muramidase and Rhinitis--Allergic--Perennial

Topical sodium cromoglycate is used to treat allergic diseases of the upper and lower airways. To investigate its mechanisms of action, intranasal histamine challenge was used in nine subjects with perennial allergic rhinitis. After a preliminary day where subjects' reactivity thresholds (D100) for histamine were determined, intranasal sodium cromoglycate was administered in a double-blind, placebo-controlled fashion. Graded (D100/3, D100, D100X3), sequential challenges were performed on days 1 and 21 of each course, and responses measured by changes in nasal airway resistance, sneezes, secretion volume and secretion content: total protein, lysozyme and mucin. After a single dose of sodium cromoglycate, there was no change in resistance, but secretion volumes fell significantly (3.12 ml/5 min c.i. 2.83-3.4; placebo 3.61, c.i. 3.32-3.90: P = 0.026). After a 3-week-course, there was a significant fall in resistance (4.29 cm H2O/l/s, c.i. 3.85-4.72; placebo 5.45, c.i. 5.01-5.88: P < 0.0001). No change in other parameters was observed. Thus, in perennial allergic rhinitis, intranasal sodium cromoglycate has both short- and long-term effects on nasal reactivity to histamine challenge. Acutely, there is a reduction in nasal lavage fluid volume which may be the result of reduced irritant receptor activity. After a 3-week course, there is a reduction in nasal resistance responses, a possible anti-inflammatory effect.

Topics: Administration, Intranasal; Adult; Aged; Airway Resistance; Anti-Inflammatory Agents; Cromolyn Sodium; Double-Blind Method; Female; Histamine; Humans; Male; Middle Aged; Mucins; Muramidase; Nasal Lavage Fluid; Nasal Mucosa; Nasal Provocation Tests; Nose; Placebos; Proteins; Rhinitis, Allergic, Perennial; Sneezing

The association of perennial allergic rhinitis (PAR) with recurrent sinusitis (RS) is well recognized. Anatomic abnormalities at the osteomeatal complex or ciliary dysfunction may play a significant role in some patients. However, for most patients with allergy, the determinants of RS are unknown.. To determine whether altered concentrations of antimicrobial peptides and proteins, such as lysozyme, lactoferrin, human beta-defensin-2 (HBD-2), and human neutrophil peptides 1 to 3 (HNP-1 to 3), contribute to the development of RS in patients with PAR.. Nasal secretions were collected by vacuum aspiration from 15 individuals with PAR+RS, 16 with PAR alone, and 16 controls. Lysozyme and lactoferrin levels were determined in nasal secretions by using quantitative enzyme-linked immunosorbent assay, and HBD-2 and HNP-1 to 3 levels were determined in nasal secretions by using semiquantitative Western blot analysis. Eosinophil-derived neurotoxin (EDN) levels were measured by using enzyme-linked immunosorbent assay as a marker of nasal eosinophilia in all 3 groups.. Levels of EDN were elevated significantly in patients with PAR+RS compared with controls. Lysozyme levels were decreased significantly in patients with PAR+RS compared with PAR alone or controls. Mean lysozyme levels were significantly lower in patients with EDN levels greater than 1,000 ng/mL vs those with levels of 1,000 ng/mL or less in the PAR+RS group. There were no statistically significant differences in lactoferrin, HBD-2, and HNP-1 to 3 levels among the 3 groups.. The presence of eosinophils and their products and reduced lysozyme concentrations may be critical factors that predispose the airways of patients with PAR to RS.

