Ciprandi G, Ricca V, Passalacqua G, Fasolo A, Canonica G W
Department of Internal Medicine, University of Genoa, Italy.
Clin Exp Allergy. 1998 Mar;28(3):293-9. doi: 10.1046/j.1365-2222.1998.00239.x.
Allergen specific nasal challenge (ASNC) is an optimal method to study the pathophysiological mechanisms sustaining the allergic inflammation and in particular the adhesion molecule system, which is involved in cellular infiltration of nasal mucosa. Topical steroids have been accepted as a highly effective anti-inflammatory therapy for allergic rhinitis.
The aim of this double-blind placebo- controlled study was the evaluation of clinical and cytological parameters, including ICAM-1 expression on nasal epithelial cells, after a 4 week treatment with nasal fluticasone propionate (200 microg/daily) or placebo, using the model of ASNC.
Twenty allergic rhinitics underwent nasal challenge before and after treatment. The following parameters were evaluated: (i) nasal symptoms (rhinorrhoea, itching, sneezing, obstruction), (ii) inflammatory cells (eosinophils and neutrophils), (iii) ICAM-1 expression on nasal epithelial cells at baseline, 30 min (early phase) and 6 h (late phase) after ASNC.
Fluticasone propionate was capable of reducing: (i) clinical symptoms during both early (P<0.001) and late phase (P<0.04), (ii) eosinophil (P<0.002) and neutrophil (P<0.001) infiltrate during late phase, and (iii) ICAM-1 expression on nasal epithelial cells during both early (P < 0.01) and late phase (P < 0.03).
The present results demonstrate that fluticasone propionate exerts a significant action on early and late phase clinical events following specific nasal challenge, reducing also the cellular influx during the late phase. This event is likely due to the modulation of ICAM-1 expression on epithelial cells.
变应原特异性鼻激发试验（ASNC）是研究维持变应性炎症，尤其是参与鼻黏膜细胞浸润的黏附分子系统病理生理机制的最佳方法。局部用类固醇已被公认为是治疗变应性鼻炎的一种高效抗炎疗法。
本双盲安慰剂对照研究旨在使用ASNC模型，评估经丙酸氟替卡松（200微克/每日）或安慰剂治疗4周后临床和细胞学参数，包括鼻上皮细胞上细胞间黏附分子-1（ICAM-1）的表达。
20名变应性鼻炎患者在治疗前后接受鼻激发试验。评估以下参数：（i）鼻部症状（鼻漏、瘙痒、打喷嚏、鼻塞），（ii）炎症细胞（嗜酸性粒细胞和中性粒细胞），（iii）在ASNC后基线、30分钟（早期）和6小时（晚期）时鼻上皮细胞上ICAM-1的表达。
丙酸氟替卡松能够降低：（i）早期（P<0.001）和晚期（P<0.04）的临床症状，（ii）晚期嗜酸性粒细胞（P<0.002）和中性粒细胞（P<0.001）浸润，以及（iii）早期（P < 0.01）和晚期（P < 0.03）鼻上皮细胞上ICAM-1的表达。
目前的结果表明，丙酸氟替卡松对特异性鼻激发试验后的早期和晚期临床事件具有显著作用，同时也减少了晚期的细胞内流。这一事件可能是由于上皮细胞上ICAM-1表达的调节所致。
