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Objective improvement in nasal congestion and nasal hyperreactivity with use of nasal steroids in persistent allergic

Gustavo F Wandalsen1, Aline I Mendes, Dirceu Solé

  • 1Department of Allergy and Clinical Immunology, Federal University of São Paulo, Brazil. gfwandalsen@uol.com.br

American Journal of Rhinology & Allergy
|January 30, 2010
PubMed

Insights

Topical nasal steroids effectively reduce nasal congestion and histamine hyper-reactivity in children and adolescents with persistent allergic rhinitis (PAR). This treatment offers objective improvements in nasal symptoms and airflow for young patients.

Area of Science:

  • Allergy and Immunology
  • Otorhinolaryngology
  • Pediatric Pulmonology

Background:

  • Persistent allergic rhinitis (PAR) significantly impacts children and adolescents, causing nasal congestion and hyper-reactivity.
  • Current treatments aim to alleviate symptoms, but objective measures of efficacy, particularly for nasal congestion and hyper-reactivity, are crucial.

Purpose of the Study:

  • To evaluate the efficacy of topical nasal steroids in managing nasal congestion and histamine hyper-reactivity in pediatric and adolescent patients with PAR.
  • To objectively assess treatment effects using nasal symptom scores, acoustic rhinometry, and histamine provocation tests.

Main Methods:

  • A study involving 20 atopic children and adolescents (6-18 years) with moderate-to-severe PAR.
  • Participants received mometasone furoate (100 microg daily) for 21 days.
  • Nasal symptoms, acoustic rhinometry parameters, and histamine nasal hyper-reactivity were measured before and after treatment, with comparisons to 20 controls.

Main Results:

  • PAR patients exhibited higher symptom scores, increased nasal hyper-reactivity, and reduced nasal volumes compared to controls.
  • Mometasone furoate treatment significantly decreased nasal symptom scores (8.0 to 3.8) and histamine hyper-reactivity (histamine concentration: 0.72 mg/ml to 2.60 mg/ml).
  • Acoustic rhinometry showed significant improvements in nasal congestion, with the 2-5 cm segment volume increasing by 19.8%.

Conclusions:

  • Topical nasal steroid treatment objectively reduces nasal congestion in children and adolescents with persistent allergic rhinitis.
  • The study confirms that mometasone furoate effectively decreases nasal histamine hyper-reactivity in this patient population.
  • These findings support the use of topical nasal steroids as an effective therapeutic option for pediatric PAR.
Abstract

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