Fluticasone furoate nasal spray reduces the nasal-ocular reflex: A mechanism for the efficacy of topical steroids in controlling allergic eye symptoms - 15/08/11
, Deanna Shenaq, BSc, Marcy DeTineo, BSN, JiangHong Wang, MD, Robert M. Naclerio, MD
Reprint requests: Fuad M. Baroody, MD, Section of Otolaryngology—Head and Neck Surgery, 5841 S. Maryland Ave, MC1035, Chicago, IL 60637.Abstract |
Background |
Eye symptoms frequently occur in patients with allergic rhinitis and are among the most bothersome symptoms. Intranasal steroids have been shown to reduce ocular symptoms associated with allergic nasal symptoms, even though they do not reach the eye.
Objective |
To elucidate a mechanism to explain these observations.
Methods |
We performed a double-blind, placebo-controlled, crossover experiment in 20 subjects with seasonal allergic rhinitis. Nasal antigen challenge was performed consecutively for 3 days after 1 week of treatment with either placebo or fluticasone furoate nasal spray (FFNS). Subjects recorded their nasal and ocular symptoms, and nasal secretions were quantified. Nasal scrapings to quantify eosinophils were obtained before each antigen challenge.
Results |
Nasal challenge with antigen led to sneezing, a nasonasal, and a nasal-ocular reflex. Priming in the number of sneezes, contralateral nasal secretion weights, and total eye symptoms were observed. Treatment with FFNS reduced sneezing, the nasonasal and nasal-ocular reflexes, and the amount of eosinophils in nasal secretions.
Conclusions |
We confirmed that a nasal-ocular reflex follows nasal challenge with allergen and that it can contribute to the ocular symptoms associated with allergic rhinitis. FFNS reduced eosinophil infiltration, priming, and ocular symptoms. Furthermore, our results support a mechanism by which control of eye symptoms can be achieved during nasal administration of an intranasal steroid in patients with seasonal allergic rhinitis.
Le texte complet de cet article est disponible en PDF.Key words : Allergic rhinoconjunctivitis, nasal-ocular reflex, fluticasone furoate nasal spray, nasal challenge, priming, eosinophils
Abbreviations used : FFNS, SPT
Plan
| Supported by a research grant from GlaxoSmithKline and by the McHugh Otolaryngology Research Fund. |
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| Disclosure of potential conflict of interest: F. M. Baroody served on the speakers’ bureau for Merck and GlaxoSmithKline and has received research support from GlaxoSmithKline and Alcon. R. M. Naclerio has served as a consultant and speaker for Merck; has served as a consultant for Schering and GlaxoSmithKline; has received research support from Merck, Schering, GlaxoSmithKline, and Sepracor; and is a Fellow at the American Academy of Otolaryngology—Head and Neck Surgery. The rest of the authors have declared that they have no conflict of interest. |
Vol 123 - N° 6
P. 1342-1348 - juin 2009 Retour au numéro
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