Am. J. Respir. Crit. Care Med., Vol 151, No. 2, Feb 1995, 315-320.
The effects of intranasal steroids on nasal and pulmonary responses to cat exposure
RA Wood and PA Eggleston
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
To test the hypothesis that nasal antiinflammatory treatment can modify
both upper and lower airway responses to allergen exposure, 12 cat-
allergic subjects underwent 1 h cat exposure challenges at baseline, with
nasal occlusion, and after 1 wk of treatment with either intranasal
triamcinolone acetonide or placebo in a double-blind crossover trial.
Challenges were performed in a room containing two cats with airborne Fel d
I levels ranging from 35 to 37,525 ng/m3. Overall, nasal symptoms were
moderately reduced by treatment (p = 0.06), with the greatest reduction
occurring in the first 15 and 30 min of the challenge (p < 0.01 and p
< 0.05, respectively). Mean lower respiratory symptoms were also
diminished by treatment (p = 0.02), although those effects were most
evident during the last 15 min of the challenge. Maximum changes in FEV1
were slightly reduced by the nasal therapy (p = 0.07), reaching statistical
significance only at the 30- min intervals (p < 0.05). There were no
significant differences in nasal histamine or TAME esterase levels. When
challenges were repeated with nasal occlusion, no significant differences
were detected in chest symptoms or FEV1 changes. We conclude that treatment
with an intranasal corticosteroid led to significant reductions in both
upper and lower airway responses to intense cat exposure.
