normal subjects (0.36 +/- 0.03, 0.38 +/- 0.05, 0.23 +/- 0.04 ng/ml, respectively; p less than 0.05, both comparisons); however, levels of tryptase and histamine in BAL were not correlated (r = -0.03 in the group as a whole, r = -0.12 in the asthmatic group). BAL concentration of histamine correlated inversely with FEV1 percent predicted in the asthmatic group (r = -0.44, p less than 0.005). Asthmatics with high BAL fluid histamine (greater than or equal to 100 pg/ml, n = 23) had lower FEV1 percent predicted (80 +/- 3% versus 96 +/- 3%, p = 0.0005), lower FEV1/FVC ratio (72 +/- 1% versus 77 +/- 2%, p less than 0.05), higher percentage of BAL eosinophils (2.2 +/- 0.4% versus 0.6 +/- 0.1%, p less than 0.002), and greater airway responsiveness (lower PD20 [13.1 +/- 3.4 versus 41.5 +/- 13.7 cumulative breath units, p less than 0.05]) compared with asthmatics with low BAL fluid histamine (less than 100 pg/ml, n = 23).(ABSTRACT TRUNCATED AT 250 WORDS)

[Study on eosinophil cationic protein (ECP) and arylsulfatase B in nasal secretions and sera from patients with nasal allergy]

Recently four tissue toxic proteins namely major basic protein (MBP), eosinophil peroxidase (EPO), eosinophil-derived neurotoxin (EDN), and eosinophil cationic protein (ECP) were found in eosinophilic leucocytes. Although the characteristics of these proteins concerning tissue damage in the local site of type I allergic reaction have been investigated mainly in lower respiratory tract, the actual clinico-pathological roles of these proteins in nasal allergy are not clarified. Contrary, eosinophils also have histaminase, arylsulfatase, phospholipase D, which are considered to act on a negative feedback mechanism in allergic reaction through inactivation of chemical mediators. Therefore, estimation of ECP and simultaneously arylsulfatase B in nasal secretion and the sera from patients with nasal allergy may clarify the dynamics of clinico-pathological state, especially in the late phase of allergic reaction in each patients. ECP concentrations in the nasal secretions from 22 patients and in the sera from 12 patients with nasal allergy were measured by RIA method. The activities of arylsulfatase B in the nasal secretions and the sera were also estimated in the same specimens as ECP by measuring its hydrolytic activity using p-nitro cathecol sulfate as a substrate. The results obtained were as follows; 1) There was a significant correlation between ECP concentrations in the nasal secretions and the severities of clinical symptoms, especially the degree of nasal obstruction. ECP concentrations also significantly correlated to the score of eosinophilic leucocytes in the nasal smears. 2) The serum ECP concentrations significantly correlated to the number of eosinophilic leucocytes in the peripheral blood, and also showed slight tendency of correlation to the severity of clinical symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

The sources of chemical substances in allergic nasal fluid

The sources of different chemical substances in the NF of allergic patient, such as albumin, secretory IgA, histamine, leukotriene, kinin and substance P were investigated. To accomplish this, we challenged the inferior turbinate on one side, but separately collected NF from both sides in patients with nasal allergy to house-dust. Provocation was done with paper disc containing dried allergen extract. Collection was done by suction for the first five minutes immediately after the onset of a positive response to nasal provocation. The total amount of the chemical substances on each side was analyzed separately and compared. Significant differences were seen between both sides only for histamine and leukotriene. In consideration with the previous reports, it is suggested that in nasal allergen challenge the major sources are glandular secretion for secretory IgA, and albumin, and secretion for migrating cells for histamine and leukotriene. The major sources responsible for kinin and substance P, however, are not defined.

