Nasal secretion analysis in allergic rhinitis, cystic fibrosis, & nonallergic fibromyalgia (FM)/Chronic Fatigue Syndrome (CFS) subjects

Rhinitis symptoms are present in approximately 70% of subjects

with fibromyalgia and chronic fatigue syndrome (FM/CFS).

Because only 35% to 50% have positive allergy skin tests,

nonallergic mechanisms may also play a role. To better

understand the mechanisms of nonallergic rhinitis in FM/CFS,

nasal lavages were performed, and markers of vascular

permeability, glandular secretion, and neutrophil and

eosinophil infiltration measured in 27 nonallergic FM/CFS, 7

allergic rhinitis, 7 cystic fibrosis, and 9 normal subjects.

Allergic rhinitis subjects had significantly increased

vascular permeability (IgG) and ECP levels. Cystic fibrosis

subjects had significantly higher elastase and total protein

levels. There were no significant differences between FM/CFS

and normal lavage fluids. Analysis of the constituents of

nasal mucus provides information about ongoing secretory

processes in rhinitis. There were no differences in the basal

secretion of these markers of vascular permeability,

submucosal gland serous cell secretion, eosinophil and

neutrophil degranulation in nonallergic FM/CFS subjects. This

suggests that constitutively active secretory processes that

regulate continuous production of nasal secretions are not

altered in FM/CFS. Future studies should examine alternative

mechanisms such as inducible, irritant-activated, or

reflex-mediated effects.

Baraniuk JN, Clauw D,Yuta A, Ali M, Gaumond E, Upadhyayula N,Fujita K, Shimizu T

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