Meltzer E O
Allergy & Asthma Medical Group and Research Center, San Diego, California 92123, USA.
Allergy. 1995;50(23 Suppl):15-20. doi: 10.1111/j.1398-9995.1995.tb02736.x.
Symptoms of allergic rhinitis are associated with increased numbers of inflammatory cells in the nasal mucosa. The effects of fluticasone propionate on the nasal mucosal cells of patients with symptomatic allergic rhinitis were evaluated in seven multicentre, double-blind, parallel-group, placebo-controlled, randomised studies. In three seasonal allergic rhinitis studies, significantly more patients receiving fluticasone propionate had a decrease in nasal eosinophils following treatment compared with patients receiving placebo. Similarly, more patients receiving fluticasone propionate had a decrease in nasal basophilic cells, but differences from placebo were not significant in all studies. Nearly identical results were observed in two 24-week perennial allergic rhinitis studies: significantly more patients receiving fluticasone propionate or beclomethasone dipropionate had a decrease in nasal eosinophils compared with patients receiving placebo. Furthermore, a higher percentage of patients receiving corticosteroids also had a decrease in the number of basophilic cells. In two separate seasonal allergic rhinitis studies, significantly more patients receiving fluticasone propionate had a decrease in nasal eosinophils compared with patients receiving terfenadine or astemizole, respectively. The decrease in nasal basophilic cells was also significantly greater with fluticasone propionate compared with astemizole. Inhibition of mediator release from eosinophilic and basophilic cells has also been demonstrated in patients receiving fluticasone propionate compared with patients receiving antihistamines. The results of these studies suggest that the therapeutic benefits of fluticasone propionate aqueous nasal spray in the treatment of seasonal and perennial allergic rhinitis may be related to its ability to reduce nasal mucosal inflammatory cells and to inhibit local mediator activity.
过敏性鼻炎的症状与鼻黏膜中炎症细胞数量增加有关。在七项多中心、双盲、平行组、安慰剂对照、随机研究中，评估了丙酸氟替卡松对有症状的过敏性鼻炎患者鼻黏膜细胞的影响。在三项季节性过敏性鼻炎研究中，与接受安慰剂的患者相比，接受丙酸氟替卡松治疗的患者治疗后鼻嗜酸性粒细胞减少的人数明显更多。同样，接受丙酸氟替卡松治疗的患者中，鼻嗜碱性细胞减少的人数更多，但在所有研究中与安慰剂的差异并不显著。在两项为期24周的常年性过敏性鼻炎研究中观察到了几乎相同的结果：与接受安慰剂的患者相比，接受丙酸氟替卡松或二丙酸倍氯米松治疗的患者鼻嗜酸性粒细胞减少的人数明显更多。此外，接受皮质类固醇治疗的患者中，嗜碱性细胞数量减少的百分比也更高。在两项单独的季节性过敏性鼻炎研究中，与分别接受特非那定或阿司咪唑治疗的患者相比，接受丙酸氟替卡松治疗的患者鼻嗜酸性粒细胞减少的人数明显更多。与阿司咪唑相比，丙酸氟替卡松使鼻嗜碱性细胞减少的幅度也明显更大。与接受抗组胺药治疗的患者相比，接受丙酸氟替卡松治疗的患者中，嗜酸性和嗜碱性细胞介质释放的抑制作用也得到了证实。这些研究结果表明，丙酸氟替卡松水鼻喷雾剂治疗季节性和常年性过敏性鼻炎的治疗益处可能与其减少鼻黏膜炎症细胞和抑制局部介质活性的能力有关。
