Development, characterisation and nasal deposition of melatonin-loaded pectin/hypromellose microspheres.

In this study, we present the development of spray-dried pectin/hypromellose microspheres as efficient melatonin carrier for targeted nasal delivery. Different pectin to hypromellose weight ratios in the spray-dried feed were employed (i.e. 1:0, 3:1, 1:1 and 1:3) in order to optimise microsphere physicochemical properties influencing overall powder behaviour prior, during and upon nasal delivery. All microspheres assured complete melatonin entrapment and increased dissolution rate in relation to pure melatonin powder. Among all combinations tested, combining pectin with hypromellose at 1:3 wt ratio resulted in the microspheres with the highest potential for melatonin nasal delivery as they assured highest swelling ability and most prominent mucoadhesive properties. Studies on deposition profile revealed adequate turbinate and olfactory deposition of microsphere/lactose monohydrate powder blend administered nasally using MIAT® device, complementing findings relevant for their therapeutic potential. In conclusion, developed microspheres bear the potential to ensure prolonged melatonin retention at the nasal mucosa, improved bioavailability and advanced therapeutic outcome.

Quantitative analysis of multiple elements in healthy and remodeled epithelium from human upper airway mucosa using nuclear microscopy.

Elements are vital in airway mucosal physiology and pathology, but their distribution and levels in the mucosa remain unclear. This study uses the state-of-the-art nuclear microscopy facility to map and quantify multiple elements in the histology sections of nasal mucosa from patients with nasal polyps or inverted papilloma. Our results demonstrate that P and Ca are the most abundant elements in mucosa and their distinct difference between epithelial and subepithelial regions; more importantly, our results reveal decreased amounts of Cu and Zn in the remodeled epithelium as compared to the normal epithelium. These findings suggest that Cu and Zn may be beneficial targets to regulate aberrant epithelial remodeling in airway inflammation.

[Effect of salvianolic acid B on nasal absorption in rats in situ].

This experiment focused on the effect of salvianolic acid B's nasal absorption characteristics in rats. In the study, HPLC determination of salvianolic acid B(SalB) in perfusion liquid was established to examine the SalB nasal irritation in different pH buffers and stability in nasal perfusion solution, and systematically study in vivo nasal absorption characteristics of SalB. Improved rats were adopted to establish the in situ nasal perfusion model to measure the release of total protein and lactate dehydrogenase in perfusion fluid, quantitatively evaluate the nasal irritation and the stability in perfusion liquid of pH 4.0, 5.0, 6.0 SalB phosphate buffer, compare the absorption of SalB in pH 5.0 buffer solution with low, medium and high concentrations (200, 400, 800 mg•L⁻¹). According to the results, nasal irritation: pH 4.0>pH 5.0>pH 6.0, RSD of pH 6.0 SalB buffer solution within 24 h was 3.1%, stability was poor. PH 5.0 SalB buffer solution had a smaller irritation and good stability. According to the nose perfusion test in rats, the nasal absorption of SalB fitted the first-order process and could be considered as passive absorption based on concentration gradient. SalB buffer solution of pH 5.0 had also a small nasal irritation and good stability, with a good absorption in rat nasal perfusion test, which therefore had a certain significance for the development of SalB nasal formulation.

Protective effects of rutin through regulation of vascular endothelial growth factor in allergic rhinitis.

