R126 Prevalence of Atopy to Common Aeroallergens and Moulds in Patients with Nasal Polyposis Jose Maria Guilemany, MD; Pedro A. Benitez, MD PhD; Isam Alobid, MD PhD; Manuel S Bernal-Sprekelsen, MD PhD; Cesar Picado, MD; Joaquim Mullol, MD PhD Barcelona Spain; Badalona Spain; Barcelona Spain; Barcelona Spain; Baracelona Spain; Barcelona Spain Problem: Nasal polyposis (NP) is a chronic inflammatory disease of unknown origin. Despite the frequent allergic clin- ical symptoms, some studies have concluded that allergy is not an important cause of nasal polyposis. There are hypoth- eses about the importance of common aeroallergens, includ- ing moulds in the pathogenesis of nasal polyposis. This pro- spective study investigates in patients with nasal polyposis (1) the prevalence of atopy to common aeroallergens, including moulds and (2) the prevalence of precipitins to Aspergillus fumigatus (Af). Methods: Skin prick tests were realized with a battery of common aeroallergens including 6 moulds in 154 patients with nasal polyposis, divided into 3 groups: 66 with NP without asthma, 57 with NP and aspirin-tolerant-asthma, and 31 with NP and aspirin-intolerant-asthma. Precipitines (IgG) to Af were quantified to all patients. Results: The patients with NP presented an increased prevalence in positive skin prick test to one or more common aeroallergens (41%) and one or more moulds (14%), includ- ing Af (7%). This prevalence is significantly increased in patients with NP and aspirin-intolerant-asthma (61%, 16%, and 13%, respectively). The prevalence of atopy in patients with NP is greater than in the Spanish population (15%-20%, 1%-2 %, and 0.2%-0.4 %, respectively). The precipitins titu- lation (IgG) to Af was positive in 13% of the patients, with no differences between groups and with no correlation with the results of the skin prick test (IgE). Conclusion: These results suggest an increased prevalence of atopy to common aeroallergens, including moulds, in pa- tients with nasal polyps, specially in patients with NP and aspirin-intolerant-asthma. Both IgG (precipitins) and specific IgE (skin prick test) to Aspergillus sp. was increased in patients with NP, but no correlation between them was ob- served. Significance: This study shows the importance of allergy in ethiopathology of nasal polyposis. Support: None reported. R127 Responses to Nasal Bradykinin Challenge in Normal and Allergic Subjects Patrick O’Brien Sheahan, MB BCh (presenter); Rory McConn- Walsh, MD; Michael A Walsh, FRCSI; Richard W. Costello, MD Dublin Ireland; Dublin Ireland; Dublin Ireland; Dublin Ireland Problem: Neurally mediated secretory hyper-reactivity is well-documented in allergic rhinitis; however, congestive re- sponses to nasal challenge in allergic subjects are less well characterized. Methods: Normal subjects (n = 13), and subjects with seasonal allergic rhinitis (SAR) (n = 16), perennial allergic rhinitis (PAR) (n = 24), and nonallergic rhinitis (NAR) (n = 9) underwent unilateral nasal challenge with Hartman’s solu- tion, bradykinin 50 mcg, and bradykinin 100 mcg. Acoustic rhinometry was performed at baseline and after each chal- lenge. Values for the first, second, and third minimum cross- sectional areas (csa 1, 2, 3), and the volumes to csa 2, csa 3, and to 4 cm inside the nasal cavity (vol 2, 3, 4) were recorded on each side. Results: Challenge with the first dose (50 mcg) of brady- kinin in normal subjects led to ipsilateral congestion. A ten- dency to decongest was seen after the second (100 mcg) dose. Significant changes were not seen in contralateral parameters. In contrast, subjects with SAR and PAR demonstrated sig- nificant contralateral congestion after control challenge, which persisted after both bradykinin challenges. Subjects with SAR also demonstrated significant ipsilateral congestion after challenge with bradykinin 50 mcg; however, this was not the case for subjects with PAR. Subjects with NAR did not demonstrate any significant ipsilateral or contralateral congestive responses. Conclusion: Acoustic rhinometry may be used to measure congestive responses to nasal bradykinin challenge. Allergic subjects demonstrate congestive hyper-reactivity, which is more pronounced on the contralateral side. Subjects with PAR had a less pronounced ipsilateral congestive response than did normal subjects or subjects with SAR, which may reflect greater baseline nasal congestion or disturbed regula- tion of nasal mucosal blood flow. Significance: The present study is the first to investigate nasal congestive responses to bradykinin challenge using acoustic rhinometry in a large number of subjects. Our find- ings suggest that hyper-reactive congestive reflexes may con- tribute to the symptoms of allergic rhinitis. Support: None reported. R128 Effect of Dust Allergy on Nasal Secretory Responses in Seasonal Allergic Rhinitis Patrick O’Brien Sheahan, MB BCh (presenter); Rory McConn- Walsh, MD; Michael A Walsh, FRCSI; Richard W. Costello, MD Dublin Ireland; Dublin Ireland; Dublin Ireland; Dublin Ireland Problem: Secretory hyper-reactivity to nasal provocation with bradykinin is well documented in subjects with perennial allergic rhinitis (PAR), and with seasonal allergic rhinitis (SAR) tested in-season. Hyper-reactivity is less evident in subjects with strictly seasonal symptoms tested out-of-season. However, positive skin-prick tests to dust are common in POSTERS Otolaryngology– Head and Neck Surgery P192 Research Posters August 2004