Masatake Ishihara

SEASONAL VARIATIONS OF NASAL RESISTANCE IN ALLERGIC RHINITIS AND ENVIRONMENTAL POLLEN COUNTS II: EFFICACY OF PRESEASONAL THERAPY

We gave Mao-bushi-saishin-to, a Chinese blended medicine, and azelastine to an adult patient with hay fever due to Japanese cedar pollen and measured nasal resistance and ambient floating pollen counts throughout the time of Japanese cedar pollination in separated years. In the patient Mao-bushi-saishin-to was effective against preseasonal increases in nasal airway resistance but could not control severe episodes of allergic rhinitis caused by high dose exposure to Japanese cedar pollen and also perhaps caused by a priming effect. Azelastine inhibited both pre- and post-seasonal increases in nasal airway resistance but not only on high pollen counts days.

The Distribution of Eosinophil Cationic Protein Positive Eosinophils in the Nasal Mucosa of the Nasal Allergy Patients

The relationship between the distribution of eosinophils and epithelial damage of the nasal mucosa in nasal allergy was investigated by means of hematoxylin and eosin staining and a technique of immunohistochemistry using the anti-human EG2 mouse monoclonal antibody that reacts with the secreted form of eosinophil cationic protein (ECP). Nasal mucosa tissue of 26 adult nasal allergy patients and of 24 adult non-allergic rhinitis patients was removed surgically. Eosinophilia in the nasal mucosa of the allergy group was greater than that in the non-allergy group. A great number of ECP positive eosinophils accumulating in the nasal mucosa of the allergy group were mostly degranulated at the superficial layer of the lamina propria. Desquamation of the epithelium was observed mainly in the area of eosinophilia with degranulation of the secreted form of ECP in the nasal allergy group.

Seasonal Variations of Nasal Resistance in Allergic Rhinitis and Environmental Pollen Counts

We made measurements of nasal airway resistance in a patient with Japanese cedar pollinosis and also measured the environmental pollen counts under different exposure conditions. In the season of high Japanese cedar pollen counts in Japan values of mean nasal airway resistance were significantly increased, remained elevated for 2 months after the season, and eventually decreased. In the season of low pollen counts, the mean values of nasal airway resistance measurements were increased during the season but decreased more rapidly after the season. In a year with no exposure to the environmental allergen because the subject lived out of Japan, the mean nasal airway resistances were relatively increased closely in phase with the Japanese cedar pollen season.

Seasonal Variations of Nasal Resistance in Allergic Rhinitis and Environmental Pollen Counts. III: Efficacy of Antiallergic Agents

We previously reported that, in a patient with Japanese cedar pollinosis, preseasonal increase in total nasal airway resistance (NAR) possibly caused from circannual endogenous rhythm was suppressed by preseasonal systemic administration of antiallergic agent. In this study, in order to determine the influence of preseasonal use of a topical antiallergic agent and seasonal administration of a peroral antiallergic agent, we made measurement of nasal airway resistance and pollen counts under the previous respective conditions in separated years. Preseasonal high mean values of total NAR for a couple of weeks was not suppressed by the preseasonal topical administration of ketotifen nasal spray in 1992 which was a low pollen season (974/cm2). However, the patient did not complained of severe episodes of hay fever at all throughout the season. Preseasonal increases in mean values of total NAR were observed in 1993 which was a high Japanese cedar pollen season (4,875/cm2) with NAR the same as untreated seasons. This may have been because the patient was not treated with preseasonal use of peroral azelastine. On extremely high Japanese cedar pollen count days further increased NAR occurred in the patient. The patient experienced relatively severe hay fever episodes, but used no other anti-histamine nor topical steroid during the season.