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Background: In recent years, diagnostic cytology of nasal mucosahas provided significant contributions in clarifying important
physiopathological mechanisms at the basis of several rhinological pathologies, it has been also clarified that nose mucosal is
anatomically similar to bronchial mucosal.
Aim: In a group of young athletes was performed the cytology of the nasal mucosa to show a correspondence to bronchial
hyperreactivity and the role of corticosteroids in the recovery of barrier integrity of the respiratory mucosa.
Methods & Patients: 83 young athletes (mean 21,3 +/- 3,5 yrs old; 53 Male and 30 Female), history of atopy, bronchial asthma
(BA) and concomitant allergic rhinitis (AR) were reported; they were submitted to Spirometry with challenge by Methacholine or
broncho-dilatator challenge (PFR) , Asthma Control Test (ACT) and rhino-cytology. Based on the results of their examination, a
program of their two-step treatment was proposed by topical cortical steroid therapy (mometasone 50 mg twice for 60 days).
Results: All patients (15 males and 9 females) with PFR positive had an ACT with poorly controlled asthma (ACT < 15; mean 10.1
+/-3.6) and nasal inflammatory cells (eosinophils: 9.5 +/- 4.1 and neutrophils 23.3 +/-6.2). We found that the number of eosinophils
highly correlated with all the above-mentioned parameters, including ACT and spirometric values. A significant positive correlation
was present between all inflammatory cells and neutrophils displayed only a partial correlation with pulmonary parameters (FEV1).
Methacholine test positivity significantly correlated with the number of eosinophils in the nasal smear. A close relationship between
the nasal eosinophil number and the percentage of predicted FEV1 was demonstrated (r=-0.76; p<0.0001). The patients submitted
to steroid therapy showed a recovery of barrier integrity of the respiratory mucosa a nasal cytology similar to control group (r=-0.68;
p<0.001).
Conclusion: The cytology of nose mucosal may be considered a non-invasive tool to assess airway inflammation in young asthmatics
with associated atopic rhinitis.
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