Azelastine reduces mediators of inflammation in patients with nasal polyps.
Azelastine reduces mediators of inflammation in patients with nasal polyps.
复制标题
DOI：
10.2500/108854198778612663
复制
发表时间：
1998-11
影响因子：
2.8
通讯作者：
R. Mösges;Ludger Klimek
中科院分区：
文献类型：
--
作者：
R. Mösges;Ludger Klimek
鼻息肉的症状有哪些？鼻息肉的症状有哪些？这种疾病的病因是未知的，虽然炎症机制可能发挥重要作用。在之前的研究中，我们和其他人已经表明，除了H1拮抗作用外，氮卓斯汀还影响炎症细胞的迁移和活化。在这项在16例鼻息肉和常年性螨过敏性鼻炎患者中开展的开放标签研究中，评价了氮卓斯汀鼻喷雾剂每日两次（每次0.14 mg）对鼻内手术后鼻息肉复发的影响。1例患者在3个月后退出，不愿继续服用药物。在25周内共7次访视中记录了15例患者的临床和实验室数据。其中1例患者在访视3和访视4之间的4周内需要鼻用布地奈德。所有其他患者在入选试验前或6个月观察期内未服用任何类固醇。使用双抗体放射免疫测定法在治疗前和治疗后8周和25周测定鼻分泌物中嗜酸性粒细胞的嗜酸性粒细胞阳离子蛋白（ECP）、中性粒细胞的髓过氧化物酶（MPO）和肥大细胞的类胰蛋白酶浓度，因为这些已被证明是鼻部疾病中良好的炎症标志物。在整个治疗期间，MPO的平均浓度从2724 ng/mL降至1610 ng/mL（p = 0.0015）。ECP从458 ng/mL降至264 ng/mL（p = 0.0342）。类胰蛋白酶从37.9 ng/mL降至22.4 ng/mL（p = 0.0574）。这些数据与临床症状的显著减少一致。因此，氮卓斯汀似乎对鼻息肉和螨过敏患者的嗜酸性粒细胞和中性粒细胞活化具有抑制作用。
Nasal polyps affect approximately 4% of the population in the western world. The etiology of this disease is unknown, although inflammatory mechanisms may play an important role. In preceding studies we and others have shown that besides H1-antagonism, azelastine influences the immigration and activation of inflammatory cells. In this open label study in 16 patients with nasal polyps and perennial mite-allergic rhinitis, the effect of azelastine nasal spray twice daily 0.14 mg to each nostril on recurrence of nasal polyposis after endonasal surgery was evaluated. One patient dropped out after 3 months, unwilling to take further medication. Clinical and laboratory data of 15 patients were recorded over 25 weeks in a total of seven visits. Of these one patient needed nasal budesonide during the 4 weeks between visits 3 and 4. All other patients did not take any steroids before inclusion into the trial or during the 6-month observation period. Concentrations of eosinophil cationic protein (ECP) for eosinophils, myeloperoxidase (MPO) for neutrophils and tryptase for mast cells were determined in nasal secretions before and after eight and 25 weeks of treatment using double antibody radioimmunoassays, because these have been demonstrated to be good inflammatory markers in nasal diseases. Mean concentrations of MPO decreased from 2724 ng/mL to 1610 ng/mL (p = 0.0015) over the entire treatment period. ECP decreased from 458 ng/mL to 264 ng/mL (p = 0.0342). Tryptase decreased from 37.9 ng/mL to 22.4 ng/mL (p = 0.0574). These data were consistent with a significant decrease in clinical symptoms. Thus, azelastine seems to have an inhibitory effect on eosinophil and neutrophil activation in patients with nasal polyps and mite allergy.