BACKGROUND: Allergic rhinitis (AR) is an allergic inflammatory disease induced by various mediators released by infiltrating inflammatory cells. Vascular endothelial growth factor (VEGF) increases the airway inflammatory response by promoting vascular permeability. Furthermore, it is known that Allium hookeri and one of its constituent compounds, rutin (RU), have anti-inflammatory, antioxidant, and antiplatelet effects. OBJECTIVE: The aim of this study was to evaluate the regulation of AR by RU and A. hookeri. METHODS: We assessed the therapeutic effects and the regulatory mechanisms of A. hookeri and RU on phorbol 12-myristate 13-acetate plus A23187 (PMACI) stimulated human mast cell line (HMC) 1 cells, and ovalbumin (OVA) sensitized mouse model of AR. RESULTS: A. hookeri and RU significantly inhibited the production and messenger RNA (mRNA) expression of VEGF in PMACI-stimulated HMC-1 cells and significantly decreased VEGF levels in our murine AR model. The increased rubs scores and immunoglobulin E and interleukin (IL) 4 levels in OVA-sensitized mice were significantly reduced by the administration of A. hookeri, and RU significantly inhibited the production and mRNA expression and RU. Also, A. hookeri and RU significantly reduced IL-4 and IL-5 production in OVA-stimulated splenocytes. Furthermore, A. hookeri and RU significantly decreased chemokine levels (intercellular adhesion molecule-1, macrophage inflammatory protein-2) in nasal mucosa tissues. In the mouse AR model, A. hookeri and RU significantly prevented eosinophil and mast cell infiltration and reduced inflammatory cytokine levels induced by OVA sensitization. In addition, A. hookeri and RU significantly reduced mast cell-derived caspase-1 activity in OVA-sensitized mice. CONCLUSION: The present study showed that A. hookeri or RU had an anti-allergic inflammatory effects. Analysis of these results indicated that A. hookeri and RU might protect against AR.

The effects of vitamins C and B12 on human nasal ciliary beat frequency.

BACKGROUND: This study was designed to investigate the effects of the vitamins C and B12 on the regulation of human nasal ciliary beat frequency (CBF). METHODS: Human nasal mucosa was removed endoscopically and nasal ciliated cell culture was established. Changes of CBF in response to different concentrations of vitamin C or vitamin B12 were quantified by using high-speed (240 frames per second) digital microscopy combined with a beat-by-beat CBF analysis. RESULTS: At the concentrations of 0.01% and 0.10%, vitamin C induced an initial increase, followed by a gradual decrease of CBF to the baseline level, while 1.00% vitamin C induced a reversible decrease of CBF. Vitamin B12, at the concentrations of 0.01% and 0.10%, did not influence CBF during the 20-min observation period, while a 1.00% vitamin B12 treatment caused a time-dependent but reversible decrease of CBF. CONCLUSIONS: Treatment with vitamin C or vitamin B12 caused a concentration-dependent but reversible decrease of CBF in cultured human nasal epithelial cells. Therefore, it is necessary to choose a concentration that is safe, effective, and non-ciliotoxic when applying these drugs topically in the nasal cavity.

Effect of Tong Qiao drops on the expression of eotaxin, IL-13 in the nasal mucosa of rats with allergic rhinitis.

BACKGROUND: In recent years, particularly in China, many Chinese medicines and prescriptions for treating allergic rhinitis have been evaluated for their clinical relevance. Studies have found that numerous herbs and their constituent compounds can significantly alleviate allergic symptoms and are effective treatments for allergic rhinitis. The purpose of this study was to examine the modulatory effect of Tong Qiao nose drops on allergy symptoms and the expression of cytokines in the nasal mucosa of rats with ovalbumin-induced allergic rhinitis. METHODS: Sixty healthy male Sprague Dawley rats were randomly divided into three groups (n = 20): negative, control, and experimental. Rats in the control or experimental groups were sensitized with ovalbumin to induce allergic rhinitis. The sensitized rats in the experimental group were subsequently exposed to Tong Qiao nose drops, whereas the sensitized control rats were given saline nose drops. Negative control rats were only treated with saline. Allergic symptoms and the pathologic features of the nasal mucosa were observed. The expression of eotaxin in the mucous membrane of rat nasal septums was detected by immunohistochemical staining, and the expression levels of interleukin (IL)-5 and IL-13 were measured by enzyme-linked immunosorbent assay. RESULTS: The symptom scores for the experimental group were significantly lower than those of control rats (p < 0.01). Histopathologic examination revealed pathologic changes of nasal mucosa edema in the experimental group was mild and the infiltration of eosinophils was insubstantial. The expression levels of eotaxin, IL-5, and IL-13 in the nasal mucosa from experimental rats were significantly lower than that of control rats (p < 0.01). CONCLUSION: Tong Qiao nose drops alleviated the symptoms of allergic rhinitis in a rat model and lowered the expression levels of eotaxin, IL-5, and IL-13.

