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Superior effect of MP-AzeFlu than azelastine or fluticasone propionate alone on reducing inflammatory markers

Jordi Roca-Ferrer1,2, Laura Pujols1,2, Maria Pérez-González1,2

  • 11Clinical and Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology
|December 22, 2018
PubMed
Abstract

Insights

MP-AzeFlu, a combination nasal spray, significantly reduced inflammatory markers and eosinophil survival more effectively than azelastine hydrochloride (AZE) or fluticasone propionate (FP) alone in an in vitro model. This suggests a mechanism for its superior clinical efficacy in treating allergic rhinitis (AR).

Area of Science:

  • Immunology
  • Pharmacology
  • Rhinology

Background:

  • MP-AzeFlu, an intranasal formulation combining azelastine hydrochloride (AZE) and fluticasone propionate (FP), demonstrates superior clinical efficacy in treating allergic rhinitis (AR) compared to AZE or FP monotherapy.
  • The precise anti-inflammatory mechanisms underlying the enhanced efficacy of MP-AzeFlu remain incompletely characterized.

Purpose of the Study:

  • To investigate and compare the in vitro anti-inflammatory effects of MP-AzeFlu against its individual components, AZE and FP.
  • To elucidate the impact of MP-AzeFlu on key inflammatory mediators and cellular responses in an established model of eosinophilic inflammation.

Main Methods:

  • Human nasal mucosal epithelial cells and peripheral blood eosinophils were utilized in an in vitro model.
  • Epithelial cells were stimulated and treated with MP-AzeFlu, AZE, or FP across a range of dilutions (1:10^2 to 1:10^5).
  • Interleukin (IL)-6, IL-8, and granulocyte-macrophage colony-stimulating factor (GM-CSF) secretion was quantified via ELISA, and eosinophil survival was assessed using trypan blue dye exclusion.

Main Results:

  • MP-AzeFlu and FP, along with AZE at the highest concentration (1:10^2), significantly reduced IL-6 secretion and eosinophil survival.
  • At a 1:10^2 dilution, MP-AzeFlu demonstrated a significantly greater reduction in IL-6 secretion (38.3%) compared to AZE (76.1%) and FP (53.0%).
  • MP-AzeFlu also exhibited significantly lower eosinophil survival rates at days 3 (17.5%) and 4 (2.4%) compared to AZE and FP.

Conclusions:

  • The superior in vitro reduction in cytokine secretion and eosinophil survival by MP-AzeFlu provides a potential mechanistic explanation for its enhanced clinical effectiveness in allergic rhinitis.
  • These findings support the synergistic or additive anti-inflammatory actions of combining azelastine hydrochloride and fluticasone propionate in a single intranasal formulation.
Keywords:
Allergic rhinitisAzelastineCytokinesEosinophil survivalEpithelial cellsFluticasone propionateIn vitro modelMP-AzeFluNasal mucosa

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