A comparison of the anti-inflammatory properties of intranasal corticosteroids and antihistamines in allergic rhinitis.
Allergic rhinitis manifests itself clinically due to the local release of mediators from activated cells within the nasal mucosa. Treatment strategies aim either to reduce the effects of these mediators on the sensory neural and vascular end organs, or to reduce the tissue accumulation of the activated cells that generate them. Corticosteroids intervene at a number of steps in the inflammatory pathway, and, by reducing the release of cytokines and chemokines, inhibit cell recruitment and activation. These effects are evident both in vivo and in vitro. While antihistamines also have some anti-inflammatory effects in vitro, these require higher concentrations than with corticosteroids and are not consistently reproduced in vivo. In addition, although antihistamines and corticosteroids might appear to have complementary mechanisms of action, clinical trials suggest that their co-administration does not confer any additional long-term benefits compared with that achieved with corticosteroids alone. Topical corticosteroids are therefore the preferred anti-inflammatory therapy for persistent allergic rhinitis.
Division of Respiratory Cell and Molecular Biology Research, University of Southampton School of Medicine, UK.
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Howarth
D000281:Administration, Intranasal; D000730:Androstadienes / Q000494:pharmacology / Q000627:therapeutic use*; D018926:Anti-Allergic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015550:Cell Degranulation / Q000187:drug effects; D016207:Cytokines / Q000378:metabolism; D000068298:Fluticasone; D006634:Histamine H1 Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008407:Mast Cells / Q000187:drug effects / Q000276:immunology; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology
D000730:Androstadienes; D018926:Anti-Allergic Agents; D000893:Anti-Inflammatory Agents; D016207:Cytokines; D006634:Histamine H1 Antagonists; D000068298:Fluticasone