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Effect of intranasal fluticasone proprionate on the immediate and late allergic reaction and nasal hyperreactivity in patients with a house dust mite allergy
Author(s) -
GRAAFIN'T VELD C.,
GARRELDS I. M.,
JANSEN A. P. H.,
TOORENENBERGEN A. W.,
MULDER P. G. H.,
MEEUWIS J.,
WIJK R. GERTH
Publication year - 1995
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 - 10.1111/j.1365-2222.1995.tb00399.x
Subject(s) - medicine , fluticasone propionate , house dust mite , histamine , allergy , fluticasone , nasal administration , placebo , nasal spray , nasal provocation test , eosinophil cationic protein , immunology , allergen , eosinophil , asthma , pathology , alternative medicine
Summary Background Patients with perennial allergic rhinitis develop nasal symptoms not only after allergen exposure, but generally also after non‐specific stimuli. Objective To evaluate the effect of 2 week's treatment with fluticasone propionate aqueous nasal spray (FPANS) on the nasal clinical response, inflammatory mediators and nasal hyperreactivity. Methods Twenty‐four rhinitis patients allergic to house dust mite (HDM). participated in a douhle‐blind. placebo‐controlled crossover study. After 2 week's treatment with placebo or 200 μg FPANS twice daily, patients were challenged with HDM extract. Symptoms were recorded and nasal lavages were collected for up to 9.5 h after challenge. Nasal hyperreaclivity was determined by histamine challenge 24 h later. Results Because of a carry‐over effect for the immediate symptom score, for this variable only the data from the first treatment period were used. FPANS treatment resulted in a significant decrease of nasal symptoms with 70%. 69% and 63% after 100. 1000 and 10000 Biological Units (BU)/mL of HDM extract respectively. Active treatment resulted in a 76% decrease of the late‐phase symptoms. FPANS treatment significantly reduced albumin influx after HDM 1000 BU/mL with 62% and tended to reduce tryptase release after HDM 1000 BU ml. ( P 0.0629). During the late phase FPANS treatment reduced albumin influx with 67% and eosinophil cationic protein (ECP) release with 83%. No effect of FPANS was seen on histamine levels. FPANS significantly decreased histamine‐induced symptom score with 34%, secretion with 32%, and sneezes with 41%. Conclusion FPANS significantly inhibits the immediate and late allergic response, and nasal hyperreactivity, probably by suppressing mast cells and eosinophils in the nasal mucosa.