lactoferrin and Nasal-Obstruction

We have found that acoustic rhinometry is a reliable means of assessing nasal airway caliber changes during the immediate reaction to nasal allergen challenge of sensitive subjects. Comparison of such changes with symptoms and patterns of mediator release could help in the understanding of mechanisms of immediate and late-phase reactions after allergen challenge and their clinical relevance.. Nasal minimal cross-sectional area (MCA) was assessed sequentially for 6 hours after two blinded challenges in random order with pollen antigens and buffer diluent in five sensitive human subjects. Comparisons were made with: (1) symptom scores; (2) olfaction changes; and (3) nasal secretion levels of histamine, tryptase, leukotriene C4, serum albumin (a marker of vascular permeability), lactoferrin (a marker of local glandular secretion), and inflammatory cells in nasal scrapings.. In four of five subjects there was a significantly greater decrease in MCA after antigen challenge than after diluent challenge, correlating with the degree of subjective nasal congestion. In two of these four subjects there was a prominent second late-phase decrease in MCA at 3 to 5 hours, whereas the MCA was persistently decreased in an additional subject with accompanying subjective congestion. No significant decrease in olfactory acuity occurred. Levels were significantly higher in nasal secretions obtained after antigen challenge than in those obtained after buffer challenge with histamine (9 +/- 2.7 ng/ml vs 1.2 +/- 0.5 ng/ml; p = 0.04); tryptase (95 +/- 83 ng/ml vs 3 +/- 0.9 ng/ml; p = 0.02), leukotriene C4 (5293 +/- 1385 ng/ml vs 578 +/- 183 ng/ml; p = 0.02), and albumin (123 +/- 9 ng/ml vs 19 +/- 1.6 ng/ml; p = 0.005) but not with lactoferrin (4.6 +/- 1.2 ng/ml vs 4.1 +/- 28 ng/ml; p = not significant). Granulocyte exudation was seen after antigen challenge but not after buffer diluent challenge. However, there was not a precise correlation between decreases in MCA with changes in levels of these mediators in individual subjects.. Acoustic rhinometry can quantitatively assess congestion during immediate and late-phase reactions after nasal challenge without significant correlation to the degree of individual inflammatory events assessed.

Topics: Acoustics; Adult; Albumins; Cerebrospinal Fluid Rhinorrhea; Chymases; Eosinophils; Granulocytes; Histamine Release; Humans; Lactoferrin; Leukotriene C4; Nasal Cavity; Nasal Mucosa; Nasal Obstruction; Nasal Provocation Tests; Serine Endopeptidases; Time Factors; Tryptases

Despite the availability of a number of pharmacological options, relief of allergic rhinitis (AR) symptoms, especially nasal obstruction, is often limited and local and systemic adverse reactions are not infrequent. The main aim of the present pilot study was to provide subjective and objective evidence of the clinical efficacy in reducing symptoms and safety of a medical device-Grip stop DMG (lactoferrin, carboximetil β-glucan, D-panthenol, dipotassiumglycyrrhizinate) in children affected by allergic rhinitis.. A prospective study with a pre- and post-design has been performed consecutively enrolling 50 pediatric both genders patients affected by persistent AR. Patients received 2 puffs into each nostril twice a day over the course of 4 weeks. The severity of AR symptoms was assessed subjectively as measured by a 0 to 5 Visual Analog Scale, and objectively through active anterior rhinomanometry (AAR) and by means of the evaluation of mucociliary transport time (MCTt). Differences in symptoms scores measured before and after the treatment were compared using Paired-Sample Wilcoxon Signed Rank Test. Proportion of participants with adverse effects attributed to the treatment was computed. The relationship between the subjective score and the AAR and MCT measurements was also assessed.. All considered symptoms, including nasal congestion, significantly improved after treatment (P<0.001), while only 1 patient suffered from moderate adverse effects.. Results confirm efficacy and safety of this device used in the pediatric population. As previously reported in the scientific literature, also in our study, patient's perception of nasal symptoms corresponded with objective testing.

Topics: Administration, Intranasal; Adolescent; beta-Glucans; Child; Equipment Design; Female; Glycyrrhizic Acid; Humans; Lactoferrin; Male; Nasal Obstruction; Pantothenic Acid; Pilot Projects; Prospective Studies; Rhinitis, Allergic; Severity of Illness Index; Statistics, Nonparametric; Treatment Outcome