Institute for Medical Research and Occupational Health
Abstract
Malo se zna o vezi između reaktivnosti gornjih i donjih dišnih putova. U 11 bolesnika s alergijskim rinitisom bez znakova bronhalne astme, u 11 radnika profesionalno eksponiranih iritansima dišnog sustava i u 11 zdravih osoba ispitali smo nespecifičnu nosnu reaktivnost i promjenu razine nespecifične bronhalne reaktivnosti nakon testa nespecifične nosne reaktivnosti. Prije i nakon nosnog testa učinjena je nespecifična bronhoprovokacija kumulativnorn metodom (prema Chai H. i sur, J Allergy Clin lmmunol 1975;56:323-7), inhalacijom otopine histamina od 0,125 mg/ml do 128 mg/ml. Nespecifična nosna provokacija izvedena je uštrcavanjem podvostručujućih koncentracija histamina (0,125-32 mg/ml) u obje nosnice svake tri minute. Reakcija je praćena mjerenjem parametara: nosni inspiratorni maksimalni protok, nosni otpor, nosni forsirani ekspiratorni volumen u prvoj sekundi i nosni srednji ekspiratorni protok. Utvrdili smo značajno nižu razinu nespecifične nosne reaktivnosti u osoba oboljelih od alergijskog rinitisa. Nespecifična bronhalna reaktivnost bila je značajno niža u njih, ali i u radnika izloženih respiratornim nadražljivcima u odnosu na kontrolnu skupinu. Spremnost bronhalnog stabla da reagira spazmom na inhalirani histamin statistički značajno je umanjena nakon nespecifične nosne provokacije u zdravih osoba i u radnika izloženih iritansima dišnog sustava.Data on the relationship between nasal and bronchial reactivities are scarce. This study aimed at investigating a possible influence of the nasal provocation test on bronchial reactivity. Three groups of eleven subjects each were examined: patients suffering from allergic rhinitis with no clinical evidence of asthma, workers exposed to respiratory irritants complaining of occupational rhinitis and asthma, and healthy subjects. Non-specific bronchoprovocation was performed before and after nasal challenge with histamine. The bronchial challenge with histamine solutions (0.125mg/ml and 128 mg/ml) was performed by the five-breath cumulative method (Chai H. et al. J Allergy Clin lmmunol 1975;56:323-7). Non-specific nasal provocation was performed by spraying doubling concentrations of histamine (0.125 mg/ml - 32 mg/ml) into both nostrils al three-minute intervals. The reaction was monitored by measurement of nasal inspiratory peak flow, nasal resistance, and nasal spirometry. The level of non-specific nasal reactivity was significantly lower in patients with allergic rhinitis than in the other two groups. The bronchial reactivity of the -rhinitis- group and of those occupationally exposed to irritants was significantly lower than among healthy subjects. An immediate and significant decrease in bronchial reactivity could be observed after nasal challenge in the group of healthy subjects as well as in workers exposed to irritants, but there was no significant change in bronchial reactivity among patients suffering from allergic rhinitis
