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Objective:
Recent guidelines
reveal that allergic
rhinitis impairs
quality of life.
Neuropeptides play a
central role in
allergy-related
nasal inflammation.
The objective of
this study was to
analyze the release
of neuropeptides
(substance P,
neurokinin A, and
vasoactive
intestinal peptide)
in nasal lavage and
their modification
by intranasal fl
uticasone propionate
as an established
therapy in patients
with allergic
rhinitis.
Methods:
Eleven patients with
proven allergic
rhinitis induced by
house dust mite were
challenged before
and after
administration of
fluticasone
propionate nasal
spray. Nasal lavage
samples were
collected after
allergen challenge,
and neuropeptides
were measured using
enzyme-linked
immunosorbent assay.
Values for
histamine, protein,
and human serum
albumin were also
recorded. Eight
healthy individuals
were included as
nonatopic controls.
Results: The
neuropeptides
investigated were
detectable in nasal
lavage fluid in both
patients and
controls. Treatment
with fluticasone
propionate
significantly
decreased clinical
response to allergen
challenge (P<.01)
compared with the
controls and led to
a decrease in values
for substance P,
neurokinin A,
vasoactive
intestinal peptide,
histamine release,
human serum albumin,
and total protein
after allergen
challenge (P<.01).
Conclusions:
The demonstration of
proinfl ammatory
neuropeptides in NAL
and suppression of
their release after
allergen challenge
caused by a topical
corticosteroid
suggest a role for
neuropeptides in
allergic
inflammation.
Diminished release
of neuropeptides
induced by
fluticasone
propionate was
accompanied by an
improvement in the
clinical symptoms of
patients with
persistent allergic
rhinitis.
Key words:
Substance P.
Neurokinin A.
Vasoactive
intestinal peptide.
Persistent allergic
rhinitis.
Fluticasone
propionate. Allergen
challenge. Nasal
lavage. Neurogenic
inflammation. |