Additional properties of cetirizine, a new H1 antagonist

Cetirizine, an H1 antihistamine, has properties in addition to H1 blockade that may be useful in the treatment of seasonal rhinitis and urticaria. For example, cetirizine has been shown to block the influx of eosinophils into the site of antigen-stimulated skin blisters. Studies with other antihistamines suggest that this is not a universal property of this type of drug. Pretreatment with cetirizine also has been found to block the augmented sensitivity to methacholine that occurs 24 hours after antigen provocation of the nasal mucosa. This reduction takes place despite the absence of an effect on eosinophil influx into this area, and suggests another action of cetirizine. Our study of allergic rhinitis patients examined the effect of cetirizine on early response to nasal challenge with antigen. Cetirizine, although it did not block the release into nasal secretions of histamine, significantly reduced sneezing and decreased levels of albumin and TAME-esterase activity, which are indicators of vascular permeability. Cetirizine also blocked the generation of leukotriene C4. In vitro studies have shown that cetirizine does not block the release of leukotriene from anti-IgE stimulated mast cells, raising the possibility that cells in the nasal mucosa in addition to mast cells generate leukotrienes.

[A study of chemical mediators in patients with allergic rhinitis. 3). Release of histamine and leukotrienes from in vitro nasal mucosa]

Responses to mite antigen and nonimmunological stimuli, substance P, of chopped fragments of nasal mucosae were studied from eleven patients with perennial allergic rhinitis who were sensitive to mite antigen. Amount of released histamine significantly increased by either stimulation. However, the release of leukotrienes (LTs) increased only by the stimulation of mite antigen, which correlated with that of histamine. By either stimulation, amount of histamine release tended to be higher in patients with severe nasal symptoms than in those with moderate nasal symptoms. Only by mite antigen stimulation, amount of the release of peptide LTs and LTB4 tended to be higher in patients with severe nasal symptoms. We concluded that the amounts of histamine and LTs released from nasal mucosa in allergic reaction were closely related with the severity of nasal symptoms in patients with allergic rhinitis.

[The study of chemical mediators in the patients with allergic rhinitis 2). Histamine, leukotriene and kinins in the nasal secretion during dual phase response]

In order to clarify the details of a late phase response (LPR) in allergic rhinitis, serial changes of nasal symptoms and concentration of chemical mediators (histamine, leukotriene (LT) C4 and kinins) in nasal lavage fluid were investigated after the nasal antigen challenge in ten patients with perennial allergic rhinitis with a positive intradermal skin reaction to mite extract. Samples were collected periodically for 8 hours following the challenge. Nasal airway resistance (NAR) and clinical symptoms were also recorded serially. Three out of ten patients showed only early phase response (EPR) and the other seven patients showed both early and late phase response after the challenge. The chief nasal symptom in LPR was nasal obstruction. In EPR, concentrations of chemical mediators in the nasal lavage fluid always increased. In dual (early and late) phase responders, increases of chemical mediators in nasal lavage fluids were notable during both early and late phase responses. In EPR, there was a significant correlation between severity of sneezing attack and concentration of histamine. In LPR, increase of LTC4 level was significantly correlated with the increase of NAR. RAST score and daily nasal symptoms tended to be higher and more sever in dual phase responders compared with early phase responders. We suggest that the amounts of released chemical mediators during allergic reaction denoted the LPR in allergic rhinitis patients.

Observations on the treatment of allergic rhinitis with the method of invigorating vital energy and strengthening the body surface resistance

From clinical practice, the authors concluded that the principal pathogenic factor in allergic rhinitis is deficient resistance of the body surface, and the patient is exposed to invasion of wind-evil. 495 cases of the allergic rhinitis have been treated with the method of invigorating vital energy and strengthening the body surface resistance (Bu Qi Gu Biao); the total effective rate was 84%, and the recurrence rate was 13.2% in a follow-up of 2 years. The changes in plasma cyclic nucleotides of the patients, and the ultrastructure of nasal mucosa of patients and animal models were also observed before and after treatment. The results showed that the TCM therapy tended to normalize the plasma cyclic nucleotide level, to improve the morphology and function of cells and organelles, to restore the function of mucosal cilia, to reduce the infiltration of eosinophils and their degranulation, to reduce tissue edema, and to eliminate the deposit of immune complexes.

