Nasal hyperreactivity

This thesis focuses on answering two questions: L How to measure nasal hyperreactivity ? 2. What is the role and clinical significance of nasal hyperreactivity, especially in nasal allergy ? After a review of the literature (part I, Chapter 2) the current methods of assessment of nasal hyperreactivity are analysed (part II). To this end, nasal challenges with various non-specific stimuli were performed in allergic and non-allergic rhinitis patients compared to healthy subjects (chapters 3,4 and 5). Subsequently the clinical aspects of hyperreactivity in nasal allergy (part III) have been investigated. The relevance of hyperresponsiveness was analysed with respect to the daily symptoms of the patient and the activity of the nasal disease at the time of the test (Chapter 6). In addition the influence of natural allergen exposure on nasal challenge tests was studied (Chapter 7). Closely connected with this study is the investigation of late phase allergic reactions in relation to nasal hyperreactivity (Chapter 8). Finally a combined nasal hyperresponsiveness and allergy to avian antigens in a birdkeeper is reported in Chapter 9. In Chapter 10 the experiments described in this thesis are summarised. In this chapter the methodology, pathophysiology and diagnostic value of measuring nasal hyperreactivity are discussed