Changes in nasal symptoms and inflammatory cells over the course of perennial allergic rhinitis

Abstract

Nasal symptoms and inflammatory cells changes over the course of perennial allergic rhinitis have been analyzed only rarely. We studied nasal symptoms, nasal physical findings, and laboratory data in five groups, which consisted of varying time periods during the course of perennial allergic rhinitis (< 1, 1-2, 2-3, 3-5 and 5+ years) of 354 patients at the time of the first visit to our allergy clinic. The mean values calculated from scored nasal symptoms (i.e. rhinorrhea, sneezing and nasal obstruction) and physical findings (i.e. inferior turbinate swelling and colour) showed significant differences among these groups. We also studied inflammatory cells, mast cells, EG2⁺ and total eosinophils, CD3⁺ and CD4⁺ T cells, and neutrophils in the nasal mucosa of five patients with a short history (< 1.5 years) of allergic rhinitis, and of 10 patients with a long history (> 3 years). The tissue density of mast cells in the epithelial layer and of eosinophils and CD4⁺ T cells in the subepithelial layer did differ between the two groups. These results indicate that perennial allergic rhinitis goes through a transition stage from onset to a few years, and thereafter becomes a chronic condition. Mast cells, eosinophils, and CD4⁺ T cells may be associated with ongoing allergic inflammation.