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Nasal allergies and HPA stimulation

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Ann Allergy Asthma Immunol. 2007 Mar;98(3):269-73.

Nasal provocation of patients with allergic rhinitis and the

hypothalamic-pituitary-adrenal axis.Kalogeromitros D, Syrigou EK, Makris M,

Kempuraj D, Stavrianeas NG, Vasiadi M, Theoharides TC.

Allergy Clinical Research Center, Allergy Section, Attikon Hospital,

University of Athens Medical School, Athens, Greece.


BACKGROUND: Allergic rhinitis is a common problem involving activation of

nasal mast cells and irritability. The hypothalamic-pituitary-adrenal (HPA)

axis is stimulated in cases of emotional or environmental stress, and mast

cells have been implicated in stress-induced immune responses. OBJECTIVE: To

investigate whether intranasal challenge of patients allergic to a single

antigen would stimulate the HPA axis. METHODS: Plasma corticotropin and

cortisol levels were measured 20, 40, 60, 80, 100, and 120 minutes after

intranasal antigen administration in healthy volunteers (n=3) and in

patients with rhinitis who are allergic to Parietaria (n=10). RESULTS: Mean

? SD corticotropin levels were 24.43 ? 14.38 pg/mL in patients compared

with 8.83 + 5.02 pg/mL in controls, and this increase was statistically

significant (P = .049). Patient cortisol levels also increased to a mean ?

SD of 8.87 ? 4.90 pg/mL (at 40 minutes) compared with 4.36 ? 1.72 pg/mL

in controls (P = .11 due to 1 outlier). Compared with individual patient

prechallenge levels, corticotropin levels increased in 7 patients and

cortisol levels increased in 5 at 40 minutes. CONCLUSION: These results

suggest that allergic rhinitis may activate the HPA axis. A larger study

with additional controls is required for definitive conclusions.


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