Suppression by ingested eicosapentaenoic acid of the increases in nasal mucosal blood flow and eosinophilia of ryegrass-allergic reactions

Nasal mucosal blood flow, assessed by a laser Doppler probe technique, and the concentration of eosinophils in nasal secretions were quantified during challenge of one nostril with ryegrass-pollen antigen and the other nostril with diluent alone in seven patients with ryegrass-allergic rhinitis. The identical studies were repeated after an 8-week course of 3.5 gm/day of eicosapentaenoic acid (EPA). Ryegrass antigen evoked mean rises in nasal blood flow of 30% to 100% after 10 and 30 minutes that were significant, relative to prechallenge levels and to levels after diluent challenge, both before and after EPA. Antigen-induced increases in nasal blood flow were significantly less after than before EPA at 10 minutes, and at 180 minutes increases were significant only before EPA. In ryegrass-allergic patients with rhinitis who did not take EPA between the two studies, the increases in blood flow after antigen challenge were the same on both occasions. Similarly, the nasal eosinophilia elicited by antigen was significant at 180 minutes only before EPA. Both a composite index of signs and symptoms and the constituent variables, reflecting the clinical response to antigen challenge, were unaffected by EPA. The suppression by EPA of responses of nasal blood flow and nasal eosinophils to antigen challenge supports a role for fatty acid and phospholipid mediators in allergic rhinitis, but the clinical assessment did not provide evidence for any symptomatic benefit from EPA.