Prostaglandin D2 measurement in nasal secretions is not a reliable marker for mast cell activation in atopic patients


D. Wang, Department of Otorhinolaryngology, University Hospital, Free University Brussels (AZ-VUB), Laarbeek-laan 101, 1090 Brussels, Belgium.


Background Prosia gland in D2 (PGD2) is a very important mast cell product during the early-phase nasal allergic reaction. However, the quantification of PGD2 in nasal secretions has not yet been well established.

Objective Quantitative determination of PGD2 in nasal secretions of atopic patients (n=17) after nasal allergen challenge (NAC) and in non-allergic healthy volunteers (n=10).

Methods The nasal microsuction sampling technique was used to obtain the nasal secretions with an exactly known and minimally diluted volume. A sensitive and specific enzyme immunoassay was chosen to measure the more stable 11-methoxime derivative of PGD2. which was obtained after extraction in acelone/ethanol and conversion using methoxamine-HCl. The concentrations of PGD2 in nasal secretions obtained from 10 non-allergic healthy volunteers were used as reference values.

Results There was no significant difference in the concentrations of PGD2 between men (median: 569pg/mL) and women (median: 407pg/mL), nor between the baseline concentrations from atopic patients (median: 410pg/mL) and non-allergic controls (median: 477 pg/mL). In the atopic patient group, PGD2 did not significantly increase during the entire sampling period after NAC. The absence of PGD2 response contrasted with the nasal symptoms manifested by sneezing, increased nasal airway resistance, and the significant increases of the concentrations of histamine, tryptase, and leukotriene C4 (LTC4) 5min after NAC.

Conclusion This observation suggests that the measurement of PGD2 alone in the nasal secretions does not give reliable information on mast cell activation during a nasal allergic reaction.