Rhinitis, or inflammation of the nasal mucosa, can present with nasal obstruction, nasal discharge, itch or sneezing. If the sinusal mucosa is involved as well, it is called rhinosinusitis and facial pain or loss of smell is possible. Several causes are known, such as an underlying allergy ("allergic rhinitis", AR). If at least 2 symptoms are present for at least 12 weeks, it is called "chronic rhinosinusitis" (CRS). Up to 2/3 of the AR and CRS patients have symptoms upon exposure to triggers such as sudden temperature changes, smoke, fragrances… a phenomenon called "nasal hyperreactivity" (NHR). It is currently not clear why some patients suffer NHR while others do not. In this study, the investigators want to identify the mediators associated with NHR in patients with allergic rhinitis, chronic rhinosinusitis and healthy control subjects.To do so, participants will be provoked with cold, dry air in order to objectively diagnose NHR. Before and after provocation, the peak nasal inspiratory flow will be measured and samples will be collected (nasal secretions, biopsies).
Patients with perennial allergic rhinitis, chronic rhinosinusitis with nasal polyps and healthy control subjects will be recruited. At baseline, nasal secretions and mucosal biopsies will be collected. After 3 weeks, participants will be provoked with cold, dry air, and samples will be harvested again. A decrease in the peak nasal inspiratory flow of \>20% will be used as a cutoff to define nasal hyperreactivity. Nasal secretions will be analysed for various mediators using a multiplex assay. The biopsies will be used for RT-q-PCR and immunohistochemistry of various transient receptor potential (TRP) channels.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
144
Participants will be exposed to cold (\<-10°C, \<10% relative humidity), dry air for 15 minutes.
KULeuven
Leuven, Belgium
Objective nasal hyperreactivity
The peak nasal inspiratory flow will be measured before and after provocation with cold, dry air. A decrease of \>20% will be used as a cutoff to objectively diagnose nasal hyperreactivity.
Time frame: 3 weeks
Levels of histamine in nasal secretions
In nasal secretions, the investigators will measure the levels of histamine by using a multiplex assay. They will do so at baseline and after cold dry air provocation test.
Time frame: 3 weeks
Levels of tryptase in nasal secretions
In nasal secretions, the investigators will measure the levels of tryptase by using a multiplex assay. They will do so at baseline and after cold dry air provocation test.
Time frame: 3 weeks
Levels of substance P in nasal secretions
In nasal secretions, the investigators will measure the levels of substance P by using a multiplex assay. They will do so at baseline and after cold dry air provocation test.
Time frame: 3 weeks
Levels of neurokinin A in nasal secretions
In nasal secretions, the investigators will measure the levels of neurokinin A by using a multiplex assay. They will do so at baseline and after cold dry air provocation test.
Time frame: 3 weeks
Levels of neurokinin B in nasal secretions
In nasal secretions, the investigators will measure the levels of neurokinin B by using a multiplex assay. They will do so at baseline and after cold dry air provocation test.
Time frame: 3 weeks
Levels of calcitonin gene-related peptide in nasal secretions
In nasal secretions, the investigators will measure the levels of calcitonin gene-related peptide by using a multiplex assay. They will do so at baseline and after cold dry air provocation test.
Time frame: 3 weeks
Levels of interleukin (IL) 4 in nasal secretions
In nasal secretions, the investigators will measure the levels of IL-4 by using a multiplex assay. They will do so at baseline and after cold dry air provocation test.
Time frame: 3 weeks
Levels of IL-5 in nasal secretions
In nasal secretions, the investigators will measure the levels of IL-5 by using a multiplex assay. They will do so at baseline and after cold dry air provocation test.
Time frame: 3 weeks
Levels of IL-13 in nasal secretions
In nasal secretions, the investigators will measure the levels of IL-13 by using a multiplex assay. They will do so at baseline and after cold dry air provocation test.
Time frame: 3 weeks
Presence of TRP Vanilloid 1 in nasal mucosa.
The investigators will determine the presence of TRP vanilloid 1 on nasal mucosal biopsies at baseline and after provocation with cold, dry air by using RT-q-PCR and immunohistochemistry.
Time frame: 3 weeks
Presence of TRP Ankyrin 1 in nasal mucosa.
The investigators will determine the presence of TRP Ankyrin 1 on nasal mucosal biopsies at baseline and after provocation with cold, dry air by using RT-q-PCR and immunohistochemistry.
Time frame: 3 weeks
Presence of TRP Melastatin 8 in nasal mucosa.
The investigators will determine the presence of TRP Melastatin 8 on nasal mucosal biopsies at baseline and after provocation with cold, dry air by using RT-q-PCR and immunohistochemistry.
Time frame: 3 weeks
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