The online version of this article (doi:10.1186/1476-7961-10-4) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
KI, JPP and MPB designed the study. KI and BG designed the analysis of CC16. BG carried out the CC16 analyses. KI and BG evaluated the results and KI performed the statistical analyses. KI, BG and MPB wrote the manuscript. All authors have read, revised and approved the manuscript.
Clara cell protein (CC16) is ascribed a protective and anti-inflammatory role in airway inflammation. Lower levels have been observed in asthmatic subjects as well as in subjects with intermittent allergic rhinitis than in healthy controls. Nasal nitric oxide (nNO) is present in high concentrations in the upper airways, and considered a biomarker with beneficial effects, due to inhibition of bacteria and viruses along with stimulation of ciliary motility. The aim of this study was to evaluate the presumed anti-inflammatory effects of nasal CC16 and nNO in subjects with allergic rhinitis.
The levels of CC16 in nasal lavage fluids, achieved from subjects with persistent allergic rhinitis (n = 13), intermittent allergic rhinitis in an allergen free interval (n = 5) and healthy controls (n = 7), were analyzed by Western blot. The levels of nNO were measured by the subtraction method using NIOX®. The occurrences of effector cells in allergic inflammation, i.e. metachromatic cells (MC, mast cells and basophiles) and eosinophils (Eos) were analyzed by light microscopy in samples achieved by nasal brushing.
The levels of CC16 correlated with nNO levels (r2 = 0.37; p = 0.02) in allergic subjects.
The levels of both biomarkers showed inverse relationships with MC occurrence, as higher levels of CC16 (p = 0.03) and nNO (p = 0.05) were found in allergic subjects with no demonstrable MC compared to the levels in subjects with demonstrable MC. Similar relationships, but not reaching significance, were observed between the CC16 and nNO levels and Eos occurrence. The levels of CC16 and nNO did not differ between the allergic and the control groups.
The correlation between nasal CC16 and nNO levels in patients with allergic rhinitis, along with an inverse relationship between their levels and the occurrences of MC in allergic inflammation, may indicate that both biomarkers have anti-inflammatory effects by suppression of cell recruitment. The mechanisms behind these observations warrant further analyses.
Lindahl M, Svartz J, Tagesson C: Demonstration of different forms of the anti-inflammatory proteins lipocortin-1 and Clara cell protein-16 in human nasal and bronchoalveolar lavage fluids. Electrophoresis. 1999, 20: 881-890. 10.1002/(SICI)1522-2683(19990101)20:4/5<881::AID-ELPS881>3.0.CO;2-6 CrossRefPubMed
Benson M, Jansson L, Adner M, Luts A, Uddman R, Cardell LO: Gene profiling reveals decreased expression of uteroglobin and other anti-inflammatory genes in nasal fluid cells from patients with intermittent allergic rhinitis. Clin Exp Allergy. 2005, 35: 473-478. 10.1111/j.1365-2222.2005.02206.x CrossRefPubMed
Lundberg JO: Nitric oxide and the paranasal sinuses. Anat Rec. 2008, 291: 1479-1484. 10.1002/ar.20782. CrossRef
Borres MP, Irander K, Björkstén B: Nasal metachromatic cells in infants in relation to allergic disease and family history of atopy. Pediatr Allergy Immunol. 1991, 4: 184-189. CrossRef
, : ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med. 2005, 171: 912-930. CrossRef
Zetterquist W, Pedroletti C, Lundberg JON, Alving K: Salivary contribution to exhaled nitric oxide. Eur Resp J. 1999, 13: 327-333. 10.1034/j.1399-3003.1999.13b18.x. CrossRef
Turner S: The role of exhaled nitric oxide in the diagnosis, management and treatment of asthma. Mini Rev Med Chem. 2007, 7: 539-542. PubMed
Larsson AK, Bäck M, Hjoberg J, Dahlén SE: Inhibition of nitric-oxide synthase enhances antigen-induced contractions and increases release of cysteinyl-leucotrienes in guinea pig lung parenchyma: nitric oxide as a protective factor. J Pharmacol Exp Ther. 2005, 315: 458-465. 10.1124/jpet.105.086694 CrossRefPubMed
Lundberg JO: Airborne nitric oxide: inflammatory marker and aerocrine messenger in man. Acta Physiol Scand Suppl. 1996, 633: 1-27. PubMed
- Clara cell protein in nasal lavage fluid and nasal nitric oxide - biomarkers with anti-inflammatory properties in allergic rhinitis
Jörgen P Palm
Magnus P Borres
- BioMed Central
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