Topics: Adult; alpha-Defensins; beta-Defensins; Blotting, Western; Enzyme-Linked Immunosorbent Assay; Eosinophil-Derived Neurotoxin; Eosinophilia; Female; Humans; Lactoferrin; Male; Muramidase; Nasal Lavage Fluid; Recurrence; Rhinitis, Allergic, Perennial; Ribonucleases; Sinusitis; Skin Tests

There is a need to evaluate possible health effects of ventilation improvements and emissions from new buildings, in longitudinal studies. New methods to study biological effects on the eyes and upper airways are now available.. A longitudinal study was performed on 83 trained social workers in two offices in Uppsala, Sweden. The exposed group (n = 57) moved to a newly redecorated building nearby. Low emitting building material had been used, including a new type of solvent-free water-based paint. The control group (n = 26) worked in the same office during the study period (November 1995 to February 1996). Hygiene management was carried out in both offices, at the beginning and the end of the investigation. Tear film stability (BUT) was measured. Nasal patency was measured by acoustic rhinometry, and eosinophilic cationic protein (ECP), myeloperoxidase (MPO), lysozyme and albumin were analyzed in nasal lavage fluid (NAL).. The relocation resulted in an increase in the personal outdoor airflow rate from 11 to 22 l/s. Indoor concentrations of terpenes were higher in the new building, and powdering of the new linoleum floor was observed. Measurements showed low levels of volatile organic compounds (VOC), formaldehyde, carbon dioxide (CO(2)), nitrogen dioxide, respirable dust, and microorganisms in the air of all buildings. The move resulted in an increased nasal patency and an increase of ECP and lysozyme in NAL, after adjusting for changes in the control group. No changes were observed for nasal or ocular symptoms. A seasonal effect, with a decrease of ECP, was observed in the control group. CONCLUSSION A well-ventilated office building can be redecorated without any major ocular or nasal effects, or measurable increase of indoor air pollution if low-emitting building materials are selected. In agreement with previous evidence, the improved ventilation flow may explain the increase of nasal patency. The increase of ECP and lysozyme in NAL suggested an inflammatory effect in the new building. Since this building had increased ventilation flow, increased concentrations of terpenes, and powdering from the polish on the new linoleum floor, identification of causative agents was difficult. The hygiene measures did not give any evidence that emissions from the new type of solvent-free water-based paints or building dampness were responsible for the observed nasal effects. Considering the higher emissions of VOC reported from older types of water-based latex paints and solvent-based wall paints, the new type of solvent-free water-based paint seems to be a good choice from the hygiene point of view.

Topics: Adult; Air Pollutants, Occupational; Albumins; Biomarkers; Blood Proteins; Case-Control Studies; Environmental Monitoring; Eosinophil Granule Proteins; Female; Humans; Inflammation Mediators; Longitudinal Studies; Male; Middle Aged; Muramidase; Nasal Lavage Fluid; Occupational Diseases; Paint; Peroxidase; Rhinitis, Allergic, Perennial; Ribonucleases; Sick Building Syndrome; Ventilation

Rhinorrhea is a prominent symptom of the common cold. Although increases in vascular permeability and serous cell secretion have been demonstrated in human nasal mucus during active rhinovirus infections, changes in mucin constituents have not been quantified. Nonallergic (n = 48) and asymptomatic allergic rhinitis (n = 32) subjects were inoculated with rhinovirus type hanks before the spring allergy season. Nasal lavages were performed before inoculation (day 0), then daily for 5 days afterward. The subjects were divided into infected and noninfected groups on the basis of evidence of successful rhinovirus infection (nasal shedding of virus or fourfold increases in specific serum antibodies). Concentrations of interleukin (IL)-8, markers of vascular leak (IgG), seromucous cells (lysozyme), and mucoglycoprotein exocytosis [7F10-immunoreactive mucin (7F10-irm) and Alcian blue staining of acidic mucoglycoproteins] were measured in lavage fluids. The infected subgroup had maximal increases in nasal lavage fluid concentrations of IL-8 (sevenfold), IgG (fourfold), total protein (twofold), and gel-phase 7F10-irm (twofold) on day 3. There were no differences between infected allergic and nonallergic subjects. IL-8 and gel-phase 7F10-irm were significantly higher in infected than in noninfected subjects. In addition to promoting plasma exudation, rhinovirus hanks infection increases IL-8 and gel-phase mucin secretion. These processes may contribute to a progression from watery rhinorrhea to mucoid discharge, with mild neutrophilic infiltration during the common cold.

