Interleukin (IL)-4 and IL-6, respectively, markers of neutrophilic and eosinophilic inflammation, were analyzed in nasal and oral exhaled breath condensate to understand the inflammation of upper and lower airways in subjects with aspirin-induced asthma (AIA) syndrome, evaluating possible differences between AIA and the single pathological conditions included in AIA syndrome.
Methods
Twelve patients with AIA, 17 patients with mild asthma (MA), 12 patients with nasal polyposis (NP), 11 patients with mild asthma + nasal polyposis (MA + NP), and 10 healthy subjects (HSs) were enrolled. Nasal and oral exhaled IL-4 and IL-6 were measured by enzyme immunoassay kit.
Results
Higher levels of nasal and oral exhaled IL-4 and IL-6 were observed in AIA compared with MA, NP, MA + NP, and HSs. Moreover, a positive correlation was identified between nasal exhaled IL-4 and IL-6 and, respectively, the number of neutrophils and eosinophils and in nasal scraping.
Conclusion
The concentration of eosinophilic and neutrophilic markers in upper and lower airways of subjects with AIA syndrome is higher compared with HS and subjects with MA, NP, and MA + NP.
JenkinsC., CostelloJ., and HodgeL.Systematic review of prevalence of aspirin induced asthma and its implication for clinical practice.BM J328: 434, 2004.
2.
WidalF., AbramiP., and LermoyezJ.Anaphylaxie et idio-syncrasie.Press Med30: 189–193, 1922.
3.
MeikleD.Aspirine sensitivity and recurrent polyposis.Clin Otalaryngol13: 1–3, 1988.
4.
SanakM., SimonH.U., and SzczeklinA.Leukotriene C4 synthase promoter polymorphism and risk of aspirin-induced asthma.Lancet350: 1599–1600, 1997.
5.
PodsR., RossD., van HulstS.RANTES, eotaxin and eotaxin-2 expression and production in patients with aspirin triad.Allergy58: 1165–1170, 2003.
6.
BabuK.S., and SalviS.S.Aspirine and asthma.Chest118: 1470–1476, 2000.
7.
Di LorenzoG., DragoA., Esposito PellitteriM.Measurement of inflammatory mediators of mast cells and eosinophils in native nasal lavage fluid in nasal polyposis.Int Arch Allergy Immunol125: 164–175, 2001.
8.
ZhangN., HoltappelsG., ClaeysC.Pattern of inflammation and impact of Staphylococcus aureus enterotoxins in nasal polyps from southern China.Am J Rhinol4: 445–450, 2006.
9.
MeyerJ.E., BartelsJ., GöröghT.The Role of RANTES in nasal polyposis.Am J Rhinol19: 15–20, 2005.
10.
LarsenK.The clinical relationship of nasal polyps and asthma.Allergy Asthma Proc17: 243–249, 1996.
11.
KowalskiM.L., GrzegorczykJ., PawliczakR.Decreased apoptosis and distinct profile of infiltrating cells in nasal polyps with ASA hypersensibility.Allergy57: 493–500, 2002.
12.
StevensonD.D., and ZurawB.L.Pathogenesis of aspirin exacerbated respiratory disease.Clin Rev Allergy Immunol24: 169, 2003.
13.
ShareS.A., AustenK.F., and DrazenJ.M.Eicosanoids and the Lung. In Lung cell biology: Lung biology in health and disease.L'EnfantC., and MassaroD. (Eds). New York: Marcel Dekker, Inc., 1989.
14.
SladekK., DworskiR., SojaJ.Eicosanoids in bronchoalveolar lavage fluid of aspirin-intolerant patients with asthma after aspirin challenge.Am J Respir Crit Care Med149: 940–946, 1994.
15.
ObaseY., ShimodaT., TomariS.Y.Effects of pranlukast on chemical mediators in induced sputum on provocation tests in atopic and aspirin-intolerant asthmatic patients.Chest121: 143–150, 2002.
16.
