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Nasal nitric oxide and nasal eosinophils decrease with levocetirizine in subjects with perennial allergic rhinitis.

Angela P Bautista¹, Claudia P Eisenlohr, Miguel J Lanz

¹Department of Allergy, Asthma, and Rhinosinusitis, AAADRS Clinical Research Center, Coral Gables, Florida 33134, USA.

American Journal of Rhinology & Allergy

|December 22, 2011

Summary

Oral levocetirizine dihydrochloride (LC) effectively reduced airway inflammation in perennial allergic rhinitis (PAR) patients. The study demonstrated significant decreases in nasal nitric oxide (nNO) and nasal eosinophils (nEos) with LC treatment.

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Area of Science:

Allergy and Immunology
Respiratory Medicine
Pharmacology

Background:

Allergic rhinitis is frequently managed with antihistamines.
Noninvasive monitoring of airway inflammation via nasal nitric oxide (nNO) is clinically valuable.
This study investigated the anti-inflammatory effects of oral levocetirizine dihydrochloride (LC) on perennial allergic rhinitis (PAR) subjects.

Purpose of the Study:

To assess the anti-inflammatory impact of oral levocetirizine dihydrochloride (LC) in patients with perennial allergic rhinitis (PAR).
To evaluate changes in objective inflammatory markers, specifically nasal nitric oxide (nNO) and nasal eosinophils (nEos), following LC treatment.
To correlate nNO and nEos levels with symptom improvement.

Main Methods:

A randomized, double-blind, placebo-controlled crossover study was conducted with 31 PAR subjects.
Participants received either oral LC (5 mg) or placebo for two weeks, followed by a washout period and then the alternative treatment.
Measurements included nasal nitric oxide (nNO) using NIOX, nasal eosinophils (nEos) via microscopy, and symptom reporting using the Rhinitis Quality of Life Questionnaire (RQLQ) and Total Symptom Score (TSS-4).

Main Results:

Oral LC significantly decreased nasal nitric oxide (nNO) levels compared to placebo (-125 ppb vs. +14 ppb; p < 0.05).
A significant reduction in nasal eosinophils (nEos) was observed with LC treatment compared to placebo (3.1-2.5 vs. 2.9-2.6; p < 0.05).
Levocetirizine dihydrochloride (LC) significantly improved Rhinitis Quality of Life Questionnaire (RQLQ) scores, with a trend toward improvement in Total Symptom Score (TSS-4).

Conclusions:

Oral levocetirizine dihydrochloride (LC) effectively reduces objective markers of inflammation, including nasal nitric oxide (nNO) and nasal eosinophils (nEos), in patients with perennial allergic rhinitis (PAR).
LC treatment also leads to significant improvements in patient-reported quality of life and symptom scores.