title: Immediate effect of topical budesonide on allergen challenge-induced nasal mucosal fluid levels of granulocyte-macrophage colony-stimulating factor and interleukin-5.
abstract: The nasal antiinflammatory effects produced by maintenance treatment with topical steroids include reduced production of cytokines. The present study explored nasal mucosal effects induced during the first 9 h after a single dose of topical budesonide. Nine subjects with allergic rhinitis due to birch or timothy pollen were given budesonide (256 microg; Rhinocort Aqua) or placebo in a double-blind, randomized, crossover (4 wk washout) manner. Nasal allergen challenges were performed 30 min after the steroid/placebo pretreatment. Before and 30 min, 1, 3, 5, 7, and 9 h after challenge, filter paper strips were placed on the nasal septum and inferior turbinates for 10 min to sample undiluted mucosal fluids. Strips were then extracted in 1 ml buffer for cytokine analysis (ELISA). Allergen challenge produced acute nasal symptoms that peaked at 30 min and then tapered off. Conversely, both GM-CSF and IL-5 were increased only at 3, 5, 7 and 9 h (p < 0.05 compared with baseline). Budesonide did not affect the nasal symptoms but inhibited (p < 0. 05; compared with placebo treatment) the allergen challenge-induced mucosal output of GM-CSF and IL-5. These data demonstrate that GM-CSF and IL-5 are induced in a nonsymptomatic, late phase response to nasal allergen challenge, and that this cytokine response is prevented by single dose budesonide pretreatment.
authors.affiliation: Experimental Medicine, AstraZeneca R&D, Lund, Sweden. margareta.linden@astrazeneca.com
authors.forename: M
authors.initials: M
authors.lastname: Linden
authors.forename: C
authors.initials: C
authors.lastname: Svensson
authors.forename: E
authors.initials: E
authors.lastname: Andersson
authors.forename: M
authors.initials: M
authors.lastname: Andersson
authors.forename: L
authors.initials: L
authors.lastname: Greiff
authors.forename: C G
authors.initials: CG
authors.lastname: Persson
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000485:Allergens; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D019819:Budesonide / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000378:metabolism*; D006801:Humans; D015848:Interleukin-5 / Q000378:metabolism*; D008297:Male; D009297:Nasal Mucosa / Q000378:metabolism*; D009299:Nasal Provocation Tests; D011058:Pollen; D006255:Rhinitis, Allergic, Seasonal / Q000378:metabolism*
chemical_list: D000485:Allergens; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D015848:Interleukin-5; D019819:Budesonide; D016178:Granulocyte-Macrophage Colony-Stimulating Factor