General clinical study of mucus from the nose

In healthy people, in the smears obtained by scraping from the posterior part of the inferior nasal cavity and stained according to Wright-Giemsa, cylindrical, ciliated cylindrical, goblet and basal cells are identified that are dyed blue;eosinophils, basophils and mast cells are absent, the number of neutrophils and bacteria is insignificant;the content of goblet cells does not exceed 50% of the total number of epithelial cells.

Normally and with banal inflammation, eosinophilic leukocytes are secret from the nasal cavity, or the ratio of eosinophils to neutrophils is 1:10.The detection of a large number of eosinophils in the secretion of the nasal cavity reflects the allergic reaction of the body to the introduction of allergens into the upper respiratory tract. Local diagnostics of the allergic process is facilitated by the fact that the relative content of eosinophils in tissues and on the surface of the mucous membrane of the upper respiratory tract during allergic diseases sharply exceeds their content in the peripheral blood. Especially valuable is the research of

mucus from the nose has for the diagnosis of allergic diseases of the nasal cavity and paranasal sinuses.

The number of eosinophils in the secretion of the nasal cavity increases with allergic processes in the mucosa of the upper respiratory tract, but to varying degrees depending on the type of allergen, such as an allergic reaction, exacerbation or remission of an allergic disease. Therefore, in some cases, when exacerbating allergic rhinosinusitis in smears from the nose, a large number of eosinophils are found, and only single eosinophils are detected during the inter-episode period;in other cases, the difference in the number of eosinophils in secret, depending on the phase of the disease is not traced. The number of eosinophils in the secretion of the nasal cavity depends on the type of allergen and the ways of its penetration into the body. With inhalation allergy, marked eosinophilia, and with food sensitization, the number of eosinophils is less. The study of the secretion of the nasal cavity plays an important role in the differential diagnosis of allergic and vasomotor rhinitis. Eosinophilia is characteristic of allergic rhinitis. The presence of eosinophilia in the secretion of the nasal cavity is an important diagnostic sign not only of allergic rhinitis, but of respiratory allergies in general.

In recent years, great importance in the diagnosis of allergic diseases is attached to the secretion of the nasal cavity of mast cells. During the exacerbation of allergic rhinitis, a large number of mast cells and eosinophils are present in the secretion of the nasal cavity, that is, the increase in the number of these cells goes in parallel, and in the remission period, the content of these and others decreases, but eosinophils are always more than fat cells. When examining the secretion of the nasal cavity, attention is paid to the number of goblet cells, if it exceeds 50% of all epithelial cells - this also indicates a local allergy.

The evaluation of the activity of the allergic reaction from the scraping of the nasal mucosa( average number of cells in 10 fields of vision at a 1000-fold magnification of the microscope) is given in Table.

Table Evaluation of the degree of activity of the allergic reaction from the scraping of the nasal mucosa [Lolor-Junior G. et al., 2000]

Table Evaluation of the degree of activity of an allergic reaction based on the results of scraping from the nasal mucosa [Lolor, Jr., G., et al., 2000]

Interrelationbetween the nature of the pathological changes in scrapings from the nasal mucosa and the presumptive diagnosis is presented in Table. .

Table Changes in scrapings from the nasal mucosa and the presumptive diagnosis

Table Changes in scrapings from the nasal mucosa and presumptive diagnosis

Similarly, the scrapeswith conjunctiva for allergic eye diseases. An increase in the number of eosinophils, basophils and mast cells is evidence in favor of allergic conjunctivitis;prevalence of neutrophils - about bacterial conjunctivitis, conjunctivitis caused by irritants( in combination with an increase in the content of eosinophils - allergic conjunctivitis);lymphocytes - about viral conjunctivitis.