Nasal nitric oxide measurements in the assessment of nasal allergen challenge.

BACKGROUND: Several objective methods are used to assess the result of nasal allergen challenge. OBJECTIVE: The aim of this study was to compare the diagnostic value of nasal nitric oxide (nNO) measurements with that of peak nasal inspiratory flow (PNIF), nasal lavage fluid beta-tryptase levels, and changes in cell count after nasal challenge with grass pollen. METHODS: The study population comprised 24 patients allergic to grass pollen and 24 healthy controls. All participants underwent grass allergen challenge preceded by administration of placebo. A visual analog scale was administered. nNO and PNIF were determined, and nasal lavage fluid was collected before and 30 minutes after administration of placebo and allergen. The study was performed outside the pollen season. RESULTS: Significant changes in nNO, PNIF, nasal lavage fluid beta-tryptase level, and cell count were observed only in allergic patients after administration of the allergen. Receiver operating characteristic (ROC) curves were drawn for each determination. A change in nNO levels of -11.987% was indicated as the best cutoff point for differentiating between allergic patients and healthy participants with a sensitivity of 60.9%, specificity of 100%, negative predictive value of 71%, and positive predictive value of 100%. Comparison of the area under the ROC curve did not show significant differences between the diagnostic value of changes in nNO levels and other objective methods of assessing the outcome of the challenge. CONCLUSION: Changes in nNO levels do not differ significantly from other methods used to objectively assess the outcome of nasal challenge. Given their insufficient sensitivity, nNO measurements have limited value as the sole diagnostic tool when assessing the outcome of nasal challenge.

Nasal nitric oxide and other diagnostic procedures in seasonal allergic rhinitis: elderly vs juvenile patients.

PURPOSE: The type of allergy and other diagnostic procedures were analyzed in a group of elderly seasonal allergic rhinitis (SAR) patients and were compared with young SAR people and a control group. MATERIALS AND METHODS: Study group consisted of 248 patients with mean age 64.1 ± 4.2 years. They were compared with 289 young SAR people (mean age, 23.7 ± 5.8 years) and with a control group. Allergic sensitization was assessed using the skin prick test (SPT) and specific immunoglobulin (Ig) E measurements. The SAR symptoms were monitored using visual graphic scale. Measurement of nasal fractional exhaled nitric oxide (FeNO) level obtained with handheld chemiluminescence analyzer during and after pollen season was compared with control groups. RESULTS: In the elderly patient group, a prevalence of allergy to grass, rye, and mugwort was noticed. In 134 (54%) patients, SPT results to grass were positive; and the specific IgE level was elevated (mean value, 22.8 ± 13.1 IU/mL), whereas in 83 (33%) subjects, positive SPT results to mugwort and elevated serum specific IgE concentration (mean value, 31.9 ± 9.1 IU/mL) were observed. During the pollen season, a significantly higher FeNO level was noted in both young and elderly SAR patients in comparison with their respective control groups. In young patients, the mean FeNO level was 61.8 ± 17.2 parts per billion, whereas in the elderly group, it was 58.2 ± 11.8 parts per billion. CONCLUSIONS: SAR in elderly patients is a problem that cannot be neglected. The natural course of SAR in the elderly is similar to other age groups. However, hypersensitivity to different pollens in the analyzed group needs further study.

Development and characterization of mucoadhesive in situ nasal gel of midazolam prepared with Ficus carica mucilage.

