Leukotriene C4 and histamine in early allergic reaction in the nose

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Abstract
We have examined the measurements of LTC4 and histamine in nasal lavage fluids and blown secretions as a possible model of the early mediator events during nasal allergy. A nasal challenge with grass pollen extract was undertaken on two separate occasions in 20 patients with a history of seasonal rhinitis and a positive immediate skin test to grass pollen. A 2 ml nasal lavage was performed before allergen challenge, and blown secretion collected separately 15 min after the provocation, followed by a final 2 ml nasal lavage. The dilution of nasal secretion by the lavage fluid was determined using 99mTc‐labelled albumin as an exogenous marker added to the fluid. The amounts of admixture in the nasal lavages did not correlate to the concentrations of LTC4 and histamine, indicating that the variable amounts of nasal secretion in nasal lavage do not constitute a confounding variable for measurements of LTC4 and histamine. In the pre‐challenge lavages, the median concentrations, of LTC4 and histamine were 1.7 and 52 nmol/1 respectively. Following allergen challenge neither LTC4 nor histamine measured in nasal lavage showed any significant change from pre‐challenge baseline values. However, measurements of both mediators in the blown secretion showed a significantly higher concentration than in the pre‐ or post‐challenge lavage samples, compatible with transitory release during the acute allergic reaction. However, it seems doubtful whether measurements of LTC4 or histamine can be compared between blown secretion and nasal lavage fluid, even if the dilution factor is disregarded. While allergen provocation of the nasal mucosa releases inflammatory mediators locally, uncontrolled variables confound their measurement in the nasal lavage fluids to an extent which limits the application of this model to study details of mediator release during nasal allergy.

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