scholarly journals Comparison of Intranasal Hypertonic Dead Sea Saline Spray and Intranasal Aqueous Triamcinolone Spray in Seasonal Allergic Rhinitis

2005 ◽  
Vol 84 (7) ◽  
pp. 426-430 ◽  
Author(s):  
Scott Cordray ◽  
Jim B. Harjo ◽  
Linda Miner

Intranasal corticosteroids are well known to be efficacious in the treatment of allergic rhinitis. Nasal irrigation with saline, including hypertonic saline, has long been recommended for the treatment of sinonasal disease, and it has been shown to have a positive effect on the physiology of the nasal mucosa. Until now, no study of the clinical efficacy of intranasal hypertonic Dead Sea saline as a monotherapy for seasonal allergic rhinitis has been reported. We conducted a prospective, randomized, single-blind, placebo-controlled comparison of intranasal hypertonic Dead Sea saline spray and intranasal aqueous triamcinolone spray in 15 patients with seasonal allergic rhinitis. Results were based on a 7-day regimen. Based on Rhinoconjunctivitis Quality of Life Questionnaire scores, clinically and statistically significant (p < 0.0001) improvements were seen in both active-treatment groups; as expected, the corticosteroid spray was the more effective of the two treatments. No significant improvement occurred in the control group. Our preliminary results not only confirm the efficacy of intranasal corticosteroid therapy in moderate-to-severe allergic rhinitis, they also suggest that the Dead Sea saline solution can be an effective alternative in mild-to-moderate allergic rhinitis, particularly with respect to nasal and eye symptoms. The hypertonicity of the Dead Sea solution may have a positive effect on the physiology of the nasal mucosa by improving mucociliary clearance. In addition, the dominant cation in the Dead Sea solution— magnesium— probably exerts anti-inflammatory effects on the nasal mucosa and on the systemic immune response.

1998 ◽  
Vol 5 (6) ◽  
pp. 455-460 ◽  
Author(s):  
William H Yang ◽  
Jerry Dolovich ◽  
Michel A Drouin ◽  
Paul Keith ◽  
Jennifer Haddon ◽  
...  

OBJECTIVE: To compare the effect of budesonide Turbuhaler 400 µg/day with budesonide aqua 256 µg/day in the treatment of seasonal allergic rhinitis (SAR). Secondarily to ascertain patients' preferences for the two nasal devices and to assess quality of life.DESIGN: Randomized, multicentre, double-blind, double- dummy, parallel groups study.SETTING: Private practices and hospital clinics in Ontario, Quebec and Manitoba.POPULATION: Two hundred and eighty-four out-patients with SAR, who were symptomatic during the ragweed season, volunteered for enrolment (243 randomized).RESULTS: Mean daily nasal symptom scores were significantly reduced with treatment. There were no statistically significant changes from baseline for eye symptoms. Most patients (more than 80%) achieved substantial control of their symptoms with budesonide. The most common nasal and non-nasal adverse events for both groups were epistaxis and headache. Turbuhaler was easier to use and more convenient to carry, had less of an unpleasant taste, and caused less nasal irritation than the aqua spray. More than twice as many patients preferred Turbuhaler to the aqua spray (69% versus 31%). Improvement in quality of life from baseline to clinic visits was statistically significant in both groups.CONCLUSION: Once daily use of 256 mg of budesonide aqua and 400 mg of budesonide Turbuhaler are equally safe and efficacious in the treatment of SAR. Patients preferred the budesonide powder formulation delivered via Turbuhaler two to one over the aqua formulation.


2008 ◽  
Vol 122 (7) ◽  
pp. 700-706 ◽  
Author(s):  
T Chalastras ◽  
P Nicolopoulou-Stamati ◽  
E Patsouris ◽  
A Eleftheriadou ◽  
D Kandiloros ◽  
...  

AbstractObjective:The aim of this study was to investigate expression of the neuropeptides substance P, vasoactive intestinal peptide and heat shock protein 70 in the nasal mucosa cells of patients with seasonal allergic rhinitis, in order to obtain more information on the pathophysiological and immunological role of these markers in allergic rhinitis.Material and methods:Nasal epithelium specimens obtained from 42 patients with allergic rhinitis were studied, using Shandon's Papspin liquid-based cytology method. Smears were immunostained with antibodies against substance P, vasoactive intestinal peptide and heat shock protein 70, and the results were correlated with the clinical features of seasonal allergic rhinitis.Results:A positive reaction for substance P, vasoactive intestinal peptide and heat shock protein 70 was observed in 73.8, 66.7 and 69.0 per cent of the allergic rhinitis mucosal smears, respectively. The Pearson chi-square test showed that 40.5 per cent of the immunostained smears had a positive reaction for one or two of the markers studied (i.e. substance P, vasoactive intestinal peptide or heat shock protein 70), and that 47.6 per cent of the smears had a positive reaction for all the markers (p < 0.0001).Conclusions:We found a high level of expression of substance P and vasoactive intestinal peptide in the nasal mucosa smears of patients suffering from allergic rhinitis. This indicates a role for these neuropeptides in the neuroregulation of immunity and hypersensivity in this disease. Furthermore, expression of heat shock protein 70 may contribute to the development of allergic rhinitis.


