BACKGROUND: Because intercellular adhesion molecule (ICAM) 1 and recruitment of eosinophils are crucial in supporting allergic inflammation, their down-regulation may bring additional benefits in patients' recovery. We have assessed nasal eosinophilia and serum soluble ICAM-1 (sICAM-1) concentrations in relation to nasal symptoms in patients with persistent allergic rhinitis (AR) treated for 6 weeks with either desloratadine, levocetirizine, montelukast alone, or in combination. METHODS: In this single-center, randomized, double-blind, placebo-controlled, crossover, two-arm study, 40 patients with persistent AR were randomized to receive either montelukast and/or levocetirizine or placebo (n = 20) or to receive treatment with montelukast and/or desloratadine or placebo (n = 20). Nasal eosinophilia and concentration of sICAM-1 in peripheral blood were assessed before and on the last day of each treatment period. RESULTS: All active treatments in both arms of the study resulted in the decrease of sICAM-1 and nasal eosinophilia, which correlated with the severity of nasal symptoms. In the montelukast/levocetirizine arm, montelukast decreased nasal eosinophilia more significantly than levocetirizine, whereas in reduction of sICAM-1 all active treatment options were equally effective. However, in the desloratadine/montelukast arm, the resulting improvement of combination therapy of sICAM-1 and the influx of eosinophils was not statistically significant. CONCLUSION: The improvement of nasal symptoms in patients with AR treated withantihistamines, with or without montelukast, may additionally result from the reduction of sICAM-1 and nasal eosinophilia. Because the combination therapy may bring inconclusive benefits in this area there is a strong need of further studies to find mechanisms that favor combination therapy.
RCT Entities:
BACKGROUND: Because intercellular adhesion molecule (ICAM) 1 and recruitment of eosinophils are crucial in supporting allergic inflammation, their down-regulation may bring additional benefits in patients' recovery. We have assessed nasal eosinophilia and serum soluble ICAM-1 (sICAM-1) concentrations in relation to nasal symptoms in patients with persistent allergic rhinitis (AR) treated for 6 weeks with either desloratadine, levocetirizine, montelukast alone, or in combination. METHODS: In this single-center, randomized, double-blind, placebo-controlled, crossover, two-arm study, 40 patients with persistent AR were randomized to receive either montelukast and/or levocetirizine or placebo (n = 20) or to receive treatment with montelukast and/or desloratadine or placebo (n = 20). Nasal eosinophilia and concentration of sICAM-1 in peripheral blood were assessed before and on the last day of each treatment period. RESULTS: All active treatments in both arms of the study resulted in the decrease of sICAM-1 and nasal eosinophilia, which correlated with the severity of nasal symptoms. In the montelukast/levocetirizine arm, montelukastdecreased nasal eosinophilia more significantly than levocetirizine, whereas in reduction of sICAM-1 all active treatment options were equally effective. However, in the desloratadine/montelukast arm, the resulting improvement of combination therapy of sICAM-1 and the influx of eosinophils was not statistically significant. CONCLUSION: The improvement of nasal symptoms in patients with AR treated with antihistamines, with or without montelukast, may additionally result from the reduction of sICAM-1 and nasal eosinophilia. Because the combination therapy may bring inconclusive benefits in this area there is a strong need of further studies to find mechanisms that favor combination therapy.
Authors: Sarah K Wise; Sandra Y Lin; Elina Toskala; Richard R Orlandi; Cezmi A Akdis; Jeremiah A Alt; Antoine Azar; Fuad M Baroody; Claus Bachert; G Walter Canonica; Thomas Chacko; Cemal Cingi; Giorgio Ciprandi; Jacquelynne Corey; Linda S Cox; Peter Socrates Creticos; Adnan Custovic; Cecelia Damask; Adam DeConde; John M DelGaudio; Charles S Ebert; Jean Anderson Eloy; Carrie E Flanagan; Wytske J Fokkens; Christine Franzese; Jan Gosepath; Ashleigh Halderman; Robert G Hamilton; Hans Jürgen Hoffman; Jens M Hohlfeld; Steven M Houser; Peter H Hwang; Cristoforo Incorvaia; Deborah Jarvis; Ayesha N Khalid; Maritta Kilpeläinen; Todd T Kingdom; Helene Krouse; Desiree Larenas-Linnemann; Adrienne M Laury; Stella E Lee; Joshua M Levy; Amber U Luong; Bradley F Marple; Edward D McCoul; K Christopher McMains; Erik Melén; James W Mims; Gianna Moscato; Joaquim Mullol; Harold S Nelson; Monica Patadia; Ruby Pawankar; Oliver Pfaar; Michael P Platt; William Reisacher; Carmen Rondón; Luke Rudmik; Matthew Ryan; Joaquin Sastre; Rodney J Schlosser; Russell A Settipane; Hemant P Sharma; Aziz Sheikh; Timothy L Smith; Pongsakorn Tantilipikorn; Jody R Tversky; Maria C Veling; De Yun Wang; Marit Westman; Magnus Wickman; Mark Zacharek Journal: Int Forum Allergy Rhinol Date: 2018-02 Impact factor: 3.858
Authors: Ioana Corina Bocsan; Ioana Adriana Muntean; Nicolae Miron; Irena Pintea; Carmen Teodora Dobrican; Corina Ureche; Anca Dana Buzoianu; Diana Deleanu Journal: J Clin Med Date: 2021-12-26 Impact factor: 4.241