Nasal nitric oxide in the inferior turbinate surface decreases with intranasal steroids in allergic rhinitis: A prospective study |
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| Institution: | 1. Sen-En Rifu Otological Surgery Center, Miyagi, Japan;2. Department of Otolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan;3. Osaka Ear & Eustachian Tube Clinic, Osaka, Japan;1. Department of Otorhinolaryngology, Higashi-hiroshima Medical Center, 513 Jike, Saijyo-cho, Higashi-hiroshima-shi, Hiroshima, 739-0041, Japan;2. Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hirhoshima-shi, Hiroshima, 734-8551, Japan;1. Department of Chemical Science and Technology, Faculty of Bioscience and Applied Chemistry, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-0003, Japan;2. Research Center for Micro-Nano Technology, Hosei University, 3-11-15 Midori-cho, Koganei, Tokyo 184-8584, Japan;3. Research Center for Functional Materials, National Institute for Materials Science, 1-2-1, Sengen, Tsukuba, 305-0047, Japan |
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| Abstract: | ObjectiveIt remains controversial whether nasal nitric oxide (NO) serves as a reliable parameter to evaluate treatment efficacy in patients with allergic rhinitis (AR). The measurement of local nasal NO levels has been shown to be a sensitive marker for the diagnosis of symptomatic AR patients. Here we assessed the applicability of nasal NO to evaluations of the efficacy of intranasal steroids (INS) in a prospective design.MethodsWe enrolled 25 patients with perennial AR and 10 age-matched healthy participants. The AR patients received fluticasone furoate (FF) once daily for 2 months. Fractional exhaled NO and nasal NO measurements were carried out using an electrochemical analyzer at pretreatment and at 2 weeks and 2 months after treatment. Nasal NO levels were directly measured at two different areas of the nasal cavity: the surface of the inferior turbinate (IT area) and the front of the middle meatus (MM area). Subjective nasal symptoms were also recorded at each visit.ResultsThe mean total nasal symptom score in the AR patients decreased significantly after FF treatment (p < 0.0001). The mean nasal NO levels in the IT area in the AR patients were significantly higher at pretreatment than those of the healthy participants (109 vs. 62.5 ppb, respectively; p < 0.001). After FF administration, the nasal NO levels in the IT area of the AR group showed a significant reduction at both 2 weeks and 2 months (79.1 and 71.9 ppb, respectively; p < 0.05 and p < 0.01). There was no significant difference in nasal NO levels in the MM area between the controls and the AR group at any visit timepoint. When the ratio of the MM area to the IT area (MM/IT ratio) was plotted for each subject, the untreated AR patients showed a marked decrease in the ratio, whereas after the FF treatment, the AR patients' mean MM/IT ratios showed a significant increase. No significant difference compared to the control group existed at 2 months.ConclusionNasal NO measurement around the inferior turbinate is an objective measure to evaluate allergic conditions and is useful to monitor therapeutic effects of INS. |
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| Keywords: | Allergic rhinitis Fractional exhaled nitric oxide Inferior turbinate Intranasal steroids Middle meatus Nasal nitric oxide |
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