Effects of the common cold and intranasal fluticasone propionate treatmenton mucosal host defense assessed by human saliva

Objective. The purpose of this investigation was to study the effect of a p otent topical steroid, fluticasone propionate, on patients with early signs and symptoms of the common cold. To characterize the mucosal inflammatory response, salivary defense factors and flow rate in these patients were ana lyzed. Study design. Forty patients with symptoms of the common cold were randomiz ed into 2 groups to receive either high-dose fluticasone propionate (100 mu g per nostril) or placebo 4 times daily for 6 days. Paraffin-stimulated wh ole saliva was collected on day 1 (before the onset of medication), day 7 ( posttreatment), and day 21 (follow-up). Results. Salivary flow rate, innate host defense factors, and total protein content were not affected by the common cold. IgA increased between day 7 and day 21 (P less than or equal to.01; Student 2-tailed t test), and the r elative proportions of salivary peroxidase and IgA increased on day 7 (P =. 01) and day 21 (P =.05). In patients receiving fluticasone, saliva flow rat e was lower on day 21 (P less than or equal to.05) than on days 1 and 7. Th e innate salivary defense factors were not affected, but IgA increased both on day 7 (p less than or equal to.001) and on day 21 (P less than or equal to.001) in comparison with day 1. Conclusions. Of the oral mucosal defense factors, only IgA is activated dur ing the common cold. Intranasally administrated fluticasone propionate does not have a suppressive effect on salivary antimicrobial capacity.