[The study of chemical mediators in the patients with allergic rhinitis. 1). Histamine, leukotriene and kinins in the nasal secretion during early phase response]

For the purpose of studying the roles of chemical mediators during early phase response of allergic rhinitis, the levels of histamine, leukotriene C4 (LTC4) and kinins in the nasal lavage fluid were measured before and after the nasal challenges with antigens. Seventeen patients with perennial allergic rhinitis with positive intradermal skin reactions to mite antigen extracts were included in this study. The nasal samples were obtained both by aspirating and instilling 5 ml of saline into patient's nostrils before and ten minutes after the nasal challenges. After the nasal challenge with control disk, the concentration of histamine in the nasal samples increased, and the concentrations of LTC4 and kinins did not increase significantly. After the nasal challenges with mite or house dust disk, the concentration of histamine increased as much the same as that after the nasal challenges with control disk, and the concentrations of LTC4 and kinins increased significantly compared with those after the nasal challenges with control disk. delta histamine and delta kinins (delta: net increments in the concentrations after the nasal challenge with antigen over values before the nasal challenge) were significantly correlated with delta albumin. The patients with severe nasal symptoms tended to present more remarkable net increments of chemical mediators than the patients with mild and moderate nasal symptoms. Similar tendencies were recognized in the relationships between the severity of nasal symptoms provoked by nasal challenge with antigen and net increments of chemical mediators. We suggest that the amounts of chemical mediators during the allergic reaction denoted the severity of nasal symptoms in allergic rhinitis patients.

Evidence for elevated levels of histamine, prostaglandin D2, and other bronchoconstricting prostaglandins in the airways of subjects with mild asthma

Histamine and certain cyclooxygenase products of arachidonic acid have been implicated as mediators of inflammation and are potent constrictors of human airways. Because asthma may represent manifestations of chronic inflammation of the airways, the levels of histamine and six prostanoid mediators were measured in airway fluids obtained by bronchoalveolar lavage (BAL) of 12 normal, 11 allergic rhinitic, and 15 asymptomatic, allergic asthmatic subjects. Simultaneous profiling of prostanoid mediators in individual samples was performed using gas chromatography-mass spectrometry. Levels of PGD2, 9 alpha,11 beta-PGF2 and PGF2 alpha were 12 to 22 times higher in asthmatic than in normal subjects (p less than 0.01), with concentrations in airway fluids of asthmatic subjects after correction for dilution of 3.8, 0.5, and 1.4 nanomolar, respectively. Levels of PGD2 and 9 alpha,11 beta-PGF2 were increased nearly tenfold in asthmatic subjects compared with those in rhinitic subjects (p less than 0.01), distinguishing the subjects with lower airway disease from those with another atopic condition. Histamine levels were increased fourfold in asthmatic subjects compared with those in normal subjects (p less than 0.001); however, similar increases were found in rhinitic subjects. We conclude that elevated levels of multiple mediators with potent bronchoconstricting activity are present in the airways of subjects with mild asthma, indicating that even mild disease is associated with evidence of airway inflammation. The interactions of bronchoconstricting mediators and airway inflammation may play important roles in the pathogenesis of asthma.

Mediator release after endobronchial antigen challenge in patients with respiratory allergy

The aim of the present study was to evaluate the release of some potential mediators of allergic reactions, such as histamine, peptide leukotrienes (LTs), LTB4 and prostaglandin D2 (PGD2), in bronchoalveolar lavage (BAL) fluids from 11 patients with respiratory allergy (eight with bronchial asthma and three with allergic rhinitis), who underwent specific endobronchial challenge. Histamine, peptide LT, and PGD2 levels in BAL fluids increased significantly after antigen stimulation both in patients with asthma and in patients with rhinitis. By contrast, LTB4 concentration was always below the limits of detection of the radioimmunoassay. In patients with asthma, histamine concentration increased from 5.3 +/- 0.6 ng/ml in lavages obtained before provocation to 20.2 +/- 5.8 ng/ml (mean +/- SEM; p less than 0.04) 5 minutes after bronchoprovocation. Peptide LTs increased from 0.32 +/- 0.08 to 0.82 +/- 0.21 ng/ml (p less than 0.02) and PGD2 from 0.06 +/- 0.01 ng/ml to 0.36 +/- 0.09 ng/ml (p less than 0.02). Elevated histamine, peptide LT, and PGD2 concentrations were also found in the 15-minute postchallenge BAL fluids. Similar results were obtained in patients with rhinitis. Histamine concentration was 3.4 +/- 0.6 ng/ml in prechallenge bronchial lavages and 11.3 +/- 1.7 ng/ml in postchallenge lavages; peptide LTs increased from 0.13 +/- 0.008 ng/ml to 0.73 +/- 0.21 ng/ml, and PGD2 from 0.05 +/- 0.01 ng/ml to 0.26 +/- 0.06 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

