Allergic rhinitis: association between clinical manifestations and inflammatory markers of the airways

Aim of study: Oxidative stress (OS) is well documented in asthma but so far little data has been reported m non asthmatic patients with Seasonal Allergic Rhinitis (SAR). The aim of this study was to investigate the degree of OS and airway inflammation in patients with SAR with and without concomitant Asthma (SAR +A) using breath markers in exhaled air and in Exhaled Breath Condensate (EBC). In addition the effects of natural allergen exposure and intranasal steroid treatment on these markers were evaluated. Patients-Methods: Exhaled NO (eNO) and CO combined with measurements of 8-lsoprostane (lso-8) Leukotriene B4 (LTB4) and nitrate/nitrite in EBC were performed in 23 patients, 11 with SAR 12 with SAR+A and 16 healthy subjects. All patients were evaluated in three time points a) during pollen season, b) 30 days later after topical nasal steroid treatment (fluticasone propionate 100mg/d) and c/ 4-7 months later out of pollen season while were totally asymptomatic. Results: lso-8 and LTB4 were significantly increased in both groups of patients (median values 43.6 pg/ml and 138.4 pg/ml in SAR group 38.9 pg/ml and 164.6 pg/ml in SAR+A group respectively p>0.05) compared to healthy subjects (18.6 pg/ml and 7.8 pg/ml p0.05) σε σύγκριση με τους υγιείς μάρτυρες (18.6 pg/ml και 7.8 pg/ml p<0.05. Τα επίπεδα νιτρικών/νιτρωδών και eNO levels ήταν αυξημένα και στις δύο ομάδες ασθενών σε σχέση με τους μάρτυρες, αλλά ήταν σημαντικά υψηλότερα στην ομάδα ΕΑΡ+Α σε σχέση με την ΕΑΡ ομάδα (νιτρικά/νιτρώδη 9 μΜ και 3.9 μΜ p=0.025 και eNO 18.5 ppb έναντι 12.5 ppb αντίστοιχα p<0.05. Η τοπική ρινική θεραπεία με στεροειδές μείωσε σημαντικά τα επίπεδα LTB4 και 8-iso και στις δυο ομάδες ασθενών p