Effect of intranasal corticosteroid on pre-onset activation of eosinophils and mast cells in experimental Japanese cedar pollinosis

Yasuyuki Noyama; Mitsuhiro Okano; Tazuko Fujiwara; Shin Kariya; Sei-Ichiro Makihara; Takenori Haruna; Kengo Kanai; Takaya Higaki; Kazunori Nishizaki

doi:10.1016/j.alit.2015.12.007

Effect of intranasal corticosteroid on pre-onset activation of eosinophils and mast cells in experimental Japanese cedar pollinosis

Allergol Int. 2016 Jul;65(3):259-65. doi: 10.1016/j.alit.2015.12.007. Epub 2016 Feb 19.

Authors

Yasuyuki Noyama¹, Mitsuhiro Okano², Tazuko Fujiwara¹, Shin Kariya¹, Sei-Ichiro Makihara³, Takenori Haruna¹, Kengo Kanai⁴, Takaya Higaki¹, Kazunori Nishizaki¹

Affiliations

¹ Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
² Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. Electronic address: [email protected].
³ Department Otorhinolaryngology, Kagawa Rosai Hospital, Kagawa, Japan.
⁴ Department Otorhinolaryngology, Kagawa Prefectural Central Hospital, Kagawa, Japan.

PMID: 26907728
DOI: 10.1016/j.alit.2015.12.007

Abstract

Background: Minimal persistent inflammation (MPI) contributes to hyperreactivity in allergic rhinitis. However, little is known regarding whether pre-onset activation of eosinophils and mast cells is present or not in Japanese cedar pollinosis (JCP). Furthermore, a prophylactic effect of intranasal corticosteroids on such MPI in JCP has not been investigated.

Methods: We designed a double-blinded, randomized, placebo-controlled, crossover trial. Twenty patients with JCP were examined outside the pollen season (UMIN000008410). Nasal provocation with paper discs containing extracts of Japanese cedar pollen was performed once a day for 3 consecutive days. Onset of nasal symptoms was monitored over 15 min after each provocation. The levels of eosinophil cationic protein (ECP) and tryptase in nasal secretions were examined. Fluticasone furoate nasal spray or placebo treatment was started one day before the first provocation.

Results: In the placebo group, 25% of the patients showed onset of nasal symptoms following provocation on the first day. In addition, 75% and 68% of the patients showed symptom onset on the second and third day of provocation, respectively. After the first provocation, the levels of ECP and tryptase in nasal secretions were significantly increased. These increases were seen not only in symptomatic but also in asymptomatic subjects in response to provocation, and the levels were similar between these subjects. Prophylactic treatment with fluticasone significantly suppressed the increase in nasal ECP and tryptase associated with repeated provocations.

Conclusions: These results suggest that pre-onset activation of eosinophils and mast cells is present in experimental JCP, and that prophylactic treatment with intranasal corticosteroids has the potential to control such activation.

Keywords: Eosinophil cationic protein; Intranasal corticosteroids; Japanese cedar pollinosis; Minimal persistent inflammation; Tryptase.

Publication types

Clinical Trial
Randomized Controlled Trial

MeSH terms

Administration, Intranasal
Adrenal Cortex Hormones / administration & dosage*
Adult
Allergens / immunology
Cross-Over Studies
Cryptomeria / adverse effects*
Eosinophil Cationic Protein / metabolism
Eosinophils / immunology*
Female
Humans
Male
Mast Cells / immunology*
Middle Aged
Nasal Mucosa / immunology
Nasal Mucosa / metabolism
Pollen / immunology*
Rhinitis, Allergic, Seasonal / diagnosis
Rhinitis, Allergic, Seasonal / drug therapy*
Rhinitis, Allergic, Seasonal / immunology*
Risk Factors
Treatment Outcome
Tryptases / metabolism
Young Adult

Substances

Adrenal Cortex Hormones
Allergens
Eosinophil Cationic Protein
Tryptases