Retrospective study on fluticasone propionate aqueous nasal spray efficacyin patients with allergic rhinitis: evaluation of clinical and laboratory parameters

Background: In allergic rhinitis, allergenic stimulation causes the release of various mediators that induce symptoms and the development of chronic i nflammation, which, in turn, is caused by cells involved in the late phase of inflammation, such as eosinophils. The eosinophils also cause damage at the mucosal level through the secretion of eosinophil cationic protein and other preformed factors contained in their granules. The objective was to v erify the efficacy of fluticasone propionate aqueous nasal spray in patient s with allergic rhinitis; in a retrospective study, we have evaluated media tors of inflammation, making correlations with the clinical symptoms score during and outside the pollen season. Methods: Forty patients with allergic rhinitis and 15 normal controls were included in our study. Eosinophil cationic protein, eosinophil chemotactic activity, and blood and nasal lavage cosinophil count were evaluated as lab oratory parameters. Results: We found a significant increase in nasal lavage levels of eosinoph il cationic protein in allel gic patients, and this was strictly correlated with the clinical symptoms score. No differences were found in the eosinop hil count of allergic patients and in the serum eosinophil cationic protein of patients sensitized to seasonal allergens in comparison with normal sub jects. By contrast, an increase in serum cosinophil cationic protein level was found in patients sensitized to perennial allergens. After topical admi nistration of fluticasone propionate aqueous nasal spray, a reduction in na sal lavage eosinophil cationic protein secretion was obtained with a reduct ion of eosinophil chemotactic activity at the local level. This reduction c orrelated with an improvement of clinical symptoms. Conclusions: The clinical improvement and reduction in nasal lavage eosinop hil cationic protein and eosinophil chemotactic activity after administrati on of fluticasone propionate aqueous nasal spray further confirms the role of this treatment in allergic rhinitis.