Segundo Gesmar Rs, Gomes Fabíola A, Fernandes Karla P, Alves Ronaldo, Silva Deise Ao, Taketomi Ernesto A
Department of Pediatrics.
Biologics. 2009;3:469-74. doi: 10.2147/btt.2009.3595. Epub 2009 Oct 12.
Therapy for allergic rhinitis aims to control symptoms and improve the quality of life. The treatment of allergic rhinitis includes allergen avoidance, environmental controls, pharmacologic treatment, and specific immunotherapy.
The aim of this study is to evaluate the clinical changes and the levels of interferon-gamma (IFN-gamma) and interleukin-5 (IL-5) in nasal lavage fluid from children with allergic rhinitis after different types of pharmacologic treatment (mometasone, montelukast, or desloratadine).
Twenty-four children aged from six to 12 years with moderate persistent allergic rhinitis were randomized into three groups receiving monotherapy treatment over four weeks: nasal corticosteroid (mometasone), leukotriene modifier (montelukast), or antihistamine (desloratadine). The perception of symptom improvement during the medication use was evaluated at the end of the treatment. Samples of nasal lavage fluid were collected before and after treatment for measuring IFN-gamma and IL-5 cytokines by ELISA.
All parents perceived an improvement in symptoms. Significant enhancement was seen in the mometasone group compared to those with montelukast (P = 0.01) and desloratadine (P = 0.02). No significant differences were found among the three groups in the levels of IL-5 and IFN-gamma in nasal fluid at baseline or after treatment. Only the group treated with mometasone showed a slight but significant reduction in IL-5 levels after the treatment period as compared with levels before the treatment (P = 0.0469).
The group treated with mometasone showed better improvement of clinical symptoms and a slight reduction in IL-5 levels in the nasal fluid. This may indirectly reflect the relative immunomodulatory effects of the drugs tested.
过敏性鼻炎的治疗旨在控制症状并提高生活质量。过敏性鼻炎的治疗包括避免接触过敏原、环境控制、药物治疗和特异性免疫疗法。
本研究旨在评估不同类型药物治疗（莫米松、孟鲁司特或地氯雷他定）后过敏性鼻炎患儿鼻灌洗液中干扰素-γ（IFN-γ）和白细胞介素-5（IL-5）的水平及临床变化。
将24名6至12岁的中度持续性过敏性鼻炎患儿随机分为三组，接受为期四周的单一疗法治疗：鼻用糖皮质激素（莫米松）、白三烯调节剂（孟鲁司特）或抗组胺药（地氯雷他定）。在治疗结束时评估用药期间症状改善的感知情况。在治疗前后收集鼻灌洗液样本，通过酶联免疫吸附测定法（ELISA）测量IFN-γ和IL-5细胞因子。
所有家长均察觉到症状有所改善。与孟鲁司特组（P = 0.01）和地氯雷他定组（P = 0.02）相比，莫米松组症状改善显著。三组在基线或治疗后鼻液中IL-5和IFN-γ水平上均未发现显著差异。仅莫米松治疗组在治疗期后与治疗前相比，IL-5水平有轻微但显著的降低（P = 0.0469）。
莫米松治疗组临床症状改善更佳，鼻液中IL-5水平略有降低。这可能间接反映了所测试药物的相对免疫调节作用。
