An evaluation of short-term corticosteroid response in perennial allergic rhinitis using histamine and adenosine monophosphate nasal challenge.
OBJECTIVE
To evaluate the role of AMP nasal challenge as a measure of short-term treatment response in patients receiving intranasal corticosteroids. Adenosine monophosphate (AMP) challenge has been shown to be a good inflammatory surrogate in the lower airways, but it has not been properly evaluated as a nasal challenge test.


METHODS
Fourteen patients with perennial allergic rhinitis (PAR) were randomized to receive 2 weeks treatment with placebo (PL) or 200 microg intranasal mometasone furoate (MF) once daily in a randomized single-blind crossover study. AMP (25-800 mg ml-1) and histamine (0.25-8 mg ml-1) nasal challenge testing were performed after each treatment period with 30% decrease in minimal cross-sectional area (MCA). Domiciliary symptom data were collected.


RESULTS
There was a significant (P < 0.05) improvement in PC30 MCA and nasal volume with AMP but not with histamine comparing MF vs PL. This amounted to a 2.8 (95% CI 1.5, 4.0) and 0.7 (95% CI -0.5, 1.9) doubling-dose change for AMP and histamine challenges, respectively. There were significant (P < 0.05) improvements in nasal symptoms and quality of life.


CONCLUSIONS
AMP nasal challenge using acoustic rhinometry may be a useful test to assess short-term treatment response in patient with PAR.
Wilson
Andrew M
AM
Asthma & Allergy Research Group, Ninewells Hospital & Medical School, University of Dundee, Dundee DD1 9SY, Scotland, UK.
Sims
Erika J
EJ
Orr
Linda C
LC
Robb
Fiona
F
Lipworth
Brian J
BJ
D000249:Adenosine Monophosphate; D000287:Administration, Topical; D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids; D006632:Histamine; D006801:Humans; D008297:Male; D000068656:Mometasone Furoate; D009299:Nasal Provocation Tests; D011244:Pregnadienediols / Q000008:administration & dosage*; D012129:Respiratory Function Tests; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D016037:Single-Blind Method
D018926:Anti-Allergic Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011244:Pregnadienediols; D000068656:Mometasone Furoate; D000249:Adenosine Monophosphate; D006632:Histamine