Rhinitis patients with sputum eosinophilia show decreased lung function in the absence of airway hyperresponsiveness.

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|    Allergy Asthma Immunol Res. 2013 Jul;5(4):232-238. English. Published online 2013 May 03.  http://dx.doi.org/10.4168/aair.2013.5.4.232  Copyright © 2013 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease Rhinitis Patients With Sputum Eosinophilia Show Decreased Lung Function in the Absence of Airway Hyperresponsiveness Min-Suk Yang,1,2,3 Hyun-Seung Lee,3 Min-Hye Kim,2,3 Woo-Jung Song,2,3 Tae-Wan Kim,4 Jae-Woo Kwon,5 Sae-Hoon Kim,2,3,6 Heung-Woo Park,2,3 Yoon-Seok Chang,2,3,6 Sang-Heon Cho,2,3 and Kyung-Up Min2,3 1Department of Internal medicine, SMG-SNU Boramae Medical Center, Seoul, Korea. 2Department of Internal medicine, Seoul National University College of Medicine, Seoul, Korea. 3Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea. 4Department of Internal Medicine, Korean Armed Forces Capital Hospital, Seongnam, Korea. 5Division of Allergy and Clinical Immunology, Department of Internal Medicine, Kangwon National University College of Medicine, Chuncheon, Korea. 6Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.  Correspondence to: Sang-Heon Cho, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea. Tel: +82-2-2072-2971; Fax: +82-2-764-3954; Email:shcho@snu.ac.kr  Received August 23, 2012; Revised November 13, 2012; Accepted December 04, 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose Sputum eosinophilia is observed frequently in patients with rhinitis. Sputum eosinophilia in patients with non-asthmatic allergic rhinitis has been suggested to be related to nonspecific airway hyperresponsiveness (AHR). However, the clinical significance of sputum eosinophilia in patients with non-asthmatic rhinitis without AHR has not been determined. We conducted a retrospective study examining the influence of sputum eosinophilia in patients with non-asthmatic rhinitis without AHR on pulmonary function and expression of fibrosis-related mediators. Methods Eighty-nine patients with moderate-to-severe perennial rhinitis without AHR were included. All underwent lung function tests (forced expiratory volume in 1 second [FEV1] and forced vital capacity [FVC]), skin tests to inhalant allergens, methacholine bronchial challenge tests, and hypertonic saline-induced sputum to determine eosinophil counts. Sputum mRNA levels for transforming growth factor-β (TGF-β), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) were also examined. Patients were divided into two groups according to the presence of sputum eosinophilia (≥3%, eosinophilia-positive [EP] and <3 eosinophilia-negative="" groups="" p=""> Results FEV1 was significantly lower (P=0.04) and FEV1/FVC tended to be lower (P=0.1) in the EP group than in the EN group. In sputum analyses, the MMP-9 mRNA level (P=0.005) and the ratio of MMP-9 to TIMP-1 expression (P=0.01) were significantly higher in the EP group than in the EN group. There was no significant difference in TGF-β mRNA expression between the two groups. Conclusions Sputum eosinophilia in patients with moderate-to-severe perennial rhinitis without AHR influenced FEV1 and the expression pattern of fibrosis-related mediators. Keywords: Sputum, eosinophil, rhinitis, forced expiratory volume, matrix metalloproteinase-9.   Open Access      |