Effect of slow-release theophylline on nasal antigen challenge in subjects with allergic rhinitis

Abstract

It has been recognized recently that theophylline possesses anti-inflammatory effects that could be of clinical interest in patients with airway inflammatory diseases such as asthma and allergic rhinitis (AR). The aim of the present study was to explore the effect of theophylline on the nasal eosinophilic inflammatory response following allergen challenge in patients with AR. Fourteen subjects suffering from seasonal rhinitis with an early reaction after nasal allergen provocation were challenged outside the pollen season after pretreatment for 3 weeks with placebo or slow-release theophylline (Euphylong in a randomized double-blind, cross-over study. Nasal blocking index (NBI), nasal airway resistance and symptoms were recorded before, and 1 and 5 h after challenge; additionally, nasal lavage fluid was collected before, as well as 1 and 5 h after challenge. Eosinophil cationic protein (ECP) was measured in the lavage as well as the number of eosinophils before, and 1 h and 5 h after allergen challenge. After 3 weeks of treatment, baseline concentrations of ECP in nasal lavage amounted to 826+/-329 ng x L(-1) (placebo) and 936+/-351 ng x L(-1) (theophylline). The ECP levels did not increase during the early phase response. Five hours after challenge, ECP in the placebo group increased markedly (p<0.01), whereas no significant increase was observed during theophylline treatment. In parallel, the number of eosinophils in the nasal lavage fluid was lower during theophylline treatment. Additionally, theophylline therapy also significantly reduced the nasal symptoms and had some protective effect against nasal obstruction following allergen challenge. These results confirm the anti-inflammatory effects of theophylline and suggest that these effects may be of clinical benefit in patients with allergic rhinitis.

Effect of Formaldehyde on Asthmatic Response to Inhaled Allergen Challenge

“…This challenge involved an automatic inhalation-synchronized Mefar MB3 dosimeter jet nebulizer (Mefar SpA, Bovezzo, Italy). We used the same standardized extract of five grass pollen allergens as for the skin test (Stallergenes Laboratory) The initial allergen concentration of standardized pollen extract was 0.1 or 0.2 IR (index of reactivity), as previously described by Aubier et al (1998). The concentration of inhaled allergen was doubled every 15 min; the FEV 1 was measured immediately after each doubling and again 10 min after each inhalation.…”

Adenosine receptors: novel targets for drug development in allergic rhinitis

“…In a small double‐blind crossover study, treatment out of season of rhinitic patients with theophylline reduced the release of mediators from mast cells and attenuated sneezing after nasal allergen challenge [22]. Another controlled study in patients with seasonal allergic rhinitis demonstrated that treatment with theophylline reduced symptoms, nasal obstruction, eosinophils influx and ECP concentration in nasal lavage fluid after nasal allergen challenge [23]. Similar studies with topical corticosteroids found an effect on nasal obstruction of the same order of magnitude.…”