Rhinophototherapy: A new therapeutic tool for the management of allergic rhinitis

• Published in: Journal of allergy and clinical immunology 2005-03, Vol.115 (3), p.541-547
• Main Authors: Koreck, Andrea I., Csoma, Zsanett, Bodai, Laszlo, Ignacz, Ferenc, Kenderessy, Anna Szabo, Kadocsa, Edit, Szabo, Gabor, Bor, Zsolt, Erdei, Anna, Szony, Barnabas, Homey, Bernhard, Dobozy, Attila, Kemeny, Lajos
• Format: Article
• Language: English
• Subjects: Allergic rhinitis; Allergies; Apoptosis; Apoptosis - radiation effects; Disease; Drug dosages; eosinophils; Eosinophils - radiation effects; Flow Cytometry; Hay fever; Histamine; Humans; IL-5; Investigations; Light; Light therapy; Nasal Mucosa - immunology; Nasal Mucosa - radiation effects; Nose; Phototherapy; Rhinitis, Allergic, Perennial - therapy; T cells; T-Lymphocytes - radiation effects; Treatment Outcome; Ultraviolet Rays
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2004.11.005

Phototherapy has a profound immunosuppressive effect and is able to inhibit hypersensibility reactions in the skin. We evaluated whether phototherapy using a combination of UV-B (5%), UV-A (25%), and visible light (70%), referred to as mUV/VIS, is effective in treating allergic rhinitis. We conducted a randomized, double-blind study, in 49 patients with hay fever. The study was performed during the ragweed season. Each intranasal cavity was illuminated 3 times a week for 3 weeks with mUV/VIS or with low-intensity visible light. Symptom scores, inflammatory cells, and their mediators were assessed in nasal lavages. In vitro effects of mUV/VIS irradiation on T-cell and eosinophil apoptosis and its inhibitory effect on mediator release from basophils were examined. Rhinophototherapy was tolerated well and resulted in a significant improvement of clinical symptoms for sneezing ( P < .016), rhinorrhea ( P < .007), nasal itching ( P < .014), and total nasal score ( P < .004). None of the scores improved significantly in the control group. Scores for nasal obstruction slightly improved after mUV/VIS treatment and significantly increased in the control group ( P < .017). In the nasal lavage, phototherapy significantly reduced the number of eosinophils and the level of eosinophil cationic protein and IL-5. In vitro irradiation of T cells and eosinophils with mUV/VIS light dose-dependently induced apoptosis. Furthermore, mUV/VIS irradiation inhibited the mediator release from RBL-2H3 basophils. These results suggest that phototherapy is an effective modality to treat allergic rhinitis and offer new options for the treatment of immune-mediated mucosal diseases.