The Treatment of Vasomotor Rhinitis With Intranasal Corticosteroids

World Allergy Organization Journal

Eli O Meltzer¹ 

[1] Allergy & Asthma Medical Group & Research Center; Clinical Professor of Pediatrics, University of California, San Diego; Allergy & Asthma Medical Group & Research Center, 9610 Granite Ridge Dr., Suite B San Diego, CA

关键词: mometasone furoate;    fluticasone propionate;    budesonide;    beclomethasone dipropionate;    intranasal corticosteroids;    vasomotor rhinitis;    nonallergic rhinitis;   

Others  :  1180842
DOI  :  10.1097/WOX.0b013e3181af7c93

【 摘 要 】

Objective

Intranasal steroids (INS) are firmly established as the therapy for choice for allergic rhinitis, but their role in vasomotor rhinitis (VMR) is not fully characterized. This review examines the potential mechanisms of action and reported efficacy of INS in patients with VMR.

Results

INS, through intracellular activation of the glucocorticoid receptor, down-regulate the recruitment and activation of inflammatory cells (T-lymphocytes, eosinophils, mast cells, basophils, neutrophils, macrophages), increase degradation of neuropeptides, and reduce epithelial cell activity, vascular permeability, and chemokine secretion. It is likely that more than vasoconstriction is responsible for the clinical effects of INS.

Eight INS can be prescribed for rhinitis in the US; only 4 have been studied for VMR. Seventy-four percent of patients treated with beclomethasone dipropionate considered themselves symptom-free or greatly improved versus 31% with placebo. Budesonide significantly reduced rhinitis symptoms and methacholine-induced nasal secretions compared with placebo. Fluticasone propionate compared with placebo provided significantly greater relief from nasal obstruction; computed tomographic scans showed significant reductions in the mucosal area of the lower turbinates. Mometasone furoate produced numerically better rhinitis symptom scores and, when discontinued, lower relapse rates than placebo.

Conclusion

Data supports INS as beneficial pharmacotherapy for VMR.

【 授权许可】

   
2009 World Allergy Organization; licensee BioMed Central Ltd.

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