Allergy, Asthma & Immunology Research  2013;5(4):232-238

doi:10.4168/aair.2013.5.4.232

Rhinitis Patients With Sputum Eosinophilia Show Decreased Lung Function in the Absence of Airway Hyperresponsiveness.

Min Suk YANG 1 ; Hyun Seung LEE ; Min Hye KIM ; Woo Jung SONG ; Tae Wan KIM ; Jae Woo KWON ; Sae Hoon KIM ; Heung Woo PARK ; Yoon Seok CHANG ; Sang Heon CHO ; Kyung Up MIN

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Keywords

Sputum; eosinophil; rhinitis; forced expiratory volume; matrix metalloproteinase-9

Country

Republic of Korea

Language

English

Abstract

PURPOSE: Sputum eosinophilia is observed frequently in patients with rhinitis. Sputum eosinophilia in patients with non-asthmatic allergic rhinitis has been suggested to be related to nonspecific airway hyperresponsiveness (AHR). However, the clinical significance of sputum eosinophilia in patients with non-asthmatic rhinitis without AHR has not been determined. We conducted a retrospective study examining the influence of sputum eosinophilia in patients with non-asthmatic rhinitis without AHR on pulmonary function and expression of fibrosis-related mediators. METHODS: Eighty-nine patients with moderate-to-severe perennial rhinitis without AHR were included. All underwent lung function tests (forced expiratory volume in 1 second [FEV1] and forced vital capacity [FVC]), skin tests to inhalant allergens, methacholine bronchial challenge tests, and hypertonic saline-induced sputum to determine eosinophil counts. Sputum mRNA levels for transforming growth factor-beta (TGF-beta), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) were also examined. Patients were divided into two groups according to the presence of sputum eosinophilia (> or =3%, eosinophilia-positive [EP] and <3%, eosinophilia-negative [EN] groups). RESULTS: FEV1 was significantly lower (P=0.04) and FEV1/FVC tended to be lower (P=0.1) in the EP group than in the EN group. In sputum analyses, the MMP-9 mRNA level (P=0.005) and the ratio of MMP-9 to TIMP-1 expression (P=0.01) were significantly higher in the EP group than in the EN group. There was no significant difference in TGF-beta mRNA expression between the two groups. CONCLUSIONS: Sputum eosinophilia in patients with moderate-to-severe perennial rhinitis without AHR influenced FEV1 and the expression pattern of fibrosis-related mediators.