2013 ◽  
Vol 10 (6) ◽  
pp. 20-24
Author(s):  
Yu A Tyurin ◽  
A A Sharifullina ◽  
I G Mustafin ◽  
R S Fassakhov

Background. Determination of local epithelial cells expressing TLR2 as an indicator of local immunity in allergic rhinitis (AR) patients with opportunistic species of staphylococci nasal mucosa colonization. Methods. Washed epithelium samples obtained from patients with seasonal AR (n=8) aged 19—42 years, and perennial AR (n=15) aged 19 —45 years, as well as a control group (20 patients) aged 19—45 years without allergic diseases were investigated. Epithelial cells expressing TLR2 receptors were determined by flow cytometry. Results. The level of epithelial cells expressing TLR2 receptor in patients with seasonal AR was almost in 1,9 times, in perennial AR group — in 1,7 times lower then in healthy individuals. In patients with perennial AR S. aureus was obtained in 96,0% (CI: 79,5—99,2), in association with Str. pyogenes in 29% (CI: 14,9—49,2), Neisseria spp. — in 63,0% (CI: 42,7—78,8). Seasonal allergic rhinitis was characterized by association of S. aureus and S. hemolyticus (70,0%, 44,4—85,8). Conclusion. Ratio of epithelial cells positive for TLR2 in nasal lavage from patients with AR was lower than in healthy volunteers. Indicators proportion of epithelial cells expressing TLR2 in nasal lavage in patients with seasonal AR during an exacerbation period was significantly reduced (1,7—1,9 times), in comparison with healthy volunteers. In AR patients with increased density of staphylococci strains in nasal mucosa increased local epithelial cells expressing TLR2 in nasal lavage was established.


Author(s):  
Олексій Кузнєцов

Introduction. Seasonal allergic rhinitis is AZ of mucous membranes (primarily the conjunctiva of the eye and nasal mucosa), due to hypersensitivity to aerosol allergens of plant pollen and fungi spores, the concentration of which in the air periodically becomes prijenosnog. The leading clinical manifestation of SAR is considered as allergic conjunctivitis. According to statistics, about 70-90% of patients with SAR develops Pulawy conjunctivitis, characterized by itching of eyes, eyelids, their redness, photophobia, lacrimation. Clinically important is the combination of SAR and conjunctivitis. Although the SAR attention usually emphasize on nasal symptoms, more than 80% of patients, as practice shows, suffer from symptoms from the eyes. According to the European and North American researchers, more than 70% of patients with SAR suffer from eye and nasal symptoms, and their severity the majority of patients assessed asmoderate or severe.Materials and methods. Clinical and anamnestic study was done in 120 patients aged from 19 to 45 years. All the studied patients were divided according to the degree of severity of the disease: 58 patients with moderate course of seasonal allergic rhinitis and conjunctivitis (EYE), which caused Pilica ambrosia and 62 patients with severe SARK, which pilca caused by ragweed. Of these, 43 (35,8%) women, 77 (64.1%) of men aged 19 to 25 years – 76 (63.3 per cent), from 25 to 45 years – 44 (36.6%) patients. The control group consisted of 30 healthy people.Research results. The differentiation of the history of infectious diseases patients. In the studied patients SARK with moderate current, acute respiratory illness (ARI) was observed in 54 (26,9%) patients, varicella – 16 (8,0%), mumps – 12 (6,0%), measles in 11 (5,5%), viral hepatitis in 4 (1,9%) patients, acute bronchitis 36 (17,9%), pneumonia – 17 (8,5%), the scarlet fever in 6 (2.9%) and intestinal infection in 7 (3,5%), sore throat – 25 (12,4%), otitis in 13 (6,5%) patients. In patients with severe SARK, ARI was observed in 59 (23,3%) patients, varicella – 24 (9,5%), mumps – in 18 (7.1 percent), measles – in 16 (6.3 percent), viral hepatitis in 7 (2.8%) and acute bronchitis – in 43 (17%), pneumonia in 19 (7,5%), scarlet fever in 8 (3,2%), intestinal infection in 9 (3,6%), angina 32 (12,6%), otitis media – in 18 (7.1 per cent) patients.Analyzing the structure of infectious diseases in the anamnesis in the studied patients SARK need to emphasize that their structure is dominated infection in the upper respiratory tract and broncho-pulmonary system that leads to depletion of nonspecific and specific immunity factors, formation of secondary immunodeficiency in these systems.Discussion of research. In the study of biochemical parameters of blood in patients with SARK in the period of aggravation established that the greatest changes are observed from endogenous cholesterol and phospholipids, which may indicate the failure of the macrophage link of immunity. At the same time, β-lipoproteins and NIK was increased only in the group of patients with severe SARK. The increase of phospholipids in serum of patients with severe SARK can point to the implementation of late phase allergic inflammation in cellular tissue structure of the nasal mucosa.Conclusions. Conducted research of history data, the structure of comorbidity, laboratory parameters allergological studies have shown that SARK is formed on the background of progressive sensitization and allergization of the organism, which is implemented in the manifestation of allergic reactions, forming the severity of SARK, and on the strength of the immune response to a variety of ecoalign that define the types of immunopathological reactions in this cohort of patients.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Chengsong Liao ◽  
Yangyang Han ◽  
Zhijing Chen ◽  
Huricha Baigude

