Meltzer E O, Orgel H A, Rogenes P R, Field E A
Allergy and Asthma Medical Group and Research Center, San Diego, CA 92123.
J Allergy Clin Immunol. 1994 Oct;94(4):708-15. doi: 10.1016/0091-6749(94)90178-3.
Nasal cytograms of patients with allergic rhinitis contain increased numbers of eosinophils and basophilic cells. Neutrophils are also more numerous in cytograms of allergic persons. Topical intranasal corticosteroid therapy for allergic rhinitis has been shown to decrease the numbers of some inflammatory cell types. Fluticasone propionate aqueous nasal spray, a potent synthetic corticosteroid preparation, is effective therapy for seasonal and perennial allergic rhinitis.
Nasal mucosal scrapings were obtained with a Rhinoprobe (Apotex Scientific, Inc. Arlington, Texas) before and after therapy with fluticasone propionate aqueous nasal spray at several doses in patients with either seasonal allergic rhinitis (2 to 4 weeks' therapy) or perennial allergic rhinitis (24 weeks' therapy). More than 1000 paired nasal cytograms obtained from patients participating in five multicenter studies were evaluated.
The percentage of patients with nasal eosinophils (p < 0.01, most studies) and basophilic cells (p < 0.05, most studies) decreased significantly after treatment with fluticasone propionate compared with placebo-treated patients. Similar findings were observed with beclomethasone dipropionate in one study. The number of neutrophils remained relatively unchanged after treatment with the intranasal corticosteroids or placebo.
These findings suggest that the therapeutic benefits of topical intranasal fluticasone propionate and beclomethasone dipropionate for the therapy of seasonal and perennial allergic rhinitis are reflected by the decrease in inflammatory cells in the nasal mucosa.
变应性鼻炎患者的鼻细胞学涂片显示嗜酸性粒细胞和嗜碱性细胞数量增加。变应性个体的细胞学涂片中中性粒细胞数量也较多。已证明局部鼻内皮质类固醇治疗变应性鼻炎可减少某些炎症细胞类型的数量。丙酸氟替卡松水性鼻喷雾剂是一种强效合成皮质类固醇制剂，是治疗季节性和常年性变应性鼻炎的有效疗法。
在季节性变应性鼻炎（治疗2至4周）或常年性变应性鼻炎（治疗24周）患者中，使用丙酸氟替卡松水性鼻喷雾剂以几种剂量治疗前后，用鼻探针（阿波特克斯科学公司，得克萨斯州阿灵顿）获取鼻黏膜刮片。对参与五项多中心研究的患者获得的1000多对鼻细胞学涂片进行了评估。
与接受安慰剂治疗的患者相比，丙酸氟替卡松治疗后，鼻嗜酸性粒细胞（大多数研究中p<0.01）和嗜碱性细胞（大多数研究中p<0.05）百分比显著降低。在一项研究中，用二丙酸倍氯米松观察到了类似结果。鼻内皮质类固醇或安慰剂治疗后，中性粒细胞数量保持相对不变。
这些发现表明，局部鼻内丙酸氟替卡松和二丙酸倍氯米松治疗季节性和常年性变应性鼻炎的治疗益处体现在鼻黏膜炎症细胞的减少上。
