29 METHACHOLINE-INDUCED HISTAMINE RELEASE IN NASAL SECRETIONS. Gordon D. Raphael, M.D., Howard M. Druce, M.D., Ralph Wright, R.N., and Michael A. Kaliner, M.D., Bethesda, Maryland.

Does nonimmunoloaic challenae with metha- choline cause nasallhistamine release? In order to answer this question, 22 atopic and 21 non- atopic patients received methacholine (MCH) nasal provocations. Nasal challenge involved washing the nose with 4 ml saline (S) x 4, and then MCH or S control challenges. Nasal washes were collected by a suction catheter placed 6 cm along the nasal floor. Histamine (H) (single isotope radioenzyme assay) averaged 9.7k1.6 rig/ml in the initial wash, and was reduced to 7.3k1.2 rig/ml after 4 washes (n=37). 14 subjects received 0.5, 5, 50, and 100 mg MCH challenges, and the H in the secretions were significantly elevated compared to S challenge. 0.5 mg MCH induced the largest H release (33.4k3.4 rig/ml; n=14) compared with 20.8, 21.2, and 19.5 rig/ml with 5, 50, and 100 mg challenges, respectively. The H in the first and last prewash was 18.5k5.3 and 14.6k4.5 rig/ml for these 14 subjects (pcO.05 compared with 0.5 mg MCH challenge). MCH challenges at 5 mg, either as a single dose, or repeated x 4, failed to cause H release in 14 subjects.

Therefore, low dose MCH (0.5 mg) induced H release reproducibly in atopic and nonatopic subjects suggesting the presence of nasal neurotransmitter-induced histamine release in humans.

30 KININOMNS IN NASAL SBCRETIONS OF ALLBRQIC INDI- VIDDALS. C.P. Bauasar en. Y.D.. B.Y.. Naolerio. M.D.. A.G. Toaiaa. M.D’. L.Y. Liahtenataia. Y.D, Ph.D.. P.S. Norman. M.D. and D. Proud. Ph.D,, Baltimore, Maryland.

Nasal challon8o of l llorgio individuals with spooific allor#on rosalts in gonoration of ki- nins in socrotions. As a first stop towards understanding the q ochaniams of kinin prodao- tion, wo porformod the prosont study to ostab- lish tho availability and origin of kininogons in nasal soorotions.

High molecular weight kininogon (BNWK), total kininogon (TK), albumin (MB) and kinins word moasurod in nasal rashas obtainod beforo and af- tor challongo of allor~c (nd) and nonallot@ (n=S) individual?. Drwtic inoroasos in EMFK (1730 + 510 rig/ml), lX (3810 + 1035 q/ml), AUI (0.85 + 0.2 mg/rl) and kinin (9.46 2 i.75 q/al) wore observod upon challongo of l llor&io, but not nonallorgio, individuals and oorrolatod (p <O.OOl) with the onset of aymptoma and with in- croasos in histamine and TAJIE-ostoraso activity. Bxoollont oorrolationa (p <O.OOl ‘in aloh casp) wero obtained botroon inaroasor in I!#&, ALB and kinint in both doao-raspoaao and time-oourar or- poriments. For oath individual, tho ratio roRlr/ l’X in plasma and nasal raahoa wore similar. 001 filtration of nasal raahor rovoalod profilos for HAWK and TK which wore oaaontially tho same as those soon upon gel filtration of plasma. Those data suggort that, during tho allorgio reaction, thoro is inoroasod traasudation of kininogona from plaama into nasal soorotioaa, rharo they oan provido substrate for kinin-folring enzymes.

31 SLJLPHIDOPEPTIDE LEUKOTRIENES AND LTB4 IN NASAL SECRETIONS AND NASAL POLYPOSIS.- Penny Fitsharris, MD, R.J. Shaw, MRCP, A.J. Wardlaw, MRCP, 0. Cromwell, PhD, A. Drake-Lee, FRCS and A.B. Kay, MD, PhD, London, U.K.

We have measured leukotrienes (LTC4/LTD4 and LTB4) in allergic rhinitis and nasal polyps. Specific (LTC4/D4 and LTB4) radioimmunoassays (confirmed by high pressure liquid chromato- graphy (HPLC)) were used to identify these lipid mediators in nasal washings from patients with allergic rhinitis who underwent nasal challenge with specific allergen. The concentrations of LTC4/LTD4 were directly related to the dose of allergen, and were recovered in washings in a time-dependent fashion after challenge. Smaller, but significant, amounts of LTB4 were also detected. When the patients were subjected to methacholine nasal challenge on a control day only negligible amounts of either the sulphidopeptide leukotrienes or LTB4 were identified. By radioimmunoassay of reverse phase-HPLC fractions, the extracellular fluid of surgically removed nasal polyps from 4 patients was also shown to contain LTC4, LTD4 and LTE4, but not LTB4. These studies suggest that not only are sulphidopeptide leukotrienes and LTB4 released into the nose after exposure to allergen, but there might also be a persisent immunological reaction occurring within nasal polyps with subsequent generation of sulphidopeptide leukotrienes.

32 CYTOLOGICAL CHANGES IN THE NASAL SECRETIONS DU- RING NASAL CHALLENGE. Dr. Z. Pelikan, M.D. and Dr. M. Pelikan, M,D., Breda, The Netherlands.

In patients with allergic rhinitis due to the immediate hypersensitivity, the nasal challen- ges with allergens (NPT) were supplemented by cytological examination of the nasal secretions (NS).The 117 positive i ediate nasal responses (INR) and 68 negative I 3 correlating with his- tory and skin tests were .&udied. The NS speci- mens were stained by modified Hansel's method, toluidine blue and MGG. Results:l) The eosino- hils appeared in NS in 85% of positive and in 56% of negative INR. Their count changed before and after allergen in 68% positive and 29% nega- tive INR. Four basic patterns of these changes were observed; 2)The basophils were found in 16% of positive and in 11% of negative INR. Their count changed before and after allergen in 16% of positive and in 2% of negative INR (mainly decrease after allergen);3) The neutrophils ap- peared in NS in 91% of positive and in 66% of negative INR. Their count changed after the al- lergen in 43% of positive and in 10% of negati- ve INR; 4)The goblet cells were present in NS in 87% of positive and in 34% of negative INR.Their count changed after the allergen in 48% of the positive and-in 6% of negative INR (mainly in- crease within 10 minutes after the allergen); 5) The lymphocytes appeared in 11% of positive and in 2% of negative INR, while their count remai- ned unchanged in most cases; 6)The epithelial cells appeared in 68% of positive and in 63% of the negative INR. Their count remained unchanged in most cases; 7) The plasma cells and monocytes appeared in NS only sporadically.

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