[Changes in the partial pressure of oxygen of the nasal mucosa caused by stellate ganglion block]

Stellate ganglion block (SGB) is clinically used for the treatments of various lesions diseases. SGB gives rise to nasal obstruction of transient duration. It is also suggested that derangement of the autonomic nervous system underlies nasal allergy. In order to study the hemodynamics of the nasal mucosa after SGB, two groups of the subjects, i.e. healthy volunteers and patients with nasal allergy, were included for evaluation of the partial pressure of oxygen of nasal mucosa (PtsO2) after SGB. Simultaneous evaluations were done to assess the nasal patency in the normal group and the temperature at the anterior tip of the inferior nasal turbinate in the nasal allergy group. The results thus obtained are summarized as follows: 1) In the normal group, SGB was resulted in a reduction in nasal patency on the blocked side and a significant increase in PtsO2 when compared with the non-blocked side. The PtsO2 remained higher than normal after although nasal patency was restored. 2) The PtsO2 at rest was lower in the nasal allergy group than in the normal group. 3) Changes in PtsO2 following SGB were similar in the two groups. 4) A parallelism was noted between changes in the temperature at the tip of inferior nasal turbinate and those in PtsO2 during SGB. These results suggest that SGB augments the arterial blood flow in the nasal mucosa. The compromised nasal mucosa of nasal allergy patients is in a state of hypoxia but showed virtually the similar improvement in circulation after SGB as noted in the nasal mucosa of normal subjects.

Eosinophils and eosinophil cationic protein in nasal lavages in allergen-induced hyperresponsiveness: effects of topical glucocorticosteroid treatment

Airway challenges with allergen are frequently followed by an increase in responsiveness to both specific and unspecific stimuli. This phenomenon in the lower airways has been linked to the presence of a late phase response to allergen challenge. One of the hallmarks of the late phase response is a tissue infiltration of granulocytes, specifically the eosinophils. A hypothesis for the increase in responsiveness has been that local activation of these eosinophils with subsequent release of the toxic granular constituents leads to a decrease in the barrier function of the airway epithelium. The aim of the present study was to further explore this hypothesis. Ten patients with previously demonstrated nasal allergen-induced hyperresponsiveness participated in a double-blind cross-over study involving pretreatment for various periods with topical glucocorticosteroids. The patients were challenged intranasally with allergen on one day, rechallenge 24 h later and the increase in responsiveness noted. In a nasal lavage performed immediately prior to challenge the number of eosinophilic granulocytes and the level of eosinophilic cationic protein (ECP) was determined. As expected, the placebo-treated patients demonstrated an increase in nasal responsiveness at rechallenge accompanied by a tendency for an increase in eosinophils as well as ECP in the lavage preceding the rechallenge compared with the initial allergen challenge 24 h previously. The amount of ECP found in the lavage on the second day correlated with the TAME-esterase activity, a marker of ongoing inflammatory activity (r = 0.64; P less than 0.05) in the same lavage, suggesting participation of the eosinophilic granulocyte in the inflammatory response to allergen.(ABSTRACT TRUNCATED AT 250 WORDS)

[Electron microscopic study of intercellular junction in nasal mucosa of nasal allergy by lectin histochemistry]