The objective of the present study was to prepare mucoadhesive in situ nasal gels with mucilage isolated from fig fruits (Ficus carica, family: Moraceae) containing midazolam hydrochloride. Nasal gels of midazolam were prepared using three different concentrations (0.5%, 1.0% and 1.5% w/v) of F. carica mucilage (FCM) and synthetic polymers (hydroxypropylmethyl cellulose and Carbopol 934). Evaluation of FCM showed that it was as safe as the synthetic polymers for nasal administration. In situ gels were prepared with mixture Pluronic F127 and mucoadhesive agents. Evaluation of the prepared gels was carried out, including determination of viscosity, texture profile analysis and mucoadhesive strength. In vitro drug permeation study was conducted with the gels prepared with and without permeation enhancer (0.5% w/v sodium taurocholate) using excised goat nasal mucosa. In vitro permeation profiles were evaluated, and histological study of nasal mucosae before and after permeation study was also conducted to determine histological change, if any. In vivo experiments conducted in rabbits further confirmed that in situ nasal gels provided better bioavailability of midazolam than the gels prepared from synthetic mucoadhesive polymers. It was observed that the nasal gel containing 0.5% FCM and 0.5% sodium taurocholate exhibited appropriate rheological, mechanical and mucoadhesive properties and showed better drug release profiles. Moreover, this formulation produced no damage to the nasal mucosa that was used for the permeation study, and absolute bioavailability was also higher compared to gels prepared from synthetic polymers.

An incident study about acute and chronic human exposure to uranium by high-resolution inductively coupled plasma mass spectrometry (HR-ICPMS).

From the year 2003 to 2005 around 1700 Dutch soldiers made a part of the international stabilisation force in Iraq. An incident happened as a group of four Dutch soldiers found a 30mm bullet identified as containing depleted uranium (DU). The main pathway of the acute exposure is via inhalation of small uranium containing particles, e.g. from a bullet during its explosion. To develop a method for acute exposure investigations were carried out about finding an efficient and suitable way to sample nasal mucus as medium of inhalation. Generally, in human exposure studies with regard to natural uranium (NU) or DU, urine is the matrix for analysis. Uranium concentrations in urine are based on daily ingestion depending on the composition of drinking water and food. A second possibility is the acute exposure to uranium after an incident, either through inhalation or impact. Nevertheless, the results deliver only interpretations in respect to chronic/long-term exposure. For the acute exposure procedures like sniffling out into cleansing tissues and rinsing the nose were tested with real-life samples from four soldiers involved in an incident with possibly acute exposure to uranium. For the quantification of uranium high-resolution inductively coupled plasma mass spectrometry (HR-ICPMS) was applied.

Effects of intranasal phototherapy on nasal mucosa in patients with allergic rhinitis.

RATIONALE: Rhinophototherapy has been shown to be effective in the treatment of allergic rhinitis. Considering that phototherapy with ultraviolet light (UV) induces DNA damage, it is of outstanding importance to evaluate the damage and repair process in human nasal mucosa. METHODS: We have investigated eight patients undergoing intranasal phototherapy using a modified Comet assay technique and by staining nasal cytology samples for cyclobutane pyrimidine dimers (CPDs), which are UV specific photoproducts. RESULTS: Immediately after last treatment Comet assay of nasal cytology samples showed a significant increase in DNA damage compared to baseline. Ten days after the last irradiation a significant decrease in DNA damage was observed compared to data obtained immediately after finishing the treatment protocol. Difference between baseline and 10 days after last treatment was not statistically significant. Two months after ending therapy, DNA damage detected by Comet assay in patients treated with intranasal phototherapy was similar with that of healthy individuals. None of the samples collected before starting intranasal phototherapy stained positive for CPDs. In all samples collected immediately after last treatment strong positive staining for CPDs was detected. The number of positive cells significantly decreased 10 days after last treatment, but residual positive staining was present in all the examined samples. This finding is consistent with data reported in skin samples after UV irradiation. Cytology samples examined two months after ending therapy contained no CPD positive cells. CONCLUSION: Our results suggest that UV damage induced by intranasal phototherapy is efficiently repaired in nasal mucosa.

