Wang J H, Devalia J L, Rusznak C, Bagnall A, Sapsford R J, Davies R J
Academic Department of Respiratory Medicine, St Bartholomew's and the Royal London School of Medicine and Dentistry, The London Chest Hospital, UK.
Clin Exp Allergy. 1999 Feb;29(2):234-40. doi: 10.1046/j.1365-2222.1999.00440.x.
The authors have recently demonstrated that prior exposure for 6 h to 400 p.p.b. nitrogen dioxide significantly enhances the early phase response of eosinophils in the nasal airways of allergic rhinitics to subsequent allergen provocation.
To investigate whether treatment with fluticasone propionate aqueous nasal spray (FP) can alter the inflammatory response in the nasal airways under these conditions.
Sixteen allergic, rhinitic patients were recruited for this double-blind, randomized, cross-over study and received either topical FP 200 microg once daily or matched placebo for 4 weeks. At the end of treatment, all underwent nasal lavage followed by a 6 h exposure to 400 p.p.b. NO2. Following exposure to NO2, nasal allergen challenge was performed and nasal lavage repeated. After a 4 week washout period, patients were given alternate treatment and tested as above.
Analysis of eosinophil cationic protein (ECP) in lavage samples from patients treated with placebo, demonstrated that this was significantly increased from a median value of 2.3 ng/mL (range: 1.0-7.1) to 15.1 ng/mL (range: 1.5-40.0; P = 0.001) following exposure to NO2 and allergen challenge. However, in patients treated with FP, ECP concentrations only increased from 3.3 ng/mL (range: 0.2-9.2) to 5.1 ng/mL (range: 0.3-20.0; P = 0.034) following exposure to NO2 and allergen challenge. The difference of the changes in ECP concentration between the placebo and the FP-treated group was significant (P = 0.003). Similarly, there was a significant increase in the number of eosinophils in nasal lavage after exposure to NO2 and allergen challenge in the placebo group, and this increase was inhibited in FP group (P = 0.002).
These results suggest that FP influences NO2- and allergen-induced changes in eosinophil function, as well as eosinophil number in the nasal airway of allergic rhinitics.
作者最近证明，预先暴露于400 ppm的二氧化氮6小时可显著增强变应性鼻炎患者鼻气道中嗜酸性粒细胞对后续过敏原激发的早期反应。
研究丙酸氟替卡松水性鼻喷雾剂（FP）治疗能否在这些条件下改变鼻气道中的炎症反应。
招募16名变应性鼻炎患者进行这项双盲、随机、交叉研究，患者每天接受一次200微克的局部FP治疗或匹配的安慰剂治疗，为期4周。治疗结束时，所有患者均进行鼻腔灌洗，然后暴露于400 ppm的二氧化氮中6小时。暴露于二氧化氮后，进行鼻腔过敏原激发试验并重复鼻腔灌洗。经过4周的洗脱期后，患者接受交替治疗并按上述方法进行检测。
对接受安慰剂治疗患者的灌洗样本中的嗜酸性粒细胞阳离子蛋白（ECP）进行分析，结果表明，暴露于二氧化氮和过敏原激发后，ECP从中位数2.3 ng/mL（范围：1.0 - 7.1）显著增加至15.1 ng/mL（范围：1.5 - 40.0；P = 0.001）。然而，在接受FP治疗的患者中，暴露于二氧化氮和过敏原激发后，ECP浓度仅从3.3 ng/mL（范围：0.2 - 9.2）增加至5.1 ng/mL（范围：0.3 - 20.0；P = 0.034）。安慰剂组和FP治疗组之间ECP浓度变化的差异具有显著性（P = 0.003）。同样，安慰剂组暴露于二氧化氮和过敏原激发后鼻腔灌洗中嗜酸性粒细胞数量显著增加，而这种增加在FP组中受到抑制（P = 0.002）。
这些结果表明，FP会影响变应性鼻炎患者鼻气道中二氧化氮和过敏原诱导的嗜酸性粒细胞功能变化以及嗜酸性粒细胞数量。
