Clinical and pathologic methods to assess the long‐term safety of nasal corticosteroids

Laliberté, François; Laliberté, Marie-France; Lécart, Sandrine; Bousquet, Jean; Klossec, J M; Mounedji, Nadjat

doi:10.1034/j.1398-9995.2000.00649.x

Cited by 37 publications

(26 citation statements)

References 17 publications

(12 reference statements)

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“…Moreover, epithelial cell metaplasia has been observed in the nasal biopsies of some patients suffering from perennial rhinitis (813,814). Although the nasal and bronchial mucosa are exposed to the same noxious environment (and even more so the nose), epithelial shedding is more pronounced in the bronchi than in the nose of the same patients suffering from asthma and rhinitis (19,815).…”

Section: Allergic Inflammationmentioning

confidence: 90%

“…However, there are differences in safety between molecules, those with low bioavailability being the best tolerated (1573,1574). The current intranasal preparations are well tolerated and can be used on a long-term basis without atrophy of the mucosa (814,1508). Evidence shows that the long-term use of intranasal glucocorticosteroids is free of the concerns associated with the long-term use of oral glucocorticosteroids.…”

Section: Intranasal Glucocorticosteroidsmentioning

confidence: 99%

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Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

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3,801

1,761

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Section: Allergic Inflammationmentioning

confidence: 90%

Section: Intranasal Glucocorticosteroidsmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

Self Cite

3,801

1,761

View full text Add to dashboard Cite

“…These findings provide further evidence that the intrinsic nasal protective effects, including the nasal mucus barrier function, the mucus diluting effect of the nasal medication, and the effect of mucus pH on nasal drug activity, can compensate in vivo for toxic effects observed with these drugs in vitro. In fact, a number of studies have corroborated the preservation or even improvement of nasal mucosa structure after long-term administration of these intranasal sprays [14,15]. Indeed, some studies have addressed the long-term or short-term effect of certain intranasal steroids on ciliary function in allergic rhinitis patients, by assessing indigocarmine saccharine or radiotracer clearance from the nose as indicators of CBF, and demonstrated no significant impairment of mucociliary function [16,17].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Topical Corticosteroids, Topical Antihistamines, and Preservatives on Human Ciliary Beat Frequency

Jiao

Meng

Zhang³

2014

ORL

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Background: The aim of this study was to investigate the effect of the corticosteroids, the antihistamines, and the preservatives benzalkonium chloride (BKC) and potassium sorbate (PS) in intranasal medications on human nasal epithelial ciliary beat frequency (CBF). Methods: Primary ciliated epithelial cell cultures from the human nasal mucosa of chronic sinusitis patients were established. Changes in CBF of epithelial cell cultures treated/untreated with intranasal medications or preservatives were assessed using high-speed digital imaging methods. Results: Budesonide caused a rapid but reversible ciliostasis and showed no ciliotoxic effect at 10% dilution. Fluticasone propionate induced an irreversible ciliostatic activity and showed a reversible decrease in CBF at 10% dilution. Azelastine hydrochloride and levocabastine hydrochloride both induced a dose-dependent and irreversible decrease in CBF, although the ciliotoxic effect was not evident at 5% dilution. BKC resulted in an irreversible ciliostasis at 0.005 or 0.01% concentrations, whereas PS did not show any change in CBF at 0.12 or 0.24% concentrations. Conclusions: Crystalline BKC and BKC-containing intranasal medications, including fluticasone propionate, azelastine hydrochloride and levocabastine hydrochloride, but not PS or PS-containing intranasal budesonide spray, led to irreversible ciliostasis in human nasal epithelial cell cultures when applied at clinically relevant concentrations.

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“…Although the epithelialmesenchymal trophic unit seems to be functional in rhinitis (61), epithelial damage is only minimal (62)(63)(64) and the reticular basement membrane does not appear to be largely pseudo-thickened (65). Moreover, the demonstration of fibrogenic growth factors in the nasal mucosa of patients with allergic rhinitis is lacking, due in part to the paucity of studies.…”

Section: Nasal Remodeling In Rhinitismentioning

confidence: 99%

Epigenetic inheritance of fetal genes in allergic asthma

Bousquet

Jacot

Yssel

et al. 2004

Allergy

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Asthma has been associated with an exaggerated T‐helper type 2 (Th2) over Th1 responses to allergic and nonallergic stimuli, which leads to chronic airway inflammation and airway remodeling. In the present article, we propose that many of the genes involved in IgE synthesis and airways (re)modeling in asthma are persistent or reminiscent fetal genes which may not be silenced during early infancy (or late pregnancy). Genes of the embryologic differentiation of ectodermic and endodermic tissues may explain some of the patterns of airway remodeling in asthma. In utero programming leads to gene expression, the persistence of which may be associated with epigenetic inheritance phenomena induced by nonspecific environmental factors. Clear delineation of these issues may yield new information on the mechanisms of asthma and new targets for therapeutic intervention and primary prevention.

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Clinical and pathologic methods to assess the long‐term safety of nasal corticosteroids

Abstract: These results clearly indicate that long-term treatment with TAA has no atrophic effect on nasal mucosa.

Cited by 37 publications

References 17 publications

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

The Effect of Topical Corticosteroids, Topical Antihistamines, and Preservatives on Human Ciliary Beat Frequency

Epigenetic inheritance of fetal genes in allergic asthma

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