Using magnetic resonance imaging to quantify the inflammatory response following allergen challenge in allergic rhinitis

Title: Using magnetic resonance imaging to quantify the inflammatory response following allergen challenge in allergic rhinitis
Authors: Leaker, BR
Scadding, G
Jones, CR
Barnes, PJ
Item Type: Journal Article
Abstract: Current rhinometric and flow assessments measure nasal patency and are often poorly correlated with rhinitis symptoms. To evaluate magnetic resonance imaging (MRI) as a new method to measure inflammatory changes in nasal and sinus mucosa following nasal allergen challenge. A pilot study (n = 6) determined the optimal technical settings for MRI to measure inflammatory change which were then adopted for the main study. This study was a single blind, placebo-controlled, three-way crossover trial in 14 subjects with seasonal allergic rhinitis. Effects of cetirizine, cetirizine and pseudoephedrine (Cet+PE), or placebo on total nasal symptom scores (TNSS), peak nasal inspiratory flow (PNIF), nasal nitric oxide (nNO), acoustic rhinometry, and MRI end points following nasal intranasal allergen challenge were measured. There were significant changes in all parameters after allergen challenge (P < 0.01), except for nNO. MRI end points were less variable and more consistent than PNIF and acoustic rhinometry in detecting changes after allergen challenge. Total nasal airspace volume was the most sensitive and reproducible MRI measurement, with a mean reduction from -5.37 cm(3) (95%CI -7.35, -3.38; P < 0.001), which was maximal 60 min after allergen challenge. A change of one in TNSS corresponded to a change in MRI volume of -0.57 cm(3). There was an improvement in all parameters (except nNO) in subjects taking Cet+PE compared with placebo, however this did not achieve significance probably because of the small study size (overall analysis P > 0.07; comparison of active versus placebo P > 0.09). MRI provides novel insights into the anatomical inflammatory changes post allergen challenge and provides a new method for assessment of nasal patency and objective measurement of inflammatory responses.
Issue Date: 17-Sep-2015
Date of Acceptance: 2-Sep-2015
URI: http://hdl.handle.net/10044/1/40631
DOI: http://dx.doi.org/10.1002/iid3.86
ISSN: 2050-4527
Publisher: Wiley Open Access
Start Page: 445
End Page: 454
Journal / Book Title: Immunity, Inflammation and Disease
Volume: 3
Issue: 4
Copyright Statement: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: Acoustic rhinometry
MRI
allergic rhinitis
nasal allergen challenge
Publication Status: Published
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine



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