Allergen-induced changes in the nasal mucous membrane in seasonal allergic rhinitis: effect of nedocromil sodium.
We have obtained biopsy specimens of the nasal mucous membrane before and during the grass-pollen season in 22 patients with seasonal allergic rhinitis to grass pollen to assess the effects on cellular infiltration of natural exposure to allergen. Biopsy sections were examined by light microscopy, and quantitative assessment was made of numbers of mast cells and eosinophils. The patients were divided into 11 who were treated with placebo and 11 patients who were treated with topical nedocromil sodium. In the group as a whole, there was a significant (p less than 0.001) increase in mast cell density in tissue sections from biopsy specimens obtained during the season compared with out of season (median values, 55.0 and 15.5 cells per square millimeter, respectively). There was also a significant (p less than 0.02) increase in the density of eosinophil infiltration during the season compared with out of season (median values, 6.3 and 0 cells per square millimeter, respectively). Treatment with nedocromil sodium significantly (p less than 0.02) inhibited the accumulation of mast cells but not eosinophils. Compared with the placebo-treated group, the group treated with nedocromil demonstrated a significant (p less than 0.025) reduction in the requirements for treatment with concomitant medication (terfenadine tablets and xylometazoline/antazoline eye drops). These results indicate that natural exposure to allergen in patients with seasonal allergic rhinitis is accompanied by infiltration of mast cells and eosinophils into the nasal mucous membrane. The clinical efficacy of nedocromil sodium in this condition may be related to inhibition of infiltration by mast cells.
Lozewicz
S
S
Department of Respiratory Medicine, St. Bartholomew's Hospital, London, England.
Gomez
E
E
Clague
J
J
Gatland
D
D
Davies
R J
RJ
D000328:Adult; D000485:Allergens / Q000276:immunology*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001706:Biopsy; D002908:Chronic Disease; D004341:Drug Evaluation; D004804:Eosinophils / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D004848:Epithelium / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D008297:Male; D008407:Mast Cells / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D009297:Nasal Mucosa / Q000187:drug effects / Q000276:immunology* / Q000473:pathology; D017835:Nedocromil; D015363:Quinolones / Q000008:administration & dosage / Q000627:therapeutic use*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology
D000485:Allergens; D000894:Anti-Inflammatory Agents, Non-Steroidal; D015363:Quinolones; D017835:Nedocromil