CarpagnanoG.E., BarnesP.J., GeddesD.M.Increased leukotriene B4 and interleukin-6 in exhaled breath condensate in cystic fibrosis.Am J Respir Crit Care Med167: 1109–1112, 2003.
GwaltneyJ.M.Jr., JonesJ.G., and KennedyD.W.Medical management of sinusitis: Educational goals and management guidelines. The International Conference on sinus Disease.Ann Otol Rhinol Laryngol Suppl167: 22–30, 1995.
19.
Von MutiusE.Presentation of new GINA guidelines for pediatrics. The Global Initiative on asthma.Clin Exp Allergy30(suppl 1): 6–10, 2000.
20.
BiancoS., RobuschiM., and PetrigniG.Aspirin induced tolerance in aspirin-asthma detected by a new challenge test.J Med Sci5: 129–130, 1977.
21.
DreborgS., and FrewA.Position paper: Allergen standardization and skin tests.Allergy48: 49–82, 1993.
22.
SterkP.J., FabbriL.M., QuanjerP.H.Airway responsiveness. Standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults.Eur Respir J6(suppl 16): 53–83, 1993.
23.
LeeH.S., MajimaY., SakakuraY.Quantitative cytology of nasal secretions under various conditions.Laringoscopie103: 533–537, 1993.
24.
MeltzerE., and JalowayskiA.Nasal cytology in clinical practice.Am J Rhinol2: 47–54, 1988.
25.
BlandJ.M., and AltmanD.G.Statistics notes: Measurement error.BMJ313: 744, 1996.
26.
KramerM.F., and RaspG.Nasal polyposis: Eosinophils and interleukin-5.Allergy54: 669–689, 1999.
27.
CarpagnanoG.E., Foschino BarbaroM.P., RestaO.Exhaled markers in the monitoring of airways inflammation and its responses to steroid's treatment in mild persistent asthma.Eur J Pain519: 175–181, 2005.
28.
BachertC., GevaertP., HoltappelsG., and van CauwenbergeP.Mediators in nasal polyposis.Curr Allergy Asthma Rep2: 481–487, 2002.
29.
CarpagnanoG.E., KharitonovS.A., Foschino-BarbaroM.P.Increased inflammatory markers in the exhaled breath condensate of cigarette smokers.Eur Respir J21: 589–593, 2003.
30.
SzczeklikA., and StevensonD.D.Aspirin-induced asthma: Advances in pathogenesis and management.J Allergy Clin Immunol104: 5–13, 1999.
31.
AkpinarliA., GucD., KalayciO.Increased interleukin-4 and decreased interferon gamma production in children with asthma: Function of atopy or asthma?J Asthma39: 159–165, 2002.
32.
StankiewiczW., DabrowskiM.P., ChcialowskiA., and PlusaT.Cellular and cytokine immunoregulation in patients with chronic obstructive pulmonary disease and bronchial asthma.Mediators Inflamm11: 307–312, 2002.
33.
WongC.K., HoC.Y., KoF.W.Proinflammatory cytokines [IL-17, IL-6, IL-18, IL-12] and Th-cytokines (INF-gamma, IL-4, IL-10 and IL-13) in patients with allergic asthma.Clin Exp Immunol125: 177–183, 2001.
34.
HamilosD.L., LeungD.Y., WoodR.Evidence for distinct cytokine expression in allergic versus non allergic chronic sinusitis.J Allergy Clin Immunol96: 537–544, 1995.
35.
ZhaoX.J., McKerrG., DongZ.Expression of oestrogen and progesterone receptors by mast cells alone, but not lymphocytes, macrophages or other immune cells in human upper airways.Thorax56: 205–211, 2001.
36.
EdigerD., SinB.A., HeperA.Airway inflammation in nasal polyposis: immunopathological aspects of relation to asthma.Clin Exp Allergy35: 319–326, 2005.
37.
SanakM., KielbasaB., BochenekG., and SzczeklikA.Exhaled eicosanoids following oral aspirin challenge in asthmatic patients.Clin Exp Allergy34: 1899–1904, 2004.