Topics: Adolescent; Adult; Alcian Blue; Coloring Agents; Exocytosis; Glycoproteins; Humans; Immunoglobulin G; Interleukin-8; Middle Aged; Mucus; Muramidase; Nasal Mucosa; Picornaviridae Infections; Rhinitis, Allergic, Perennial; Rhinovirus; Therapeutic Irrigation

Serratial peptidase and lysozyme are often used as anti-inflammatory agents. There have been very few documented cases of occupational allergy caused by these substances. We report a case of a pharmaceutical industry worker who developed occupational asthma and rhinitis caused by both serratial peptidase and lysozyme chloride.. It is important to alert physicians to the possibility of occupational asthma when dealing with workers in the pharmaceutical industry.. The patient had strong positive responses to peptidase and lysozyme extracts on skin-prick tests. Bronchoprovocation tests showed a dual asthmatic response to peptidase and an early asthmatic response to lysozyme. Serum specific IgE antibodies to peptidase and lysozyme were detected by enzyme-linked immunosorbent assay (ELISA). In order to further characterize the allergenic component of these extracts, sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and electroblotting studies were also performed. More than ten components ranging form 7.3 to 83.1 kD were found in peptidase extracts, and two IgE binding components (67, 10.9 kD) were detected within the lysozyme extracts.. These findings suggest that inhalation of peptidase and lysozyme can induce IgE-mediated bronchoconstrictions in an exposed worker.

Topics: Adult; Asthma; Bronchial Provocation Tests; Drug Industry; Electrophoresis, Polyacrylamide Gel; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoblotting; Immunoglobulin E; Muramidase; Occupational Diseases; Peptide Hydrolases; Rhinitis, Allergic, Perennial; Serratia; Skin Tests

Bradykinin (BK) induces albumin exudation and glandular secretion in chronic allergic rhinitis subjects. Since bradykinin may stimulate nociceptive sensory nerves, neural reflex arcs could contribute to the secretion process. Six chronic allergic rhinitis subjects received 1000 nM bradykinin by unilateral nasal provocation using the method of Raphael et al. This dose induces optimal contralateral glandular secretion. Ipratropium bromide (80 micrograms) or saline were applied topically before the challenges. Total protein, albumin, glycoconjugate, and lysozyme were measured in lavage fluids. On the ipsilateral side, bradykinin induced significant total protein, glycoconjugate, and albumin secretion. None of these were affected by ipratropium. On the contralateral side, total protein and glycoconjugates were increased by bradykinin, while albumin and lysozyme were not significantly affected. Ipratropium bromide completely ablated total protein and glycoconjugate secretion on the contralateral side indicating that cholinergic reflexes mediated the glandular secretion. In chronic allergic rhinitis, bradykinin directly stimulated albumin secretion, but also stimulates nociceptive neuron--parasympathetic nerve reflexes to induce glandular secretion. The reflex loop was apparent on the contralateral side to the unilateral bradykinin challenge. This loop induced mucoglycoconjugate, but not serous cell, secretion in chronic allergic rhinitis subjects and can be inhibited by iptratropium bromide.

Topics: Adult; Bradykinin; Enzyme-Linked Immunosorbent Assay; Female; Glycoconjugates; Humans; Ipratropium; Middle Aged; Muramidase; Nasal Mucosa; Nasal Provocation Tests; Proteins; Rhinitis, Allergic, Perennial; Serum Albumin

