Nasal lavage fluid examination and rhinomanometry in the diagnostics of occupational airway allergy to laboratory animals

Abstract

Objectives: The purpose of this studywas to compare the cellular and biochemical findings in the nasal lavage fluid (NALF) and nasal resistance changes due to a challenge with laboratory animal allergens in 25 patients with occupational asthma and rhinitis, in 22 patients with atopic asthma and rhinitis sensitized to house dust mite, and in 15 healthy subjects.

Methods: Skin prick tests with common and occupational allergens, total serum IgE level, specific anti-allergens IgE, spirometry and nasal lavages were performed.

Results: In patients with occupational airway allergy, nasal symptoms of varying severity developed directly after specific nasal challenge. The total symptom score immediately and 24 h after specific challenge was significantly correlated with expiratory nasal resistance (ENR). The percentage of eosinophils and basophils in NALF increased significantly 5 and 24 h after specific challenge in patients with occupational asthma and it was correlated with ENR. The authors did not observe any significant increase in the percentage of eosinophils, basophils and in the level of albumin in NALF of patients with non-occupational allergy and healthy subjects at any time-point after specific challenge. None of the healthy subjects and patients with non-occupational allergy developed either allergic symptoms or increased ENR after the challenge with laboratory animal allergens and placebo.

Conclusions: The prolonged increase in the percentage of eosinophils, basophils and in the level of albumin seems to reflect allergic inflammation. The intensity of inflammation during the specific reaction is related to the symptom score and to ENR in occupational allergics.