Premium
Effect of topical corticosteroids on seasonal increases in epithelial eosinophils and mast cells in allergic rhinitis: a comparison of nasal brush and biopsy methods
Author(s) -
Mikila R. Jacobson,
Sigurður Júlíusson,
O. Löwhagen,
B Balder,
A. B. Kay,
Stephen R. Durham
Publication year - 1999
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1046/j.1365-2222.1999.00608.x
Subject(s) - fluticasone , fluticasone propionate , mucous membrane of nose , nasal spray , medicine , biopsy , mast cell , eosinophil , pathology , nasal administration , immunology , corticosteroid , asthma
Background Nasal brushing and nasal biopsy are well‐tolerated sampling techniques. Seasonal grass pollen‐induced rhinitis is characterized by epithelial mast cell infiltration and seasonal increases in both epithelial and sub‐mucosal eosinophils. Objective To compare the ability of the nasal brush and nasal biopsy techniques to detect natural seasonal increases in eosinophils and mast cells, and to assess the influence of topical corticosteroid. Methods Nasal brush samples and nasal biopsies were collected from 46 grass pollen‐sensitive seasonal rhinitis patients before the grass pollen season and at the peak of the pollen season following 6 weeks' treatment with either fluticasone propionate aqueous nasal spray (200 μg, twice daily) or placebo nasal spray. Results Placebo patients showed seasonal increases in epithelial eosinophils both with nasal brushing ( P < 0.0001) and biopsy ( P < 0.001). Epithelial mast cell numbers also increased during the pollen season as detectable by brushing ( P < 0.0001) and biopsy ( P < 0.03). Changes in cell numbers measured by nasal brushing correlated with those observed with nasal biopsy, both for eosinophils and mast cells ( P < 0.05). Sub‐mucosal eosinophils but not mast cells also increased during the pollen season ( P < 0.002). Nasal brushing and biopsy revealed that fluticasone treatment inhibited seasonal increases in epithelial eosinophils ( P < 0.00001) and epithelial infiltration by mast cells (nasal brushing P < 0.00001 and nasal biopsy P < 0.01). Fluticasone also inhibited seasonal increases in sub‐mucosal eosinophils ( P < 0.001) and significantly reduced nasal symptoms ( P < 0.001). Conclusion Nasal brushing harvests sufficient inflammatory cells from the surface of the nasal mucosa to be used in lieu of nasal biopsies in observation of the effect of drugs on the nasal epithelium.