Foresi A, Pelucchi A, Gherson G, Mastropasqua B, Chiapparino A, Testi R
Servizio di Fisiopatologia Respiratoria G. Campari, Sesto San Giovanni, Italy.
J Allergy Clin Immunol. 1996 Aug;98(2):274-82. doi: 10.1016/s0091-6749(96)70150-1.
Fluticasone propionate aqueous nasal spray, a new topical corticosteroid, has been proved to be an effective treatment for seasonal allergic rhinitis.
We studied the effect of fluticasone propionate on nasal symptoms, circulating eosinophils, and nasal inflammation in patients with seasonal allergic rhinitis after high-load pollen exposure. Moreover, we examined its efficacy in preventing the increase in bronchial responsiveness to methacholine (PD20) during the pollen season.
We conducted a double-blind, placebo-controlled, parallel-group study in patients who had a history of allergic rhinitis in response to pollens of grass and Parietaria species and were living in northern Italy. After a run-in period of 2 weeks, 24 patients were treated with fluticasone propionate (200 micrograms, once daily), and 26 patients received matched placebo for 6 weeks, starting from the beginning of the pollen season. Assessment of efficacy was based on scores of daily nasal symptoms. Nasal lavage was performed at the end of the season, and differential cell count was expressed as percent of total cells. PD20 methacholine was measured at the beginning and end of the season and after the season had ended.
Fluticasone propionate significantly reduced nasal obstruction, itching, and rhinorrhea. Eosinophils in blood (p < 0.01) and nasal lavage (p < 0.001) were also reduced. Moreover, fluticasone significantly attenuated the decrease in mean PD20 methacholine (from 1.95 to 0.89 mg) compared with placebo (from 1.38 to 0.37 mg: p < 0.01). After the season, no difference in PD20 methacholine was found between treatment groups.
The results of this study indicate that fluticasone propionate is effective in decreasing nasal symptoms and eosinophil inflammation in patients with seasonal allergic rhinitis after high-load pollen exposure. Our results also demonstrate that treatment with fluticasone propionate partially prevents the increase in bronchial responsiveness provoked by the inhalation of seasonal pollens in allergic rhinitis.
丙酸氟替卡松水鼻喷雾剂是一种新型局部用皮质类固醇，已被证明是治疗季节性变应性鼻炎的有效药物。
我们研究了丙酸氟替卡松对高负荷花粉暴露后季节性变应性鼻炎患者鼻症状、循环嗜酸性粒细胞和鼻炎症的影响。此外，我们还检测了其在预防花粉季节期间支气管对乙酰甲胆碱反应性（PD20）增加方面的疗效。
我们对有对禾本科和墙草属花粉过敏史且居住在意大利北部的患者进行了一项双盲、安慰剂对照、平行组研究。经过2周的导入期后，24例患者接受丙酸氟替卡松（200微克，每日一次）治疗，26例患者从花粉季节开始接受匹配的安慰剂治疗6周。疗效评估基于每日鼻症状评分。在季节结束时进行鼻腔灌洗，差异细胞计数以占总细胞的百分比表示。在季节开始和结束时以及季节结束后测量乙酰甲胆碱的PD20。
丙酸氟替卡松显著减轻鼻塞、瘙痒和流涕。血液（p<0.01）和鼻腔灌洗（p<0.001）中的嗜酸性粒细胞也减少。此外，与安慰剂相比（从1.38降至0.37毫克：p<0.01），丙酸氟替卡松显著减轻了平均乙酰甲胆碱PD20的下降（从1.95降至0.89毫克）。季节结束后，各治疗组之间乙酰甲胆碱的PD20没有差异。
本研究结果表明，丙酸氟替卡松对高负荷花粉暴露后季节性变应性鼻炎患者减轻鼻症状和嗜酸性粒细胞炎症有效。我们的结果还表明，丙酸氟替卡松治疗可部分预防变应性鼻炎患者吸入季节性花粉引起的支气管反应性增加。
