title: The effect of budesonide on the cytokine pattern in patients with perennial allergic rhinitis.
abstract: BACKGROUND
  A T(H)2-polarized cytokine pattern has been demonstrated in allergic rhinitis. Budesonide represents an effective topical corticosteroid in the management of allergic rhinitis.
  
  
  OBJECTIVE
  To evaluate cytokine pattern and symptoms in patients with perennial allergic rhinitis before and after treatment with intranasal budesonide.
  
  
  METHODS
  All patients received budesonide aqueous nasal spray or placebo for 2 weeks. The study was double-blind, parallel group, placebo controlled, and randomized. Nasal lavage was performed in all patients before and after treatment. A panel of cytokines, including interleukin 4 (IL-4), IL-5, and IL-6, was measured by immunoassay on fluids recovered from nasal lavage. Total symptom score (including rhinorrhea, nasal itching, sneezing, and nasal obstruction) was evaluated before and after treatment.
  
  
  RESULTS
  Twenty patients with perennial allergic rhinitis were evaluated (13 men and 7 women; mean age, 24.7 years). Budesonide aqueous nasal spray treatment showed a significant decrease of IL-4 (P = .007), IL-5 (P = .04), and IL-6 levels (P = .009). Budesonide aqueous nasal spray treatment also induced significant symptom relief (P = .006). Placebo treatment did not significantly affect the evaluated parameters.
  
  
  CONCLUSIONS
  This study shows that budesonide aqueous nasal spray is effective in exerting immunomodulatory activity by reducing cytokine pattern and relieving symptoms. These findings are evidence of the effects of intranasal budesonide in treating perennial allergic rhinitis.
authors.affiliation: Allergologia-U. O. ORL, Dipartimento Regionale Testa-Collo, Padiglione Specialità (Piano Terzo), Ospedale San Martino, Genoa, Italy. gio.cip@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Tosca
authors.forename: Ignazio
authors.initials: I
authors.lastname: Cirillo
authors.forename: Andrea
authors.initials: A
authors.lastname: Vizzaccaro
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D016207:Cytokines / Q000187:drug effects* / Q000378:metabolism*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015847:Interleukin-4 / Q000378:metabolism; D015848:Interleukin-5 / Q000378:metabolism; D008297:Male; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000378:metabolism*; D012621:Seasons; D012720:Severity of Illness Index; D013223:Statistics as Topic; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D016207:Cytokines; D015848:Interleukin-5; D015847:Interleukin-4; D019819:Budesonide