Nasal cytological changes following pharmacological intervention

Area of Science:

• Immunology
• Pharmacology
• Otorhinolaryngology

Background:

• Allergic rhinitis involves increased inflammatory cells in nasal mucosa.
• Current treatments aim to manage these inflammatory responses.

Purpose of the Study:

• To evaluate the effects of fluticasone propionate on nasal mucosal cells in patients with allergic rhinitis.
• To compare fluticasone propionate's efficacy against placebo, beclomethasone dipropionate, terfenadine, and astemizole.

Main Methods:

• Seven multicentre, double-blind, parallel-group, placebo-controlled, randomised studies were conducted.
• Nasal mucosal inflammatory cell counts (eosinophils, basophils) were assessed.
• Inhibition of mediator release from inflammatory cells was evaluated.

Main Results:

• Fluticasone propionate significantly decreased nasal eosinophils compared to placebo in seasonal and perennial allergic rhinitis.
• A decrease in nasal basophils was observed with fluticasone propionate, though not always significant compared to placebo.
• Fluticasone propionate showed greater reduction in nasal eosinophils and basophils compared to terfenadine and astemizole, respectively.
• Inhibition of mediator release was demonstrated with fluticasone propionate versus antihistamines.

Conclusions:

• Therapeutic benefits of fluticasone propionate aqueous nasal spray are linked to reduced nasal mucosal inflammatory cells.
• Fluticasone propionate effectively reduces local inflammatory cell activity in allergic rhinitis.
• The findings support fluticasone propionate's role in managing seasonal and perennial allergic rhinitis.