EFFECT OF INTRANASAL FLUTICASONE PROPIONATE ON THE IMMEDIATE AND LATEALLERGIC REACTION AND NASAL HYPERREACTIVITY IN PATIENTS WITH A HOUSE-DUST MITE ALLERGY
Cd. Veld et al., EFFECT OF INTRANASAL FLUTICASONE PROPIONATE ON THE IMMEDIATE AND LATEALLERGIC REACTION AND NASAL HYPERREACTIVITY IN PATIENTS WITH A HOUSE-DUST MITE ALLERGY, Clinical and experimental allergy, 25(10), 1995, pp. 966-973
Background Patients with perennial allergic rhinitis develop nasal sym
ptoms not only after allergen exposure, but generally also after non-s
pecific stimuli.Objective To evaluate the effect of 2 week's treatment
with fluticasone gropionate aqueous nasal spray (FPANS) on the nasal
clinical response, inflammatory mediators and nasal hyperreactivity. M
ethods Twenty-four rhinitis patients allergic to house dust mite (HDM)
, participated in a double-blind, placebo-controlled crossover study.
After 2 week's treatment with placebo or 200 mu g FPANS twice daily, p
atients were challenged with HDM extract. Symptoms were recorded and n
asal lavages were collected for up to 9.5 h after challenge. Nasal hyp
erreactivity was determined by histamine challenge 24 h later. Results
Because of a carry-over effect for the immediate symptom score, for t
his variable only the data from the first treatment period were used.
FPANS treatment resulted in a significant decrease of nasal symptoms w
ith 70%, 69% and 63% after 100? 1000 and 10 000 Biological Units (BU)/
mL of HDM extract respectively. Active treatment resulted in a 76% dec
rease of the late-phase symptoms. FPANS treatment significantly reduce
d albumin influx after HDM 1000 BU/mL with 62% and tended to reduce tr
yptase release after HDM 1000 BU/mL (P = 0.0629). During the late phas
e FPANS treatment reduced albumin influx with 67% and eosinophil catio
nic protein (ECP) release with 83%. No effect of FPANS was seen on his
tamine levels. FPANS significantly decreased histamine-induced symptom
score with 34%, secretion with 32% and sneezes with 41%. Conclusion F
PANS significantly inhibits the immediate and late allergic response,
and nasal hyperreactivity. probably by suppressing mast cells and eosi
nophils in the nasal mucosa.