[Relationship between nasal discharge eosinophils and responses to treatment of inhaled glucocorticosteroid in patients with allergic rhinitis].
OBJECTIVE
To evaluate the treatment responses of persistent allergic rhinitis with and without nasal discharge eosinophilia (EOS) to inhaled glucocorticosteroid (CS), and therefore to verify whether low nasal discharge eosinophils predict poor response to treatment with CS.


METHODS
Forty-two symptomatic allergic rhinitis patients, who had not received CS therapy in three months preceding the study, were examined before and 2 month,4 months and 6 months after treatment with CS. At each visit, all patients underwent symptom scoring and physical sign scoring. The level of eosinophil cationic protein (ECP) in the nasal discharge supernatants was measured by radioimmunoassay. The patients were divided into 2 groups according to nasal discharge EOS percentages, an EOS group (group A, EOS > or = 0.03) and a non-EOS group (group B, EOS < 0.03). The response to CS therapy (as measured by symptom and physical sign scores) and the changes of nasal discharge measurements were compared between the 2 groups.


RESULTS
In the group A, the baseline EOS [0.086 (0.065; 0.176)] and ECP level [(326 +/- 145) microg/L] were significantly higher than those of the group B [0.016 (0.005; 0.022)] and ECP level (154 +/- 58) microg/L], respectively, t = 4.40, 3.33, both, all P < 0.01. After 2 month and 6 months CS therapy, the nasal discharge EOS, ECP pred were 0.038 (0.006; 0.070), 0.019 (0.010; 0.060), (175 +/- 122) microg/L, (175 +/- 153) microg/L, respectively in the EOS group, which were significantly different as compared to baseline values (F = 6.73, 7.38, respectively, all P < 0.05). But in the non-EOS group, the nasal discharge EOS ECP pred were 0.014 (0.004; 0.032), 0.015 (0.000; 0.026), (118 +/- 60) microg/L, (112 +/- 60) microg/L, respectively at 2 and 6 months, which showed that the the nasal discharge EOS pred and the symptom and physical sign scores improved did not change (F = 0.82, P > 0.05), but the ECP level improved (F = 3.78, P < 0.05). and the average daily dose of CS wear not different between the two groups at any visits.


CONCLUSIONS
In persistent allergic rhinitis with low nasal discharge EOS, CS therapy for 6 months failed to improve symptom and physical sign.
Luo
Hong
H
Department of Otorhinolaryngology, Affiliated Xiangfan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology. Hubei 441021, China.
Yan
Neng-bing
NB
Liu
Jun
J
Tao
Ze-zhang
ZZ
Zeng
Ping-fan
PF
Jiang
Yan
Y
Yu
Ye
Y
Wang
Peng-ju
PJ
Kong
Wei-jia
WJ
D000280:Administration, Inhalation; D000328:Adult; D012634:Bodily Secretions / Q000378:metabolism*; D047150:Eosinophil Cationic Protein / Q000378:metabolism; D004804:Eosinophils / Q000276:immunology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000378:metabolism*; D016896:Treatment Outcome
D005938:Glucocorticoids; D047150:Eosinophil Cationic Protein