Endonasal phototherapy significantly alleviates symptoms of allergic rhinitis, but has a limited impact on the nasal mucosal immune cells.
The literature documents the fact that UV irradiation of cutaneous Langerhans cells (LC) in vivo prevents the development of contact allergy and produces long-lasting immunosuppression. However, not much is known about the effect of UV irradiation on the LC of the nasal mucosa and their connection with clinical scores. Local antigen presentation may be necessary for both primary and recall T cell responses to birch pollen in patients with hay fever. Endonasal phototherapy combination of UVB (5%), UVA (25%) and visible light (70%) utilises the immunosuppressive effects of UV irradiation. The aim of this study was to correlate clinical symptom scores with possible changes in the LC of the nasal mucosa induced by UV radiation. The clinical effectiveness of this form of treatment is discussed. Nasal biopsies were obtained from ten birch pollen-sensitive patients with seasonal rhinitis before and after endonasal phototherapy. All patients showed a significant clinical benefit post-treatment as assessed by standardised instruments, including total nasal symptom score, nasal congestion score, nasal itching score, sneezing score, nasal secretion score and impairment-to-health score. However, we found no significant morphological changes, to, or quantitative differences in, the CD1a+, CD4, CD8 or CD31 cells before and 14 days after treatment. Despite the positive clinical effect, the study revealed no effect of UV irradiation on the LC and other analysed cells of the nasal mucosa immune system. Possible reasons for this are discussed.
Brehmer
Detlef
D
Faculty of Medicine, University Witten/Herdecke, Friedrichstr. ¾, 37073 Göttingen, Germany. d.brehmer@hno-praxis-goettingen.de
Schön
Michael P
MP
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007111:Immunity, Cellular; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000276:immunology* / Q000473:pathology; D009666:Nose; D010789:Phototherapy / Q000379:methods*; D011058:Pollen / Q000276:immunology*; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology*; D055815:Young Adult
Eur J Immunol. 1995 Oct;25(10):2858-62
7589083
Allergy. 2006 Feb;61(2):166-72
16409191
Clin Dermatol. 2003 Sep-Oct;21(5):398-406
14678720
Eur Arch Otorhinolaryngol. 2009 Dec;266(12):1903-8
19626333
Allergy. 2008 Apr;63 Suppl 86:8-160
18331513
Ther Adv Respir Dis. 2010 Aug;4(4):209-13
20587541
Acta Otolaryngol. 1991;111(5):946-53
1759583
Rhinology. 1988 Dec;26(4):293-5
3238285
J Allergy Clin Immunol. 2003 Jul;112(1):141-8
12847491
J Exp Med. 1983 Sep 1;158(3):781-94
6193234
J Invest Dermatol. 1981 Mar;76(3):202-10
6453905
Proc Natl Acad Sci U S A. 1992 Sep 15;89(18):8497-501
1382291
Allergy. 1989 Apr;44(3):167-72
2469344
Expert Rev Med Devices. 2010 Jan;7(1):21-6
20021238
J Allergy Clin Immunol. 2005 Mar;115(3):541-7
15753902
J Invest Dermatol. 1998 Sep;111(3):373-9
9740226
J Invest Dermatol. 1995 Jul;105(1 Suppl):30S-36S
7615994
J Invest Dermatol. 2002 May;118(5):812-7
11982758
Photodermatol Photoimmunol Photomed. 2005 Jun;21(3):118-24
15888127
Br J Dermatol. 1993 Dec;129(6):674-7
7506927
Allergy. 2007 Mar;62(3):317-24
17298350
J Natl Cancer Inst. 1974 Nov;53(5):1333-6
4139281
J Dermatol. 1995 Nov;22(11):876-87
8557861
Allergy. 2001 Feb;56(2):126-31
11167372
Cell Immunol. 1995 Aug;164(1):65-72
7634352
Clin Exp Allergy. 1996 Jun;26(6):677-88
8809425
J Allergy Clin Immunol. 2006 Nov;118(5):1117-25
17088138
J Invest Dermatol. 1992 Jun;98(6 Suppl):66S-69S
1588126
J Am Acad Dermatol. 2002 Jun;46(6):926-30
12063493