U. Ruta

Changes in nasal lavage fluid due to formaldehyde inhalation

SummaryThe aim of the study was to characterize the nature of the formaldehyde-induced nasal response consisting in symptoms of rhinitis and changes in nasal lavage fluid. Eleven healthy subjects and nine patients with specific skin sensitization were provoked in a toxicological chamber with formaldehyde at a dose of 0.5 mg/m3 over 2 h. Nasal lavage was performed prior to and immediately after provocation and 4 and 18 h later. Provocation with formaldehyde caused transient symptoms of rhinitis and prolonged changes in nasal washings. There were increases in the number and proportion of eosinophils and elevated albumin and total protein levels in nasal lavage fluid 4 and 18 h after provocation. No difference in the nasal response to formaldehyde was found between patients with skin sensitization and healthy subjects. These data confirm the irritative effects of formaldehyde and are also suggestive of nonspecific proinflammatory properties when formaldehyde is inhaled at a low (0.5 mg/m3) dose.

Occupational asthma and rhinitis due to glutaraldehyde: changes in nasal lavage fluid after specific inhalatory challenge test.

Background: Glutaraldehyde (GA) is a known respiratory sensitizers, and some studies have reported occupational asthma in exposed workers. Specific changes in nasal lavage fluid (NLF) induced by high‐molecular‐weight allergen provocation in sensitized subjects were described previously. The purpose of this study was to evaluate the changes in cytogram, protein content, eosinophil cationic protein (ECP), and mast‐cell tryptase concentrations in NLF after GA inhalation challenge in patients with a positive history of GA‐induced asthma and late or dual asthmatic response due to exposure to low‐level GA.

Airway response to formaldehyde inhalation in asthmatic subjects with suspected respiratory formaldehyde sensitization.

The aim of the study was to characterize the mechanism of formaldehyde (FM)-induced nasal and bronchial response in asthmatic subjects with suspected FM allergy. Ten subjects purported to have FM rhinitis and asthma and 10 healthy subjects submitted to an inhalation provocation in an exposure chamber with FM at a dose of 0.5 mg/m3 over 2 hr. Spirometry at rest and following bronchial provocation with histamine (PC20) were recorded before and after FM inhalation. In addition, FM-specific serum IgE antibodies were measured and cellular, biochemical, and mediator changes were assessed in nasal lavage before, and immediately after, provocation and at 4 hr and 24 hr later. Provocation with FM caused only transient symptoms of rhinitis in both groups. None of the subjects supposed to have occupational asthma developed clinical symptoms of bronchial irritation. No specific IgE antibodies to FM were detected in persons with occupational exposure to FM. No differences in the nasal response to FM were found between subjects reporting to have occupational allergic respiratory diseases and healthy subjects (P > 0.05). In summary, inhaled formaldehyde at a level as low as 0.5 mg/m3 did not induce a specific allergic response either in the upper or in the lower part of the respiratory tract. Moreover, there is no difference in nasal response to FM in asthmatic subjects occupationally exposed to FM and healthy subjects.

Nasal provocation test in the diagnosis of natural rubber latex allergy

Background: Natural rubber latex (NRL) allergy in workers using rubber gloves has been an occupational health problem for the last 10 years. In the case of the occupational agents, clinical history may be far from conclusive; hence, appropriate provocation should be carried out. The objective was to evaluate the usefulness of the nasal challenge test in the diagnosis of allergic rhinitis in subjects occupationally exposed to NRL.

Eotaxin but not MCP−3 induces eosinophil influx into nasal fluid in allergic patients

Background: Eotaxin and MCP‐3 (CC chemokines), owing to their preferential action on eosinophils, seem to be the very importance in the patophysiology of allergic rhinitis and asthma. The purpose of this study was to examine the effect of intranasally administered eotaxin and MCP‐3 after specific allergen priming on the influx of inflammatory cells and their soluble mediators into the nasal mucosa.

Inhibitory effect of levocabastine on allergen‐induced increase of nasal reactivity to histamine and cell influx

For evaluation of the effect of levocabastine pretreatment on allergen‐induced rhinitis symptoms, changes in nasal washings, and nasal responsiveness to histamine, 12 asymptomatic patients with documented allergic rhinitis participated in a single‐blind, placebo‐controlled study. Eight‐day treatment with levocabastine (twice in each nostril, four times a day) caused significant reduction in nasal symptoms and inflammatory cell influx after allergen challenge, as compared with placebo administration. Levocabastine inhibited increased nasal reactivity to histamine induced by allergen provocation, as controlled by rhinitis symptoms and albumin level in nasal washings. These data reveal a high effectiveness of levocabastine in the prevention of allergen‐induced rhinitis symptoms. Moreover, its inhibitory effect on inflammatory cell influx and hyperresponsiveness to histamine suggest that levocabastine is more than a simple H1‐receptor antagonist.

Allergic contact dermatitis from disinfectants in farmers

A 56-year-old farmer raised cattle, pigs and poultry, in addition to growing staple crops (rye, wheat, barley) and vegetables. For 6 years, he had had work-related hand eczema and non-seasonal chronic rhinitis. Patch tests with the European standard and a fragrance series, plus zinc dimethyldithiocarbamate, zinc ethylenebis(dithiocarbamate), captan, benzalkonium chloride, glutaraldehyde (Chemotechnique), glyoxal and Lysol were applied to the skin of the back. Readings were made at D2 and D4, according to the ICDRG (1) (Table 1). Prick tests were performed with vegetable pollen, house dust, mildew, goose and duck feathers, hairs of domestic animals, Dermatophagoides pteronyssinus and Dermatophagoides farinae (Allergopharma). Table 1 gives the results of the patch tests. Immediate-type allergy to household dust and mite was also diagnosed from positive prick tests.