Systemic and local eosinophil inflammation during the birch pollen season in allergic patients with predominant rhinitis or asthma

BACKGROUND The aim of the study was to investigate inflammation during the birch pollen season in patients with rhinitis or asthma. METHODS Subjects with birch pollen asthma (n = 7) or rhinitis (n = 9) and controls (n = 5) were studied before and during pollen seasons. Eosinophils (Eos), eosinophil cationic protein (ECP) and human neutrophil lipocalin were analysed. RESULTS Allergic asthmatics had a larger decline in FEV1 after inhaling hypertonic saline than patients with rhinitis (median) (-7.0 vs.-0.4%, p = 0.02). The asthmatics had a lower sesonal PEFR than the rhinitis group. The seasonal increase in B-Eos was higher among patients with asthma (+0.17 x 109/L) and rhinitis (+0.27 x 109/L) than among controls (+0.01 x 109/L, p = 0.01). Allergic asthmatics and patients with rhinitis had a larger increase in sputum ECP (+2180 and +310 mug/L) than the controls (-146 mug/L, p = 0.02). No significant differences in inflammatory parameters were found between the two groups of allergic patients. CONCLUSION Patients with allergic asthma and rhinitis have the same degree of eosinophil inflammation. Despite this, only the asthmatic group experienced an impairment in lung function during the pollen season.