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

• Published in: European journal of clinical investigation 2004-01, Vol.34 (1), p.67-73
• Main Authors: Tillmann, H.-C., Stuck, B. A., Feuring, M., Rossol-Haseroth, K., Tran, B. M., Lösel, R., Schmidt, B. M., Hörmann, K., Wehling, M., Schultz, A.
• Format: Article
• Language: English
• Subjects: Allergens - immunology; Allergic rhinitis; Anti-Inflammatory Agents - therapeutic use; Betamethasone - therapeutic use; Biological and medical sciences; Bronchial Provocation Tests - methods; Cross-Over Studies; Double-Blind Method; Female; General aspects; Glucocorticoids - therapeutic use; glucocorticosteroids; Humans; Male; Medical sciences; Methylprednisolone - therapeutic use; Nasal Obstruction - drug therapy; Non tumoral diseases; Nose - drug effects; Otorhinolaryngology. Stomatology; Pruritus - drug therapy; Pulmonary Ventilation - drug effects; rapid nongenomic effects; Rhinitis, Allergic, Seasonal - drug therapy; Rhinitis, Allergic, Seasonal - immunology; Rhinomanometry - methods; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0014-2972; 1365-2362
• DOI: 10.1111/j.1365-2362.2004.01293.x

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