Pharmacology of upper airways challenge.

We have used a model of nasal provocation to study the effects of pharmacologic interventions upon various types of inflammatory reactions of the upper airways. Pretreatment of allergic individuals with aspirin reduces the levels of prostaglandins in nasal secretions during the immediate allergic response but has no effect on symptoms. Theophylline and azatadine both reduce symptoms and the levels of mast cell mediators during the allergic response. By contrast, azatadine has no effect on symptoms or mediator levels during the response to challenge with cold, dry air, suggesting different mechanisms of mast cell activation in response to allergen and cold, dry air. Both topical and systemic steroids are effective in reducing symptoms and mediators during the late allergic response, but topical steroids also significantly inhibit the immediate response. Nasal challenge provides a convenient, relatively noninvasive method to study inflammatory reactions of the upper airways.