Hypersensitivity of Nasal and Lower Airways in Patients with Nasal Polyps

Abstract

We found that the nasal respiratory resistance in patients with nasal polyps began increasing at a certain threshold level of methacholine concentration (sensitivity) and it showed a curvilinear slope (reactivity). Thus, we were able to estimate hypersensitivity of the nasal and lower airway by the dose-response curve of nasal respiratory resistance by the continuous nasal inhalation of methacholine in stepwise incremental concentrations.
There have been two current theories on pathogenesis of nasal polyps: allergic and non-allergic. However, there are little data which elucidate the mechanism of polyp formation.
In this study, patients were classified into two groups according to clinical findings: an atopy group, and a non-atopy group. We studied the difference between these two groups concerning of the reaction site of methacholine inhalation.
The nasal airway responded in all patients. However the effect of methacholine on the lower airways in the non-atopy group was not remarkable.
This objective measurement seems to be useful in the estimation of severity of the nasal and/or lower airway hypersensitivity in the patients with nasal polyps.