Manuyakorn Wiparat, Klangkalya Natchanun, Kamchaisatian Wasu, Benjaponpita Suwat, Sasisakulporn Cherapat, Jotikasthira Wanlapa
Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Allergy Asthma Immunol Res. 2017 Sep;9(5):446-452. doi: 10.4168/aair.2017.9.5.446.
Nasal Cellulose Powder (NCP), which can prevent from binding an allergen to nasal mucosa, may reduce allergic rhinitis (AR) symptoms in dust mite-sensitized children. This study was conducted to assess the efficacy of NCP in improving clinical symptoms of a nasal airflow limitation and the response of nasal inflammatory cells.
Children with dust mite-sensitized AR aged 6-18 years were recruited. After a 4-week run-in period, NCP or a placebo was administered, 1 puff per nostril 3 times daily for 4 weeks. The nasal provocation test (NPT) with Dermatophagoides pteronyssinus (Der p) was performed before and after treatment. The daily symptom scores (DSS), daily medication scores (DMS), the peak nasal inspiratory flows (PNIF), nasal airway resistance (NAR), as well as the maximum tolerated dose of NPT and eosinophil counts in nasal scraping, were evaluated.
Sixty children (30 NCP and 30 placebos) were enrolled. Before treatment, there were no significant differences in age, dust mite control measures, DSS, DMS, PNIF, NAR, the maximum tolerated dose of NPT, or nasal eosinophil scores between children receiving NCP and placebos. After treatment, there were no significant differences between the NCP and placebo groups in the median (range) of the outcomes-DSS: 2.06 (0.18-3.77) vs 1.79 (0.08-7.79), P=0.756; DMS: 1.60 (0-5.13) vs 0.56 (0-4.84), P=0.239; PNIF (L/min): 110 (60-160) vs 100 (50-180), P=0.870; NAR (Pa/cm³/s): 0.40 (0.20-0.97) vs 0.39 (0.24-1.32), P=0.690; the maximum tolerated dose of NPT and the nasal eosinophil scores: 1 (0-4) vs 1 (0-4), P=0.861.
NCP treatment may not be more effective than placebo treatment in dust mite-sensitized AR children.
鼻用纤维素粉(NCP)可防止过敏原与鼻黏膜结合,可能减轻尘螨致敏儿童的过敏性鼻炎(AR)症状。本研究旨在评估NCP改善鼻气流受限临床症状及鼻炎症细胞反应的疗效。
招募6至18岁的尘螨致敏AR儿童。经过4周的导入期后,给予NCP或安慰剂,每侧鼻孔1喷,每日3次,共4周。在治疗前后进行屋尘螨(Der p)鼻激发试验(NPT)。评估每日症状评分(DSS)、每日用药评分(DMS)、鼻吸气峰流速(PNIF)、鼻气道阻力(NAR),以及NPT的最大耐受剂量和鼻刮片中嗜酸性粒细胞计数。
共纳入60名儿童(30名接受NCP,30名接受安慰剂)。治疗前,接受NCP和安慰剂的儿童在年龄、尘螨控制措施、DSS、DMS、PNIF、NAR、NPT的最大耐受剂量或鼻嗜酸性粒细胞评分方面无显著差异。治疗后,NCP组和安慰剂组在以下结局的中位数(范围)方面无显著差异——DSS:2.06(0.18 - 3.77)对1.79(0.08 - 7.79),P = 0.756;DMS:1.60(0 - 5.13)对0.56(0 - 4.84),P = 0.239;PNIF(升/分钟):110(60 - 160)对100(50 - 180),P = 0.870;NAR(帕/立方厘米/秒):0.40(0.20 - 0.97)对0.39(0.24 - 1.32),P = 0.690;NPT的最大耐受剂量和鼻嗜酸性粒细胞评分:1(0 - 4)对1(0 - 4),P = 0.861。
对于尘螨致敏的AR儿童,NCP治疗可能并不比安慰剂治疗更有效。