de Graaf-in't Veld C, Garrelds I M, Jansen A P, Van Toorenenbergen A W, Mulder P G, Meeuwis J, Gerth van Wijk R
Department of Allergology, University Hospital Rotterdam-Dijkzigt, The Netherlands.
Clin Exp Allergy. 1995 Oct;25(10):966-73. doi: 10.1111/j.1365-2222.1995.tb00399.x.
Patients with perennial allergic rhinitis develop nasal symptoms not only after allergen exposure, but generally also after non-specific stimuli.
To evaluate the effect of 2 week's treatment with fluticasone propionate aqueous nasal spray (FPANS) on the nasal clinical response, inflammatory mediators and nasal hyperreactivity.
Twenty-four rhinitis patients allergic to house dust mite (HDM), participated in a double-blind, placebo-controlled crossover study. After 2 week's treatment with placebo or 200 micrograms FPANS twice daily, patients were challenged with HDM extract. Symptoms were recorded and nasal lavages were collected for up to 9.5 h after challenge. Nasal hyperreactivity was determined by histamine challenge 24 h later.
Because of a carry-over effect for the immediate symptom score, for this variable only the data from the first treatment period were used. FPANS treatment resulted in a significant decrease of nasal symptoms with 70%, 69% and 63% after 100, 1000 and 10,000 Biological Units (BU)/mL of HDM extract respectively. Active treatment resulted in a 76% decrease of the late-phase symptoms. FPANS treatment significantly reduced albumin influx after HDM 1000 BU/mL with 62% and tended to reduce tryptase release after HDM 1000 BU/mL (P = 0.0629). During the late phase FPANS treatment reduced albumin influx with 67% and eosinophil cationic protein (ECP) release with 83%. No effect of FPANS was seen on histamine levels. FPANS significantly decreased histamine-induced symptom score with 34%, secretion with 32% and sneezes with 41%.
FPANS significantly inhibits the immediate and late allergic response, and nasal hyperreactivity, probably by suppressing mast cells and eosinophils in the nasal mucosa.
常年性变应性鼻炎患者不仅在接触变应原后会出现鼻部症状，通常在受到非特异性刺激后也会出现。
评估丙酸氟替卡松水鼻喷雾剂（FPANS）治疗2周对鼻部临床反应、炎症介质及鼻高反应性的影响。
24例对屋尘螨（HDM）过敏的鼻炎患者参与了一项双盲、安慰剂对照的交叉研究。在接受安慰剂或每日两次200微克FPANS治疗2周后，患者接受HDM提取物激发试验。记录症状，并在激发试验后长达9.5小时收集鼻灌洗液。24小时后通过组胺激发试验测定鼻高反应性。
由于即刻症状评分存在残留效应，对于该变量仅使用了第一个治疗期的数据。FPANS治疗使在分别给予100、1000和10000生物单位（BU）/毫升HDM提取物后鼻部症状显著减轻，减轻幅度分别为70%、69%和63%。积极治疗使迟发性症状减轻了76%。FPANS治疗使在1000 BU/毫升HDM后白蛋白流入显著减少62%，并倾向于减少在1000 BU/毫升HDM后类胰蛋白酶的释放（P = 0.0629）。在迟发性阶段，FPANS治疗使白蛋白流入减少67%，嗜酸性粒细胞阳离子蛋白（ECP）释放减少83%。未观察到FPANS对组胺水平有影响。FPANS使组胺诱发的症状评分显著降低34%，分泌物减少32%，喷嚏减少41%。
FPANS可能通过抑制鼻黏膜中的肥大细胞和嗜酸性粒细胞，显著抑制即刻和迟发性过敏反应以及鼻高反应性。
