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Nasal Itching (nasal + itching)

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Medical Sciences	100%

Selected Abstracts

Delayed genomic and acute nongenomic action of glucocorticosteroids in seasonal allergic rhinitis

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2004
H.-C. Tillmann
Abstract Background, Glucocorticosteroids are effective in the treatment of allergic rhinitis, a disease characterized by a variety of symptoms, e.g. rhinorrhea and itching. The time course of symptomatic relief for allergic rhinitis by steroids has not been examined in detail to date, although the onset of steroid action is one of the main discriminations between genomic and nongenomic actions of steroids. We therefore investigated the time course of subjective and objective measures of nasal affection after steroid administration in patients with allergic rhinitis following specific allergen challenge. Methods, Six female and 18 male volunteers (median age 26 years) with a history of allergic rhinitis but currently free of symptoms were included in this randomized, placebo-controlled, double-blind, three-period crossover study. A single dose of either betamethasone (60 mg), methylprednisolone (400 mg) or placebo was given intravenously, 5 min after intranasal allergen provocation. After 10, 20, 60, 150 and 240 min, nasal itching and nasal obstruction were assessed using a standardized visual analogue scale. In addition, nasal airflow was measured by anterior rhinomanometry. Results, Nasal itching was markedly reduced following either of the two steroids within 10 min after administration of study drug. Itching was depressed by 38% following betamethasone (P < 0·05) and by 18% following methylprednisolone (P = 0·07) compared with placebo. Nasal airflow and nasal obstruction were not significantly altered by steroids during the first 2 h of the study. However, after 150 min, nasal airflow was 21% rsp. 19% higher after methylprednisolone and betamethasone (P < 0·05) compared with placebo. After 240 min, nasal airflow was increased by 20% following betamethasone (P < 0·05) and by 19% following methylprednisolone. Nasal obstruction was also beneficially affected by both steroids 150 and 240 min after administration compared with placebo (P < 0·05 for both time points following betamethasone). Conclusion, This study for the first time shows rapid in vivo effects of external glucocorticosteroids in humans. Itching, a pathophysiologically complex sensation, is favourably influenced by steroids within 10 min, therefore presumably via nongenomic mechanisms. Though no detailed mechanisms can be derived from this study, steroid interaction with receptors in the central nervous system may play an important role in mediating this effect. [source]

Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: A randomized study

PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 2 2003
Werner Garavello
Recent evidence suggests that nasal irrigation with hypertonic saline may be useful as an adjunctive treatment modality in the management of many sinonasal diseases. However, no previous studies have investigated the efficacy of this regimen in the prevention of seasonal allergic rhinitis-related symptoms in the pediatric patient. Twenty children with seasonal allergic rhinitis to Parietaria were enrolled in the study. Ten children were randomized to receive three-times daily nasal irrigation with hypertonic saline for the entire pollen season, which had lasted 6 weeks. Ten patients were allocated to receive no nasal irrigation and were used as controls. A mean daily rhinitis score based on the presence of nasal itching, rhinorrea, nasal obstruction and sneezing was calculated for each week of the pollen season. Moreover, patients were allowed to use oral antihistamines when required and the mean number of drug assumption per week was also calculated. In patients allocated to nasal irrigation, the mean daily rhinitis score was reduced during 5 weeks of the study period. This reduction was statistically significantly different in the 3th, 4th and 5th week of therapy. Moreover, a decreased consumption of oral antihistamines was observed in these patients. This effect became evident after the second week of treatment and resulted in statistically significant differences during the 3th, 4th and 6th week. This study supports the use of nasal irrigation with hypertonic saline in the pediatric patient with seasonal allergic rhinitis during the pollen season. This treatment was tolerable, inexpensive and effective. [source]

Exploring the role of leukotriene receptor antagonists in the management of allergic rhinitis and comorbid asthma

CLINICAL & EXPERIMENTAL ALLERGY REVIEWS, Issue 2 2003
R. Pawankar
Summary The links between asthma and rhinitis are well documented and are based upon epidemiological, immunological and clinical observations. Leukotriene receptor antagonists (e.g. montelukast) are an established, effective and well tolerated treatment option for asthma, and more recent evidence now demonstrates their clinical utility in the treatment of allergic rhinitis. In seasonal allergic rhinitis, montelukast monotherapy has been shown to provide relief from daytime nasal symptoms (including congestion, runny nose, nasal itching and sneezing), as well as nighttime and eye symptoms. These clinical benefits were associated with reduced eosinophil counts in the blood, suggesting an effect on the underlying mechanisms of allergic inflammation. In addition, studies that have evaluated the combination of an antileukotriene with an antihistamine have typically shown a numerical and sometimes statistical benefit of combination therapy. Given the frequent coexistence and shared pathophysiologies of asthma and allergic rhinitis, a common therapeutic approach would seem warranted. Leukotriene receptor antagonists, such as montelukast, are emerging as a rational approach to ,one airway' disease management. [source]

Does stimulation of nasal mucosa cause referred pain to the face?

CLINICAL OTOLARYNGOLOGY, Issue 5 2001
M. Abu-Bakra
Ten healthy volunteers (five men and five women, mean age 30 years 3 months), with no nasal contact points, had pressure, adrenaline (1 : 1000), substance P (10 and 80 nmol/mL) and placebo topically applied to their nasal mucosa. Areas stimulated were the nasal floor, septum and lateral wall as well as the inferior and middle turbinates in both nasal cavities. The application of stimuli was randomized and single-blinded. A numerical score of the subjective severity of pain was used to assess outcome. Pressure caused variable local nasal discomfort limited by the duration of application and the site of pressure. Substance P caused variable nasal itching and sneezing. None of the stimuli caused referred pain to the face. The results question the role of mucosal contact points in facial pain. [source]