Am. J. Respir. Crit. Care Med.,
Volume 162, Number 5, November 2000, 1705-1708
Immediate Effect of Topical Budesonide on Allergen
Challenge-induced Nasal Mucosal Fluid Levels of
Granulocyte-Macrophage Colony-stimulating
Factor and Interleukin-5
MARGARETA
LINDEN,
CHRISTER
SVENSSON,
EVA
ANDERSSON,
MORGAN
ANDERSSON,
LENNART
GREIFF,
and
CARL G. A.
PERSSON
Experimental Medicine, AstraZeneca R&D, Lund, Sweden; and Departments of Respiratory Medicine and Allergology, Otorhinolaryngology,
Head and Neck Surgery, and Clinical Pharmacology, Lund University Hospital, Lund, Sweden
The nasal antiinflammatory effects produced by maintenance treatment with topical steroids include reduced production of cytokines. The present study explored nasal mucosal effects induced during the first 9 h after a single dose of topical budesonide. Nine subjects
with allergic rhinitis due to birch or timothy pollen were given
budesonide (256 µg; Rhinocort Aqua) or placebo in a double-blind,
randomized, crossover (4 wk washout) manner. Nasal allergen challenges were performed 30 min after the steroid/placebo pretreatment. Before and 30 min, 1, 3, 5, 7, and 9 h after challenge, filter
paper strips were placed on the nasal septum and inferior turbinates for 10 min to sample undiluted mucosal fluids. Strips were
then extracted in 1 ml buffer for cytokine analysis (ELISA). Allergen
challenge produced acute nasal symptoms that peaked at 30 min
and then tapered off. Conversely, both GM-CSF and IL-5 were increased only at 3, 5, 7 and 9 h (p < 0.05 compared with baseline).
Budesonide did not affect the nasal symptoms but inhibited (p < 0.05; compared with placebo treatment) the allergen challenge-induced mucosal output of GM-CSF and IL-5. These data demonstrate
that GM-CSF and IL-5 are induced in a nonsymptomatic, late phase
response to nasal allergen challenge, and that this cytokine response is prevented by single dose budesonide pretreatment.
