Effects of intranasal corticosteroid on nasal adenosine monophosphate challenge in persistent allergic rhinitis.
BACKGROUND
Response to a single dose nasal adenosine monophosphate challenge has been used as a surrogate inflammatory marker for allergic rhinitis. Attenuation of response following intranasal corticosteroid would further validate the challenge.


OBJECTIVE
To assess the effect of 4 weeks of 200 mcg once daily mometasone furoate nasal spray on a simplified (single 160 mg dose) nasal adenosine monophosphate challenge.


METHODS
Twenty participants with persistent allergic rhinitis completed a double blind placebo-controlled crossover study. Outcome measures were the peak nasal inspiratory flow and total nasal symptoms score responses to nasal adenosine monophosphate challenge, as well as domiciliary peak nasal inspiratory flow and patient symptom diary cards.


RESULTS
Mometasone significantly (P < 0.05) attenuated response time profiles vs. placebo for peak nasal inspiratory flow but not total nasal symptom scores. For the maximum percentage fall this amounted to a mean difference of 9.6% (95% confidence interval 1.3-17.9%). The coefficient of variation for repeatability was 48.7%. Improvements were seen in prechallenge and domiciliary measurements of peak nasal inspiratory flow (both P < 0.05) and total nasal symptom scores (both P < 0.01).


CONCLUSIONS
Mometasone attenuates the peak nasal inspiratory flow response to a single 160 mg nasal adenosine monophosphate challenge. Such challenges have been shown to be sensitive to the effects of antihistamines, antileukotrienes and now nasal steroids. This further supports their application as surrogate inflammatory markers for therapeutic trials in allergic rhinitis, potentially as 20 min challenges which can be conducted in a non-hospital setting.
Barnes
M L
ML
The Asthma and Allergy Research Group, The University of Dundee, Dundee, UK.
Biallosterski
B T
BT
Fujihara
S
S
Gray
R D
RD
Fardon
T C
TC
Lipworth
B J
BJ
D000249:Adenosine Monophosphate / Q000008:administration & dosage; D000281:Administration, Intranasal; D000293:Adolescent; D018926:Anti-Allergic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D000068656:Mometasone Furoate; D009299:Nasal Provocation Tests; D011244:Pregnadienediols / Q000008:administration & dosage* / Q000009:adverse effects; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
D018926:Anti-Allergic Agents; D011244:Pregnadienediols; D000068656:Mometasone Furoate; D000249:Adenosine Monophosphate