Intranasal mometasone furoate reduces late-phase inflammation after allergen challenge.
BACKGROUND
Allergen specific nasal challenge (ASNC) is an optimal model to study the pathophysiologic mechanisms sustaining allergic inflammation, particularly the adhesion molecules promoting cellular infiltration of nasal mucosa. Topical corticosteroids have been accepted as a highly effective anti-inflammatory therapy for allergic rhinitis.


OBJECTIVE
The aim of this double-blind, randomized, placebo-controlled study was the evaluation of inflammatory events, during the late-phase, after a 2-week treatment with nasal mometasone furoate (MF), 200 microg daily, or placebo, using the model of ASNC.


METHODS
A total of 42 patients with allergic rhinitis underwent nasal challenge before and after treatment. The following parameters were evaluated at baseline, and 6 hours (late-phase) after ASNC: 1) nasal symptoms (rhinorrhea, itching, sneezing, obstruction); 2) inflammatory cells (eosinophils and neutrophils); 3) eosinophil cationic protein (ECP) and tumor necrosis factor-alpha (TNF-alpha) in nasal lavage; and 4) intercellular adhesion molecule-1 expression on nasal epithelial cells.


RESULTS
MF nasal spray was associated with late-phase reductions of: 1) clinical symptoms (P < 0.03); 2) eosinophil (P < 0.004) and neutrophil (P < 0.003) infiltration; 3) ECP (P < 0.001) and TNF-alpha (P < 0.05); and 4) intercellular adhesion molecule-1 expression on nasal epithelial cells (P < 0.001).


CONCLUSIONS
The present results demonstrate that MF has a significant effect on late-phase events, reducing the cellular influx and activation.
Ciprandi
G
G
Allergy & Respiratory Diseases, Department of Internal Medicine, University of Genoa, Italy. giocip@unige.it
Tosca
M A
MA
Passalacqua
G
G
Canonica
G W
GW
D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D000485:Allergens; D018926:Anti-Allergic Agents / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001798:Blood Proteins / Q000096:biosynthesis; D004311:Double-Blind Method; D047091:Eosinophil Granule Proteins; D004802:Eosinophilia / Q000276:immunology; D004804:Eosinophils / Q000276:immunology; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000096:biosynthesis; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D017817:Nasal Lavage Fluid / Q000276:immunology; D009297:Nasal Mucosa / Q000276:immunology; D009299:Nasal Provocation Tests; D009504:Neutrophils; D011244:Pregnadienediols / Q000008:administration & dosage* / Q000627:therapeutic use; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000276:immunology*; D012260:Ribonucleases; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis
D000485:Allergens; D018926:Anti-Allergic Agents; D000893:Anti-Inflammatory Agents; D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D011244:Pregnadienediols; D014409:Tumor Necrosis Factor-alpha; D000068656:Mometasone Furoate; D018799:Intercellular Adhesion Molecule-1; D012260:Ribonucleases