To explain of the mechanism of the enhanced nasal epithelial permeability to HRP in patients with nasal allergy, the inferior turbinate mucosa was removed from 6 normal adults and 7 adults with nasal allergy. Difference of the fine structure of the intercellular junction was compared between normal mucosa and mucosa of nasal allergy by electron microscope. Staining pattern of four kinds of HRP-conjugated lectin (HRP-WGA, PNA, UEA-I and RCA-I) was also studied by electron microscope. There was no significant difference in the intercellular space of the mucosa between the normal mucosa and mucosa of nasal allergy. In the epithelial cell membrane, pattern of HRP-lectin staining was almost similar in both groups. In normal nasal epithelium, the intercellular junction consisted of junctional complex; adherent junction, desmosome and gap junction. The intercellular space was approximately 150-250 A in width. The tight junction was located beneath the luminal surface of the epithelium, and belt-like continuation connecting the adjacent cells. It was concluded that enhanced permeability to HRP in nasal allergy was not morphologic changes of the intercellular junction and component and distribution of the glycoconjugates in epithelial cellular membrane, but this may be based on functional changes.

[Electron microscopic study of glycoconjugate in nasal mucosa of nasal allergy by lectin histochemistry]

Glycoconjugates in glandular and goblet cells of nasal mucosa were compared between normal and nasal allergy by using various horseradish peroxidase (HRP)-conjugated lectins; WGA, PNA, UEA-I and RCA-I. Specific sugar residues of glycoconjugates could be identified under electron microscope. Golgi's complex of the serous secretory cells in nasal allergic mucosa had positive staining in UEA-I. Goblet cells of nasal allergic mucosa were stained strongly in PNA, compared to normal mucosa, however, they were stained weakly in WGA. In conclusion, glycoconjugates in glandular and goblet cells seem to be changed in nasal allergy.

Variations of histamine release in an atopic population. I. Clinical situation and seasons

Two hundred and twenty-six patients (195 asthmatics and 31 rhinitics) sensitive to D. pteronyssinus were studied. Histamine release tests were performed on them and the results obtained were analyzed with respect to 3 variables: clinical situation (symptomatic and asymptomatic), diagnosis (asthma or rhinitis), and the month of extraction. There were no significant differences between the total and basal histamine in the various groups. The symptomatic individuals (48.66 +/- 29.66 ng/ml) released a greater amount of histamine than the asympomatic group (39.47 +/- 21.07 ng/ml) (p less than 0.05). There was no difference with regards to the diagnosis, although symptomatic asthmatics released more histamine than active rhinitics (p less than 0.01). These patients released more histamine during spring and autumn than during the other two seasons.

[The relationship between the number of the autonomic nerve receptors and degree of hyperreactive nasal symptoms in patients with hyperesthetic rhinitis]

It is generally accepted that abnormal autonomic responsiveness may contribute to the pathogenesis of hyperesthetic rhinitis. Histologically, in the nasal mucosa, cholinergic fibers are found close to blood vessels, but are particularly numerous around the glands. Adrenergic fibers are found mainly around the vascular structures. Physiological and pharmacological studies demonstrate that parasympathetic hypersensitivity causes hypersecretion, and sympathetic hyposensitivity causes vasodilatation. alpha 1-adrenergic receptor function is dominant for this vasodilatation. Using radioligand binding techniques, it has been found that there is an increased number of muscarinic cholinergic receptors and a decreased number of alpha 1- and beta-adrenergic receptors in patients with nasal allergy, while the binding affinities do not change. In this report, using radioligand binding techniques, we investigated the relationships between the number of receptors and the degree of the hyperreactive nasal symptoms in patients with hyperesthetic rhinitis. The results are as follows. 1. The number of muscarinic cholinergic receptors of human nasal mucosa in patients with hyperesthetic rhinitis was related significantly (P less than 0.01) to the degree of hypersecretion induced by methacholine and frequency of blowing nose estimated from allergy diary. 2. There was no relationship between frequency of sneezing and the number of muscarinic cholinergic receptors. 3. The number of alpha 1-adrenergic receptors was related significantly (P less than 0.05) to the degree of swelling of nasal mucosa induced by methoxyamine. Judging from these results, it was assumed that pathogenesis of hyperreactive nasal symptoms may be associated at least partially to the changes of number of autonomic nerve receptors in the nasal mucosa.