Passalacqua G, Albano M, Pronzato C, Riccio A M, Scordamaglia A, Falagiani P, Canonica G W
Allergy and Clinical Immunology Service, DIMI Department of Internal Medicine, Genoa University, Italy.
Clin Exp Allergy. 1997 Aug;27(8):904-8.
Local nasal immunotherapy (LNIT) with extracts in powder has been demonstrated clinically effective and devoid of side-effects in several controlled trials; nevertheless, no data concerning the long-term effects of LNIT are presently available.
In a recent double-blind, placebo-controlled study of LNIT to Parietaria pollen we observed, by means of specific nasal provocation test (SNPT) that LNIT is able to modify the local allergic inflammatory response. In the present study we followed up the same patients in open fashion for 2 further years.
The results confirmed the clinical efficacy of LNIT and showed that it is strictly dependent on pre-seasonal administration: in fact, after LNIT discontinuation a clinical relapse was observed. A certain long-lasting protective effect on SNPT parameters (nasal symptoms and neutrophils infiltration) was also observed, whereas an increase of eosinophils count and ICAM-1 expression on nasal epithelial cells appeared as possible markers of clinical relapse.
The present study suggests that pre-seasonal LNIT can be taken in consideration in selected subjects as prophylactic treatment for pollen-induced rhinitis. In addition, the results obtained provide informations about the duration of clinical efficacy and add data about the local allergic inflammation and its modulation.
在多项对照试验中，使用粉末状提取物进行的局部鼻内免疫疗法（LNIT）已被证明具有临床疗效且无副作用；然而，目前尚无关于LNIT长期效果的数据。
在最近一项针对墙草花粉的LNIT双盲、安慰剂对照研究中，我们通过特异性鼻激发试验（SNPT）观察到，LNIT能够改变局部过敏性炎症反应。在本研究中，我们以开放方式对同一组患者进行了另外两年的随访。
结果证实了LNIT的临床疗效，并表明其严格依赖于季节前给药：事实上，停止LNIT治疗后观察到了临床复发。还观察到对SNPT参数（鼻部症状和中性粒细胞浸润）有一定的长期保护作用，而鼻上皮细胞中嗜酸性粒细胞计数和ICAM-1表达的增加似乎是临床复发的可能标志物。
本研究表明，对于特定受试者，季节前LNIT可作为花粉性鼻炎的预防性治疗方法。此外，所获得的结果提供了关于临床疗效持续时间的信息，并增加了关于局部过敏性炎症及其调节的数据。
