title: Effects of nasal corticosteroids on boosts of systemic allergen-specific IgE production induced by nasal allergen exposure.
abstract: BACKGROUND
  Allergen exposure via the respiratory tract and in particular via the nasal mucosa boosts systemic allergen-specific IgE production. Intranasal corticosteroids (INCS) represent a first line treatment of allergic rhinitis but their effects on this boost of allergen-specific IgE production are unclear.
  
  
  OBJECTIVE
  Here we aimed to determine in a double-blind, placebo-controlled study whether therapeutic doses of an INCS preparation, i.e., nasal fluticasone propionate, have effects on boosts of allergen-specific IgE following nasal allergen exposure.
  
  
  METHODS
  Subjects (n = 48) suffering from grass and birch pollen allergy were treated with daily fluticasone propionate or placebo nasal spray for four weeks. After two weeks of treatment, subjects underwent nasal provocation with either birch pollen allergen Bet v 1 or grass pollen allergen Phl p 5. Bet v 1 and Phl p 5-specific IgE, IgG1-4, IgM and IgA levels were measured in serum samples obtained at the time of provocation and one, two, four, six and eight weeks thereafter.
  
  
  RESULTS
  Nasal allergen provocation induced a median increase to 141.1% of serum IgE levels to allergens used for provocation but not to control allergens 4 weeks after provocation. There were no significant differences regarding the boosts of allergen-specific IgE between INCS- and placebo-treated subjects.
  
  
  CONCLUSIONS
  In conclusion, the application of fluticasone propionate had no significant effects on the boosts of systemic allergen-specific IgE production following nasal allergen exposure.
  
  
  BACKGROUND
  http://clinicaltrials.gov/NCT00755066.
authors.affiliation: Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Egger
authors.affiliation: Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Lupinek
authors.affiliation: Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
authors.forename: Robin
authors.initials: R
authors.lastname: Ristl
authors.affiliation: Department Vienna Challenge Chamber, Allergy Centre Vienna West, Vienna, Austria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lemell
authors.affiliation: Department Vienna Challenge Chamber, Allergy Centre Vienna West, Vienna, Austria.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Horak
authors.affiliation: Department Vienna Challenge Chamber, Allergy Centre Vienna West, Vienna, Austria.
authors.forename: Petra
authors.initials: P
authors.lastname: Zieglmayer
authors.affiliation: Department of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria.
authors.forename: Susanne
authors.initials: S
authors.lastname: Spitzauer
authors.affiliation: Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Valenta
authors.affiliation: Department of Otolaryngology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.
authors.forename: Verena
authors.initials: V
authors.lastname: Niederberger
mesh_terms: D000281:Administration, Intranasal; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D005260:Female; D000068298:Fluticasone / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D065631:Rhinitis, Allergic / Q000188:drug therapy* / Q000276:immunology
chemical_list: D000305:Adrenal Cortex Hormones; D018926:Anti-Allergic Agents; D007073:Immunoglobulin E; D000068298:Fluticasone