Minimal persistent inflammation is also present in patients with seasonal allergic rhinitis

Background: The allergic reaction is characterized by an inflammatory response, which is correlated to the allergon exposure, and is detectable in mite allergic patients, even when symptoms are absent. Objective: The study was aimed at assessing the presence of inflammation in patients with pollen allergy during a long observation period. Methods: Six patients, sensitized only to Betula alba, were enrolled, Evaluated parameters were (1) nasal symptoms, (2) inflammatory markers (ie, neutrophil and eosinophil number and intercellular adhesion molecule-1 expression on nasal epithelial cells), and (3) pollen count. Patients were examined during the pollen season every 4 days for 40 days and were observed 3 times after the pollen season. Results: A significant inflammatory reaction was evident throughout the pollen season, even during the days with a law pollen count and low or absent symptoms. Conclusions: The results of this study indicate that the global therapeutic strategy for allergic rhinitis should be revised and targeted to inflammatory phenomena rather than to symptoms alone.