Immunologic Release of Chemical Mediators from Human Nasal Polyps

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Abstract
Human nasal polyps from three ragweed-sensitive atopic patients released three chemical mediators: histamine, slow reacting substance of anaphylaxis, and eosinophil chemotactic factor of anaphylaxis on challenge with ragweed antigen. Polyps from four non-ragweed-sensitive subjects passively sensitized in vitro released the same chemical mediators. In a patient with chronic sinusitis and one with cystic fibrosis, dibutyryl cyclic adenosine 3′,5′-monophosphate and the beta adrenergic agent isoproterenol both produced dose-dependent suppression of the immunologic release of mediators. Cholera toxin after a 30-minute lag period induced a marked increase in the tissue concentrations of cyclic adenosine monophosphate in a patient with chronic sinusitis and at the same time suppressed the immunologic release of mediators; each of these effects persisted through three hours of incubation. Alpha-adrenergic stimulation as achieved by combining phenylephrine with propranolol and cholinergic stimulation with carbachol enhanced the antigen-induced release of histamine and slow reacting substance in two patients with chronic sinusitis. Thus, the antigen-activated release of mediators from nasal polyps is modulated by agents affecting the intracellular concentrations of cyclic nucleotides. (N Engl J Med 289:277–281, 1973)