Effect of intranasal fluticasone proprionate on the immediate and late allergic reaction and nasal hyperreactivity in patients with a house dust mite allergy
Article first published online: 27 APR 2006
Clinical & Experimental Allergy
Volume 25, Issue 10, pages 966–973, October 1995
How to Cite
DE GRAAF-IN'T VELD, C., GARRELDS, I. M., JANSEN, A. P. H., VAN TOORENENBERGEN, A. W., MULDER, P. G. H., MEEUWIS, J. and VAN WIJK, R. G. (1995), Effect of intranasal fluticasone proprionate on the immediate and late allergic reaction and nasal hyperreactivity in patients with a house dust mite allergy. Clinical & Experimental Allergy, 25: 966–973. doi: 10.1111/j.1365-2222.1995.tb00399.x
- Issue published online: 27 APR 2006
- Article first published online: 27 APR 2006
- Submitted 19 July 1994; revised 7 April 1995; accepted 28 April 1995.
- fluticasone propionate;
- perennial allergic rhinits;
- house dust mite;
- nasal lavage;
- inflammatory mediators;
- early allergic response;
- late allergic response;
- nasal hyperreactivity
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.