Allergen-induced changes in the nasal mucous membrane in seasonal allergic rhinitis: Effect of nedocromil sodium

• Published in: Journal of allergy and clinical immunology Vol. 85; no. 1; pp. 125 - 131
• Main Authors: Lozewicz, S., Gomez, E., Clague, J., Gatland, D., Davies, R.J.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 1990; Elsevier
• Subjects: Adult; Allergens - immunology; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Biological and medical sciences; Biopsy; Chronic Disease; Drug Evaluation; Eosinophils - drug effects; Eosinophils - immunology; Eosinophils - pathology; Epithelium - drug effects; Epithelium - immunology; Epithelium - pathology; Female; Humans; Leukocyte Count - drug effects; Male; Mast Cells - drug effects; Mast Cells - immunology; Mast Cells - pathology; Medical sciences; Middle Aged; Nasal Mucosa - drug effects; Nasal Mucosa - immunology; Nasal Mucosa - pathology; Nedocromil; Pharmacology. Drug treatments; Quinolones - administration & dosage; Quinolones - therapeutic use; Respiratory system; Rhinitis, Allergic, Seasonal - drug therapy; Rhinitis, Allergic, Seasonal - immunology; Rhinitis, Allergic, Seasonal - pathology; CAER; Human; Allergy; Immunopathology; Rhinitis; Respiratory disease; Mucosa; Antiinflammatory agent; Quantization; Accumulation; Eosinophil; Optical microscopy; Treatment; Biopsy; Nose; Placebo; Mast cell; Pollen; Mechanism of action; Allergen
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/0091-6749(90)90233-T

We have obtained biopsy specimens of the nasal mucous membrane before and during the grass-pollen season in 22 patients with seasonal allergic rhinitis to grass pollen to assess the effects on cellular infiltration of natural exposure to allergen. Biopsy sections were examined by light microscopy, and quantitative assessment was made of numbers of mast cells and eosinophils. The patients were divided into 11 who were treated with placebo and II patients who were treated with topical nedocromil sodium. In the group as a whole, there was a significant ( p < 0.001) increase in mast cell density in tissue sections from biopsy specimens obtained during the season compared with out of season (median values, 55.0 and 15.5 cells per square millimeter, respectively). There was also a significant ( p < 0.02) increase in the density of eosinophil infiltration during the season compared with out of season (median values, 6.3 and 0 cells per square millimeter, respectively). Treatment with nedocromil sodium significantly ( p < 0.02) inhibited the accumulation of mast cells but not eosinophils. Compared with the placebo-treated group, the group treated with nedocromil demonstrated a significant ( p < 0.025) reduction in the requirements for treatment with concomitant medication (terfenadine tablets and xylometazoline/antazoline eye drops). These results indicate that natural exposure to allergen in patients with seasonal allergic rhinitis is accompanied by infiltration of mast cells and eosinophils into the nasal mucous membrane. The clinical efficacy of nedocromil sodium in this condition may be related to inhibition of infiltration by mast cells.