Conjunctival effects of a selective nasal pollen provocation

Authors

  • I. Callebaut,

    1. Laboratory of Experimental Immunology, University Hospitals Leuven, Catholic University Leuven, Leuven Belgium
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  • L. Spielberg,

    1. Division of Ophthalmology, University Hospitals Leuven, Catholic University Leuven, Leuven Belgium
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  • V. Hox,

    1. Laboratory of Experimental Immunology, University Hospitals Leuven, Catholic University Leuven, Leuven Belgium
    2. Division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium
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  • S. Bobic,

    1. Laboratory of Experimental Immunology, University Hospitals Leuven, Catholic University Leuven, Leuven Belgium
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  • M. Jorissen,

    1. Division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium
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  • I. Stalmans,

    1. Division of Ophthalmology, University Hospitals Leuven, Catholic University Leuven, Leuven Belgium
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  • G. Scadding,

    1. Royal National Throat, Nose and Ear Hospital, London, UK
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  • J. L. Ceuppens,

    1. Laboratory of Experimental Immunology, University Hospitals Leuven, Catholic University Leuven, Leuven Belgium
    2. Division of Clinical Immunology, University Hospitals Leuven, Leuven, Belgium
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  • P. W. Hellings

    1. Laboratory of Experimental Immunology, University Hospitals Leuven, Catholic University Leuven, Leuven Belgium
    2. Division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium
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  • Edited by: Hans-Uwe Simon

Peter Hellings, University Hospital Leuven, Otorhinolaryngology, Kapucijnenvoer 33, 3000 Leuven, Belgium.
Tel.: +32 16 332342
Fax: +32 16 343835
E-mail: Peter.Hellings@med.kuleuven.be

Abstract

To cite this article: Callebaut I, Spielberg L, Hox V, Bobic S, Jorissen M, Stalmans I, Scadding G, Ceuppens JL, Hellings PW. Conjunctival effects of a selective nasal pollen provocation. Allergy 2010; 65: 1173–1181.

Abstract

Background:  Several clinical and experimental observations suggest that allergen deposition in the nose may partially be responsible for the induction of conjunctival symptoms in allergic rhinitis. The aims of this study were to evaluate the induction of conjunctival symptoms by selective nasal allergen provocation and to assess the feasibility of the different tools for evaluation of conjunctival allergic inflammation.

Methods:  Grass pollen allergic subjects with rhinoconjunctivitis symptoms during the pollen season (n = 12) underwent a nasal sham and grass pollen provocation extra-seasonally. Nasal and conjunctival symptoms were scored using the Visual Analogue Scale (VAS) system at baseline, 15 min, 1 h and 24 h after provocation. In addition to Peak Nasal Inspiratory flow (PNIF) measurements, conjunctival inflammation and vascular congestion were evaluated and histamine and substance P levels in tear fluid were measured.

Results:  Selective nasal grass pollen provocation induced ocular pruritus, lacrimation and conjunctival vascular congestion. PNIF values correlated inversely with lacrimation (= −0.71, P < 0.001) and ocular pruritus (= −0.41, P < 0.05). Four out of 11 patients showed a conjunctival eosinophilic inflammation and levels of histamine (r = 0.73, P < 0.05) and substance P (r = 0.67, P = 0.05) in tear fluid correlated with conjunctival symptoms.

Conclusion:  Selective nasal grass pollen provocation induced conjunctival inflammation, ocular pruritus and lacrimation, which correlated with histamine and substance P levels in tear fluid and inversely with the PNIF values. These data show a naso-ocular interaction in allergic rhinitis and offer objective tools for evaluation of conjunctival inflammation in allergic rhinoconjunctivitis.

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