The effects of histamine and leukotriene receptor antagonism on nasal mannitol challenge in allergic rhinitis.
OBJECTIVE
It is unclear as to which mediators are involved in mediating the response to nasal mannitol challenge, a novel osmotic stimulus.


METHODS
A double-blind, randomized, placebo-controlled, crossover design was employed. Nine patients with allergic rhinitis were randomized to receive a single-dose of desloratadine 5 mg, montelukast 10 mg or placebo, and underwent nasal mannitol challenges with nasal peak inspiratory flow recordings over 60 min. The change in peak nasal inspiratory flow was calculated as percentage change from baseline as the peak response and area under the time-response curve (AUC).


RESULTS
Desloratadine and montelukast conferred a significant degree of protection compared to placebo for peak and AUC response, but there were no significant differences between the two drugs. For the peak response as percentage fall, the mean difference (95% CI) vs placebo was 27.7 (8.0, 47.4)% for desloratadine and 17.6 (1.9, 33.3)% for montelukast.


CONCLUSIONS
Our results suggest that histamine and cysteinyl-leukotrienes are involved in mediating the response to nasal mannitol in allergic rhinitis.
Lee
Daniel K C
DK
Asthma & Allergy Research Group, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital & Medical School, University of Dundee, Dundee DD1 9SY, UK.
Haggart
Kay
K
Currie
Graeme P
GP
Anderson
Sandra D
SD
Lipworth
Brian J
BJ
D000085:Acetates / Q000627:therapeutic use*; D000328:Adult; D018592:Cross-Over Studies; D003521:Cyclopropanes; D004234:Diuretics, Osmotic; D004311:Double-Blind Method; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use*; D006801:Humans; D007320:Inspiratory Capacity / Q000187:drug effects; D017336:Loratadine / Q000031:analogs & derivatives / Q000627:therapeutic use*; D008353:Mannitol; D008875:Middle Aged; D009299:Nasal Provocation Tests; D011804:Quinolines / Q000627:therapeutic use*; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000188:drug therapy*; D013440:Sulfides
D000085:Acetates; D003521:Cyclopropanes; D004234:Diuretics, Osmotic; D039563:Histamine H1 Antagonists, Non-Sedating; D011804:Quinolines; D013440:Sulfides; D008353:Mannitol; D017336:Loratadine; C121345:desloratadine; C093875:montelukast