Abstract Background A formulation of black cumin (Nigella sativa L.), licorice (Glycyrrhiza glabra L.), anise (Pimpinella anisum L.) and tea (Camellia sinensis (L.) Kuntze) (denoted BLAB tea) is traditionally used to relief allergy reaction including allergic rhinitis. However, little is known about its underlining mechanism of anti-allergic effects. Methods To investigate the anti-allergenic mechanism of BLAB tea, we treated ovalbumin (OVA)-induced allergic rhinitis (AR) model of mice with BLAB tea, and elucidated its possible mechanism of action. Mice in the control group were treated with phosphate-buffered saline only. Subsequently, the infiltration of different inflammatory cells was measured. In addition, histopathological changes in the nasal mucosa, and the levels of allergen-specific cytokines and OVA-specific immunoglobulins were measured. Results The aqueous extract of BLAB significantly alleviated the nasal symptoms and reduced the accumulation of inflammatory cells in the nasal mucosa and nasal lavage fluid of AR model of mice. Conclusion The aqueous extract of BLAB induced the production of Th1 and Treg cytokines and inhibited the release of Th2 cytokines and histamine in nasal mucosa and serum of mice while decreasing the serum levels of OVA-specific IgE, IgG1, and IgG2a. These results suggest the potential of the aqueous extract of BLAB as a treatment option for allergic diseases.


2019 ◽  
Vol 34 (2) ◽  
pp. 196-208 ◽  
Author(s):  
Chenjie Yu ◽  
Kaijian Wang ◽  
Xinyan Cui ◽  
Ling Lu ◽  
Jianfei Dong ◽  
...  

Background Patients with moderate to severe allergic rhinitis (AR) who are treated according to the current rhinitis management guidelines may be inadequately controlled. These patients are at risk of serious comorbidities, such as asthma and chronic sinusitis. These symptoms, sneezing and an itchy, runny, stuffy nose, may have a negative impact on patients’ daily functioning. Omalizumab is being developed as a new choice for the treatment of AR. We therefore undertook a meta-analysis to assess the efficacy and safety of omalizumab in the treatment of AR. Methods We systematically searched PubMed, Cochrane Library, and MEDLINE databases for randomized controlled studies on the treatment of AR with omalizumab. Our evaluation outcomes were symptom scores, medication efficacy, combined symptom and medication scores, and adverse events. We descriptively summarized and quantitatively synthesized original data to evaluate the efficacy and safety of omalizumab in the treatment of AR by using Stata12.0 software for meta-analyses. Results The results of our meta-analysis showed that there were statistically significant differences between the omalizumab group and the control group in the following aspects: daily nasal symptom score (standardized mean difference [SMD] = –0.443, 95% confidence interval [CI]: –0.538 to –0.347, P < .001); daily ocular symptom score (SMD = –0.385, 95% CI: –0.5 to –0.269, P < .001); daily nasal medication symptom scores (SMD = –0.421, 95% CI: –0.591 to –0.251, P < .001); proportion of days of emergency drug use (risk ratio [RR] = 0.488, 95% CI: 0.307 to 0.788, P < .005); rhinoconjunctivitis-specific quality of life questionnaire (SMD = –0.286, 95% CI: –0.418 to –0.154, P < .001); and overall evaluation (RR = 1.435, 95% CI: 1.303–1.582, P < .001). There was no statistically significant difference in safety indicator: adverse events (RR = 1.026, 95% CI: 0.916–1.150, P = .655). Conclusion Omalizumab is effective and relatively safe in patients with AR; omalizumab used in conjunction with special immunotherapy has shown promising results, especially in reducing adverse events.


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