Effect of intranasal azelastine and beclomethasone dipropionate on nasal symptoms, nasal cytology, and bronchial responsiveness to methacholine in allergic rhinitis in response to grass pollens

Effect of intranasal triamcinolone acetonide on bronchial hyper-responsiveness in children with seasonal allergic rhinitis and comparison of perceptional nasal obstruction with acoustic rhinometric assessment

“…As noted by Thio et al [15], an increased BHR at the end of study may be explained by high pollen exposure that may overcome the effect of intranasal corticosteroids on the lower airways. On the other hand, there are at least three studies where intranasal steroids failed to reduce the seasonal increase in bronchial responsiveness in allergic rhinitis to grass pollens [14][15][16]. Two of them were carried out in adult patients and patient numbers were small.…”

“…The data observed in previous studies suggest that bronchial inflammation is associated with nasal inflammation. Although inhaled steroids produce marked improvement in airway inflammation and airway responsiveness in asthmatic patients, effect of intranasal steroids on BHR in patients with seasonal AR is controversial [3,[11][12][13][14][15][16].…”

Objective monitoring of nasal airway inflammation in rhinitis

“…Atrophic rhinitis on cytologic examination reveals an epithelial squamous metaplasia and a chronic inflammatory cell infiltrate. [110][111][112][113][114] Table III summarizes the current data on nasal cytology findings in various clinical conditions.…”

“…111 Some have reported that antihistamines given orally or topically for therapy produced little change in the presence of eosinophils, basophilic cells, or neutrophils in patients with allergic rhinitis. [112][113][114] However, one recent report indicated an effect of levocetirizine on the nasal lavage eosinophil and neutrophil counts in SAR, 115 whereas another found that the combination of cetirizine and montelukast reduced nasal lavage eosinophils in SAR. 116 Decongestants.…”

Bias in observational study of the effectiveness of nasal corticosteroids in asthma

“…3 Several studies have reported reduced asthma symptoms and lower airway responsiveness when nasal corticosteroids (NCSs) are given before allergen exposure, 16,17 although the effect on lower airway function is small and has not been reproduced in 1 study. 18 In 2002, Adams et al 19 conducted an observational study by using a cohort formed from a health claims database. They reported a significant benefit of NCS on emergency department (ED) visits for asthma.…”