Effect of Fluticasone propionate Aqueous Nasal Spray Treatment onPlatelet Activating Factor and Eicosanoid Production By nasal Mucosain Patients with A house Dust Mite Allergy

Abstract

The relationship between the release of platelet activating factor (PAF), leukotriene C4/D4/EE (LTC4/D4/E4) and prostaglandin D2 (PGD2) from nasal mucosa in vivo was examined in 24 rhinitis patients allergic to the house dust mite (HDM). During a double blind placebo controlled cross-over study 200 μg fluticasone propionate aqueous nasal spray (FPANS) was administered twice daily for two weeks. In response to allergen provocation (100, 1 000, 10 000 Bu/ml) and during the 9.5 h after this challenge the nasal fluid was obtained by washing the nose with saline and the levels of PAF, LTC4/D4/E4 and PGD2, as indicators of mediator release, were measured at the following time-points: baseline (t = − 1/2), allergen provocation with 10 000 Bu/ml (t = 0), 3.5 and 7.5 h (late phase). After allergen provocation the levels of the mediators increased in the nasal fluids of placebo treated patients (x-fold increase to baseline: PAF, 15; LTC4/D4/E4, 12; PGD2, 1.5). In fluids of patients treated with FPANS these levels tended to decrease. At the time of provocation the levels of PAF, LTC4/D4/E4 and PGD2 showed a significant correlation. The results indicate that these mediators can be used as markers of allergic reactions against house dust mites and that fluticasone propionate aqueous nasal spray tended to reduce the release of mediators of inflammation correlated with beneficial effects on clinical symptoms in this type of allergic reactions.

Interleukin-5 and eosinophil cationic protein in nasal lavages of rhinitis patients

“…The protective effects of fluticasone propionate nasal spray on interleukin-5 were detected in the late phase reaction and failed to affect the initial (baseline) release of interleukin-5 as well as the early phase response to house dust mite provocation. Other factors involved in allergic rhinitis, such as albumin, tryptase, leukotriene E4, prostaglandin D 2 and platelet activating factor, are also increased after house dust mite provocation and are inhibited by fluticasone propionate nasal spray (Garrelds et al, 1994;De Graaf-in 't Veld et al, 1995).…”

“…To prevent nasal congestion, 0.25 ml oxymetazoline (0.1%) was sprayed into each nostril 5 min before the first challenge (prescribed by the Hospital Ethical Committee). Nasal lavage was performed as described before (Garrelds et al, 1994;Gerth van Wijk et al, 1992;Naclerio et al, 1983). Both nostrils were washed with 5 ml saline, prewarmed to 37°C.…”

“…Human allergen-induced responses in the nose are used as a model for allergic inflammation (Gerth van Wijk et al, 1992;Naclerio et al, 1983). After provocation with antigen, mediators, such as prostaglandin D 2, leukotriene E4, tryptase and histamine, are released during the so-called early allergic reaction, which causes sneezing, nasal blockage and rhinorrhoea.…”