Svensson C, Klementsson H, Andersson M, Pipkorn U, Alkner U, Persson C G
Department of Oto-Rhino-Laryngology, University Hospital, Lund, Sweden.
Allergy. 1994 Mar;49(3):177-83. doi: 10.1111/j.1398-9995.1994.tb00822.x.
The mucosal plasma exudate with its proteins, enzymes, derived peptides, and matrix molecules is an important factor in inflammatory airway diseases. This study investigated whether topical glucocorticosteroid treatment influences mucosal exudation of bulk plasma (fibrinogen) and the generation of plasma-derived mediators (bradykinins) in seasonal allergic rhinitis. Twenty-two patients with birch-pollen-induced allergic rhinitis participated in a double-blind, randomized, placebo-controlled study during the birch pollen season in 1989. After a 2-week run-in period, the participants received treatment with budesonide (200 micrograms per nasal cavity and day) or placebo. The patients kept a diary to record their daily nasal symptoms (itching, sneezing, nasal blockage, and secretion). The amount of birch pollen in the air was determined with the aid of a Burkhard pollen trap. A nasal lavage was performed once a week, and the levels of bradykinins and fibrinogen were determined in the lavage fluid samples. The birch pollen season was very mild, resulting in only minor nasal symptoms. In spite of the low pollen exposure, treatment with budesonide reduced the lavage fluid levels of both bradykinins and fibrinogen. The present results show that topical glucocorticosteroid treatment attenuates plasma exudation and the generation of plasma-derived mediators in seasonal allergic rhinitis. This action may not result from simple vascular antipermeability effects of the drug but may rather reflect the anti-inflammatory efficacy of topical glucocorticoids in the airway mucosa.
含有蛋白质、酶、衍生肽和基质分子的粘膜血浆渗出物是炎症性气道疾病的一个重要因素。本研究调查了局部糖皮质激素治疗是否会影响季节性变应性鼻炎中大量血浆（纤维蛋白原）的粘膜渗出以及血浆衍生介质（缓激肽）的生成。1989年桦树花粉季节，22例桦树花粉诱发的变应性鼻炎患者参与了一项双盲、随机、安慰剂对照研究。经过2周的导入期后，参与者接受布地奈德（每侧鼻腔每日200微克）或安慰剂治疗。患者记录每日鼻部症状（瘙痒、打喷嚏、鼻塞和分泌物）。借助伯克哈德花粉采样器测定空气中桦树花粉的量。每周进行一次鼻腔灌洗，并测定灌洗液样本中缓激肽和纤维蛋白原的水平。桦树花粉季节非常温和，仅导致轻微的鼻部症状。尽管花粉暴露量低，但布地奈德治疗仍降低了灌洗液中缓激肽和纤维蛋白原的水平。目前的结果表明，局部糖皮质激素治疗可减轻季节性变应性鼻炎中的血浆渗出和血浆衍生介质的生成。这种作用可能不是由药物简单的血管抗渗透作用引起的，而是可能反映了局部糖皮质激素在气道粘膜中的抗炎功效。