Preliminary study on Japanese cedar pollinosis in an artificial exposure chamber (OHIO Chamber).

BACKGROUND: A pollen exposure chamber (OHIO Chamber) was built in central Tokyo, Japan, in order to study seasonal allergic rhinitis (SAR). Since satisfactory outcomes were obtained from the controlled pollen exposure at the chamber, we conducted preliminary studies in volunteers with SAR. METHODS: Ten volunteers with SAR sensitive to Japanese cedar (JC) pollen were enrolled in this study. In order to investigate the intranasal and intraocular pollen number, volunteers were initially exposed to a low concentration of JC (2500 grains/m3) for at most 1 hour in this chamber. Before and after the exposure, nasal cavities and eyes were washed with 100ml and 25 ml of saline, respectively. Nasal and eye washing solutions were collected and the number of JC pollen was counted. After 3 hours the volunteers were subsequently exposed to a moderate concentration of JC (4500 grains/m3) for 2 hours. Subjective nasal and ocular symptoms were recorded and the amount of nasal secretion was measured during the allergen exposure periods. RESULTS: During the initial exposure, all volunteers except one stayed in the chamber for 1 hour without any nasal or ocular symptoms. The number of pollen in the nose and eyes was 249.2 +/- 120.9 and 13.6 +/- 13.6 grains, respectively. During the subsequent 2-hour exposure to JC pollen, nasal and ocular symptoms developed gradually in a time dependent manner in all the volunteers except one. CONCLUSIONS: This is the first clinical study using Japanese cedar pollen under well-controlled conditions in the OHIO chamber in which the induction of allergic symptoms was observed. The OHIO chamber will be useful for studying allergic rhinitis in Japan.

Grass pollen immunotherapy induces an allergen-specific IgA2 antibody response associated with mucosal TGF-beta expression.

Allergen immunotherapy (IT) has long-term efficacy in IgE-mediated allergic rhinitis and asthma. IT has been shown to modify lymphocyte responses to allergen, inducing IL-10 production and IgG Abs. In contrast, a putative role for IgA and local TGF-beta-producing cells remains to be determined. In 44 patients with seasonal rhinitis/asthma, serum IgA1, IgA2, and polymeric (J chain-containing) Abs to the major allergen Phl p 5 were determined by ELISA before and after a 2-year double-blind trial of grass pollen (Phleum pratense) injection IT. Nasal TGF-beta expression was assessed by in situ hybridization. Sera from five IT patients were fractionated for functional analysis of the effects of IgA and IgG Abs on IL-10 production by blood monocytes and allergen-IgE binding to B cells. Serum Phl p 5-specific IgA2 Abs increased after a 2-year treatment (approximately 8-fold increase, p = 0.002) in contrast to IgA1. Increases in polymeric Abs to Phl p 5 (approximately 2-fold increase, p = 0.02) and in nasal TGF-beta mRNA (p = 0.05) were also observed, and TGF-beta mRNA correlated with serum Phl p 5 IgA2 (r = 0.61, p = 0.009). Post-IT IgA fractions triggered IL-10 secretion by monocytes while not inhibiting allergen-IgE binding to B cells as observed with IgG fractions. This study shows for the first time that the IgA response to IT is selective for IgA2, correlates with increased local TGF-beta expression, and induces monocyte IL-10 expression, suggesting that IgA Abs could thereby contribute to the tolerance developed in IT-treated allergic patients.

Ionic composition of rat airway surface liquid determined by X-ray microanalysis.