Bradykinin (BK) is known to stimulate vascular permeability by direct actions on vascular B2 receptors, and may stimulate nociceptive sensory nerves that recruit parasympathetic reflexes which induces glandular secretion. Differences in these responses may occur in allergic rhinitis.. The effects of bradykinin (BK) on nasal secretion in vivo were studied by unilateral BK nasal challenge in 8 normal subjects and 6 subjects with severe perennial allergic rhinitis. BK (0, 100, 1,000 nmol) were applied to one nostril (ipsilateral, IL) and saline lavage fluids collected separately from the IL and contralateral (CL) nostrils for analysis of total protein, albumin, glycoconjugates, and lysozyme.. In both groups, BK induced significant dose-dependent IL total protein and albumin secretion, but significantly more total protein and albumin were stimulated in normal than rhinitis subjects after 1,000 nmol BK. Glycoconjugate and lysozyme secretion was not significantly stimulated on either the IL or CL sides in normal subjects. However, in perennial allergic subjects, BK stimulated significant, dose-dependent glycoconjugate and lysozyme secretion on the IL side. Reflex effects were studied on the CL side. Normal subjects did not have significant CL glandular secretion. In contrast, rhinitis subjects secreted significantly higher amounts of total protein and glycoconjugate on the CL side after 1,000 nmol BK. There was no reflex-mediated albumin exudation in either group.. These results indicate that in normal subjects BK stimulates predominantly vascular permeability, and that cholinergic reflexes do not significantly contribute to their BK-induced nasal secretion. In rhinitis subjects, BK again induced albumin exudation, but with less vascular permeability and greater glandular secretion than normal subjects on the challenged side. Only rhinitis subjects demonstrated significant contralateral reflex-mediated glandular secretion, and this response required the highest dose of BK. This suggests that BK is more adept at directly inducing vascular effects than glandular secretion of nociceptive nerve-parasympathetic reflexes. Alterations in BK-induced vascular permeability, glandular secretion, and neural reflexes occur in patients with severe perennial allergic rhinitis, changes suggestive of 'nasal hyperresponsiveness' to BK.

Topics: Adult; Albumins; Bradykinin; Capillary Permeability; Chronic Disease; Dose-Response Relationship, Immunologic; Female; Humans; Male; Middle Aged; Mucins; Muramidase; Nasal Mucosa; Nasal Provocation Tests; Parasympathetic Nervous System; Reflex; Rhinitis, Allergic, Perennial

Neuropeptide Y (NPY) is a neurotransmitter in sympathetic nerve fibers in human nasal mucosa. Like norepinephrine, NPY acts as a vasoconstrictor. An established method of nasal provocation was used to determine the effects of topically applied NPY on nasal resistance to airflow measured by anterior rhinomanometry, the protein content of nasal secretions, and the protein content of bradykinin-induced secretions. NPY (2.3 nmol) reduced the resistance to inspiratory airflow by 57 +/- 18% (P < 0.001) in 10 normal subjects and by 50 +/- 17% (P < 0.05) in 12 subjects with perennial rhinitis. In nasal provocations, NPY in doses of 0.1-10 nmol had no effect on vascular (albumin), glandular (lysozyme, glycoconjugate), or total proteins present in lavaged nasal secretions. Because the vasoconstrictor properties of NPY may only be apparent in the presence of increased vascular permeability and albumin exudation, bradykinin (BK) nasal provocation was performed. BK (500 nmol) significantly increase total protein (10- to 20-fold), albumin (10- to 30-fold), and glycoconjugate (2- to 5-fold) in lavage fluid. NPY (2.3 nmol) reduced BK-induced total protein by 59 +/- 15% (P < 0.05) and albumin by 63 +/- 17% (P < 0.02) but had no significant effect on glandular secretion. Therefore exogenous administration of NPY to the human nasal mucosa reduced nasal airflow resistance and albumin exudation without affecting submucosal gland secretion. NPY agonists may be useful for the treatment of mucosal diseases characterized by vasodilation, vascular permeability, and plasma exudation.

Topics: Adult; Airway Resistance; Albumins; Bradykinin; Capillary Permeability; Dose-Response Relationship, Drug; Glycoconjugates; Humans; Manometry; Middle Aged; Muramidase; Nasal Decongestants; Nasal Mucosa; Nasal Provocation Tests; Neuropeptide Y; Proteins; Regional Blood Flow; Rhinitis, Allergic, Perennial

Topics: Adolescent; Adult; Child; Humans; Middle Aged; Muramidase; Rhinitis, Allergic, Perennial; Rhinitis, Allergic, Seasonal

Topics: Adult; Female; Humans; Male; Mucus; Muramidase; Nasal Mucosa; Rhinitis, Allergic, Perennial; Specimen Handling