16283
document
Delayed genomic and acute nongenomic action of glucocorticosteroids in seasonal allergic rhinitis . 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 .
16284
Intervention_Pharmacological
Glucocorticosteroids
16285
Intervention_Control
placebo-controlled
16286
Intervention_Pharmacological
betamethasone ( 60 mg )
16287
Intervention_Pharmacological
methylprednisolone ( 400 mg )
16288
Intervention_Control
placebo
16289
Intervention_Pharmacological
betamethasone
16290
Intervention_Pharmacological
methylprednisolone
16291
Intervention_Control
placebo
16292
Intervention_Pharmacological
methylprednisolone
16293
Intervention_Pharmacological
betamethasone
16294
Intervention_Control
placebo
16295
Intervention_Pharmacological
betamethasone
16296
Intervention_Pharmacological
methylprednisolone
16297
Intervention_Control
placebo
16298
Intervention_Pharmacological
glucocorticosteroids
16299
Outcome_Physical
nasal affection
16300
Outcome_Physical
nasal itching
16301
Outcome_Physical
nasal obstruction
16302
Outcome_Other
standardized visual analogue scale
16303
Outcome_Physical
nasal airflow
16304
Outcome_Physical
anterior rhinomanometry
16305
Outcome_Physical
Nasal itching
16306
Outcome_Physical
Itching
16307
Outcome_Physical
Nasal airflow
16308
Outcome_Physical
nasal obstruction
16309
Outcome_Physical
nasal airflow
16310
Outcome_Physical
nasal airflow
16311
Outcome_Physical
Nasal obstruction
16312
Outcome_Physical
Itching
16313
Participant_Condition
seasonal allergic rhinitis
16314
Participant_Condition
allergic rhinitis
16315
Participant_Sample-size
Six
16316
Participant_Sex
female
16317
Participant_Sample-size
18
16318
Participant_Sex
male
16319
Participant_Age
26 years
16320
Participant_Condition
allergic rhinitis