The thin layer of liquid that lines the conducting airway epithelium, the airway surface liquid (ASL), is important for mucociliary clearance. Altered ionic composition and/ or volume of the ASL play a major role in the pathology of airway diseases such as cystic fibrosis. Since the ASL is a thin layer, it has been difficult to exactly determine its composition. The present paper describes two techniques that have been developed and used to study ASL composition: X-ray microanalysis of frozen hydrated rat trachea, and an ion-exchange (dextran) bead method, where dextran beads were placed on the airway epithelium to equilibrate with the ASL; the beads were then collected under silicone oil, dried and analyzed by X-ray microanalysis. The results from both frozen-hydrated specimens and from the dextran beads showed that ASL from rat trachea is hypotonic. Concentrations of Na, P, S, and K were higher in the frozen-hydrated ASL, in which mainly the mucus layer is analyzed, compared with the dextran bead method, in which mainly the periciliary liquid is sampled. Also the composition of rat nasal fluid was investigated by the dextran bead method. This fluid was somewhat hypertonic because of a high K concentration. The ionic composition of the nasal and tracheal fluid can be manipulated by cholinergic or alpha- or beta-adrenergic stimulation. Collecting ASL with dextran beads did not disturb the integrity of the airway epithelium. The ionic composition of the collected beads remained stable for several days during storage in silicone oil. It is concluded that X-ray microanalysis is a suitable method to determine the ionic composition of ASL.

A study of the effectiveness of chemosurgery with trichloroacetic acid for Japanese cedar pollenosis in terms of the chemical mediator levels in the nasal discharge and results of nasal provocation testing.

OBJECTIVE: The purpose of the present study was to investigate the effectiveness of chemosurgery with 80w/v% trichloroacetic acid (TCA) for the treatment of Japanese cedar pollenosis. The effectiveness of this treatment was evaluated in terms of the levels in the nasal washings of the chemical mediators histamine and eosinophil cationic protein, and the reactivity in the nasal provocation test. METHODS: Patients of cedar pollenosis were divided into two groups, the TCA-treated group (n=90) and the group that was not treated with TCA (nonTCA-treated group) (n=79), according to whether or not they received TCA treatment. In both the groups, the levels of the two aforementioned mediators in the nasal washings were measured during the pollen dispersal season. In addition, allergen provocation tests were performed using the disk method in volunteers from both the groups during the non-pollen dispersal season. The results of the above two determinations were compared statistically between the two groups. RESULTS: The results revealed significantly lower levels of the two mediators in the TCA-treated group than in the nonTCA-treated group (p<0.01). There was also a greater tendency for the subjects in the TCA-treated group as compared to those in the nonTCA-treated group to show negative reactivity in the allergen provocation test (p<0.01). CONCLUSION: Regional suppression of the allergic reaction to Japanese cedar pollen appears to occur as a result of chemosurgery with TCA performed as a day surgery.

Ascorbic acid in nasal and tracheobronchial airway lining fluids.

Ascorbic acid (AA) is thought to be an important antioxidant in the respiratory tract, whose regulation is yet to be fully characterized. We investigated whether AA in respiratory tract lining fluids (RTLFs) can be augmented by oral supplementation with AA. Plasma, nasal lavage fluids (NLFs), induced sputum (IS), and saliva were analyzed for AA immediately before and 2 h after ingestion of 2 g of AA in 13 healthy subjects. Concentrations of AA (median and range) were 52.5 (16.0-88.5), 2.4 (0.18-4.66), 2.4 (0.18-6.00), and 0.55 (0.18-18.90) micromol/l, respectively. Two hours after ingestion of AA, plasma AA increased 2-fold (p = .004), NLF AA increased 3-fold (p = .039), but IS and saliva AA did not increase. As AA concentrations in saliva and tracheobronchial secretions were low compared with other common extracellular components (such as urate), we evaluated the fate of AA in these fluids. Addition of AA to freshly obtained saliva or IS resulted in rapid depletion, which could be largely prevented or reversed by sodium azide or dithiothreitol. These findings suggest that oxidant-producing systems in saliva and airway secretions, such as heme peroxidases and other oxidizing substances, rapidly consume AA. Whereas oral supplementation resulted in detectable increases of AA in NLFs, its levels in tracheobronchial lining fluid, as measured by IS, were unaffected and remained relatively low, suggesting that AA may play a less significant antioxidant role in this compartment as compared with most other extracellular compartments.

