Intranasal cold dry air is superior to histamine challenge in determining the presence and degree of nasal hyperreactivity in nonallergic noninfectious perennial rhinitis.

Abstract

The objective of the study was to compare cold dry air (CDA) and histamine in differentiating patients with nonallergic noninfectious perennial rhinitis (NANIPER) from control subjects. Nasal reactivity (nasal patency, mucus production, and sneezing) in 16 symptomatic nonsmoking patients with NANIPER and seven nonsmoking control subjects was measured with standardized CDA and histamine provocation series in a randomized crossover study. Intranasal CDA resulted in increased mucus production and nasal blockage in a dose-dependent manner in patients with NANIPER but not in control subjects. Sneezing did not occur. The reproducibility of CDA for patency and mucus production was good. Sensitivity for CDA was 87% compared with 100% for histamine. However, specificity was 71% for CDA and 0% for histamine. It is concluded that the new standardized intranasal CDA provocation method uses a recognizable natural nonspecific stimulus and seems to be more suitable than histamine for characterizing and assessing the presence and degree of nasal reactivity in NANIPER.

• Authors: J P Braat, P G Mulder, W J Fokkens, R G van Wijk, E Rijntjes
• Journal: American journal of respiratory and critical care medicine (Am J Respir Crit Care Med) Vol. 157 Issue 6 Pt 1 Pg. 1748-55 (Jun 1998) ISSN: 1073-449X [Print] United States
• PMID: 9620901 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Histamine

Topics

• Adult
• Cold Temperature
• Cross-Over Studies
• Female
• Histamine
• Humans
• Male
• Mucus (metabolism)
• Nasal Cavity (physiopathology)
• Nasal Obstruction (diagnosis)
• Nasal Provocation Tests (methods)
• Reproducibility of Results
• Rhinitis, Vasomotor (diagnosis, physiopathology)
• Sensitivity and Specificity