Priming of the Nose and Eustachian Tube during Natural Pollen Exposure

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Abstract
Previous studies have suggested that seasonal allergen exposure in allergic individuals “primed” or increased the response of nasal mucosa to subsequent allergen challenge. The purpose of this study was to document the specificity of nasal “priming” and to determine if this effect extends to the eustachian tube (ET). Eight subjects with ragweed allergic rhinitis were challenged intranasally with increasing doses of ragweed (0.05, 0.125, 0.25, 0.5, 2.5, and 5.0 mg) and histamine (0.01, 0.1, 0.5, 1.0, 5.0, and 10 mg) before, during, and 4–6 weeks and 3–5 months after ragweed season. Nasal conductance and ET function were evaluated by computerized posterior rhinomanometry and sonotubometry, respectively. The dose that decreased nasal conductance below a threshold value of 0.1 L/sec/cm H2O was defined as the nasal obstructing (NO) dose and that which resulted in an inability to open the ET by swallowing was the ET obstructing (ETO) dose. For ragweed and histamine mean NO doses decreased during and up to 6 weeks after ragweed season compared to preseason and 3–5 months postseason doses. The ETO doses showed similar patterns for histamine challenges, but ET hyperresponsiveness to ragweed was limited to the ragweed season. Patients’ responses did not correlate with serum IgE antibody level. These data show that both the nose and ET can be primed by allergen exposure to manifest heightened responses to both specific allergen and a nonspecific substance.

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