Effect of seasonal allergen exposure on mucosal IL-16 and CD4+ cells in patients with allergic rhinitis.

BACKGROUND: CD4+ T cells constitute a major source of cytokines in allergic diseases such as allergic rhinitis. Interleukin (IL)-16 selectively recruits CD4+ cells. METHODS: We evaluated the effect of natural allergen exposure during a grass-pollen season on IL-16 expression and number of CD4+ cells in nasal mucosa. Patients with allergic rhinitis (n=16) were treated with either a nasal glucocorticoid beclomethasone (BDP; 400 microg/day) or placebo, and gave nasal biopsies prior to and during the grass-pollen season. The evaluated markers in allergic rhinitis patients were also compared to those in healthy control subjects (n=5). RESULTS: Prior to the pollen season, the expression of IL-16, but not the number of CD4+ cells, was significantly higher in patients with allergic rhinitis than in healthy control subjects. The grass-pollen season further increased IL-16 expression and also increased the number of CD4+ cells in placebo-treated, but not in BDP-treated, allergic rhinitis patients. The pollen-season-induced change in IL-16 expression and in CD4+ cells was significantly more pronounced in placebo- than in BDP-treated patients. There was a significant correlation between the change in IL-16 expression and the number of CD4+ cells. CONCLUSIONS: These data suggest that local upregulation of IL-16 expression contributes to the inflammation observed in seasonal allergic rhinitis. Hypothetically, inhibition of IL-16 expression can be one of several mechanisms by which nasal glucocorticoids achieve their anti-inflammatory effect in allergic rhinitis.

Eosinophil cationic protein and specific IgE in serum and nasal mucosa of patients with grass-pollen-allergic rhinitis and asthma.

BACKGROUND: After allergen exposure, IgE-bearing mast cells surface in respiratory mucosa. Eosinophils are also recruited locally by chemotactic mediators; they are the main cell directly involved in the late phase of allergic inflammation. IgE antibody and eosinophil cationic protein (ECP) are routinely determined mainly in serum although they exert their pathogenetic role more directly on mucosal surfaces. METHODS: We performed a comparative study of IgE antibody to grass and ECP on nasal mucosa and blood samples in order to evaluate the relevance of monitoring allergic inflammation in the target organ. Thirty-one patients and 10 nonatopic controls were enrolled in the protocol. Twenty-six subjects allergic to grass, 11 with rhinitis (group 1) and 15 with asthma and rhinitis (group 2), completed the study. Five patients dropped out. Specific IgE to grass and ECP was determined in nasal mucosa by our method based on in situ incubation. RESULTS: Serum IgE to grass did not increase during the pollen peak, as did nasal IgE, in group 1 from before the pollen peak, from 2.3 to 3.2 kU/l (P=0.02), and in group 2 at the pollen peak, from 4.8 to 12.2 kU/l (P=0.01). Serum ECP did not show any significant variation in group 1, but it increased at pollen peak from 6 to 11.2 microg/l (P=0.01) in group 2. Nasal ECP increased significantly in both groups even before the pollen peak. In group 1, ECP values rose from 15 to 39.9 microg/l (P=0.01). In group 2, ECP increase was much higher than in group 1, from 9 to 213 microg/l (P=0.001). Serum eosinophils, like nasal ECP, showed a significant increase of values from before the pollen peak in both groups, without correlation with serum ECP in rhinitic patients. CONCLUSIONS: Both specific IgE and ECP in the nasal mucosa showed a better correlation with allergen exposure than serum evaluations. With an appropriate method, allergic inflammation may be best monitored in the nasal mucosa.