Ciprandi G, Tosca M A, Passalacqua G, Canonica G W
Allergy & Respiratory Diseases, Department of Internal Medicine, University of Genoa, Italy.
Ann Allergy Asthma Immunol. 2001 Apr;86(4):433-8. doi: 10.1016/S1081-1206(10)62491-X.
Allergen specific nasal challenge (ASNC) is an optimal model to study the pathophysiologic mechanisms sustaining allergic inflammation, particularly the adhesion molecules promoting cellular infiltration of nasal mucosa. Topical corticosteroids have been accepted as a highly effective anti-inflammatory therapy for allergic rhinitis.
The aim of this double-blind, randomized, placebo-controlled study was the evaluation of inflammatory events, during the late-phase, after a 2-week treatment with nasal mometasone furoate (MF), 200 microg daily, or placebo, using the model of ASNC.
A total of 42 patients with allergic rhinitis underwent nasal challenge before and after treatment. The following parameters were evaluated at baseline, and 6 hours (late-phase) after ASNC: 1) nasal symptoms (rhinorrhea, itching, sneezing, obstruction); 2) inflammatory cells (eosinophils and neutrophils); 3) eosinophil cationic protein (ECP) and tumor necrosis factor-alpha (TNF-alpha) in nasal lavage; and 4) intercellular adhesion molecule-1 expression on nasal epithelial cells.
MF nasal spray was associated with late-phase reductions of: 1) clinical symptoms (P < 0.03); 2) eosinophil (P < 0.004) and neutrophil (P < 0.003) infiltration; 3) ECP (P < 0.001) and TNF-alpha (P < 0.05); and 4) intercellular adhesion molecule-1 expression on nasal epithelial cells (P < 0.001).
The present results demonstrate that MF has a significant effect on late-phase events, reducing the cellular influx and activation.
变应原特异性鼻激发试验（ASNC）是研究维持变应性炎症病理生理机制的最佳模型，尤其是促进鼻黏膜细胞浸润的黏附分子。局部用皮质类固醇已被公认为是治疗变应性鼻炎的一种高效抗炎疗法。
本双盲、随机、安慰剂对照研究的目的是，使用ASNC模型评估在使用糠酸莫米松（MF）每日200微克或安慰剂进行2周治疗后的晚期炎症事件。
共有42例变应性鼻炎患者在治疗前后接受鼻激发试验。在基线时以及ASNC后6小时（晚期）评估以下参数：1）鼻部症状（流涕、瘙痒、打喷嚏、鼻塞）；2）炎症细胞（嗜酸性粒细胞和中性粒细胞）；3）鼻灌洗液中的嗜酸性粒细胞阳离子蛋白（ECP）和肿瘤坏死因子-α（TNF-α）；4）鼻上皮细胞上细胞间黏附分子-1的表达。
MF鼻喷雾剂与晚期以下各项的减轻有关：1）临床症状（P<0.03）；2）嗜酸性粒细胞浸润（P<0.004）和中性粒细胞浸润（P<0.003）；3）ECP（P<0.001）和TNF-α（P<0.05）；4）鼻上皮细胞上细胞间黏附分子-1的表达（P<0.001）。
目前的结果表明，MF对晚期事件有显著影响，可减少细胞流入和激活。
