Light and electron microscope study in allergic rhinitis patients (ARP) with or without bronchial hyperreactivity (BHR).

Little is known about the pathogenesis of bronchial hyperreactivity associated with allergic rhinitis. For this purpose, bronchial biopsies and bronchoalveolar lavage from 6 allergic rhinitis patients with bronchial hyperreactivity, 5 allergic rhinitis patients without bronchial hyperreactivity and 3 healthy, normoreactive control subjects were obtained by fiberoptic bronchoscope and investigated with light and transmission electron microscope. Varying degrees of morphological alterations were observed in all groups; however, the intensity of the epithelial shedding, goblet cells, basement membrane thickness, stromal collagenous fibers and smooth muscle cells appeared to be increased in allergic rhinitis patients with bronchial hyperreactivity. In the mucosa and submucosa, the numbers and activation of lymphocytes, neutrophils and macrophages were lower in allergic rhinitis patients with bronchial hyperreactivity than in the control group and in allergic rhinitis patients without bronchial hyperreactivity. In accordance with these findings, bronchoalveolar lavage showed increased numbers of lymphocytes and surface alterations of phagocytic cells in allergic rhinitis patients without bronchial hyperreactivity. As a result, we could not find evidence of inflammation accompanying bronchial hyperreactivity in allergic rhinitis patients.