Efficacy of Nasal Cellulose Powder in the Symptomatic Treatment of Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Trial

Manuyakorn, Wiparat; Klangkalya, Natchanun; Kamchaisatian, Wasu; Benjaponpita, Suwat; Sasisakulporn, Cherapat; Jotikasthira, Wanlapa

doi:10.4168/aair.2017.9.5.446

Cited by 9 publications

(6 citation statements)

References 20 publications

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“…In contrast, another study demonstrated that CP conferred no significant effect on ameliorating dust mite-sensitized AR children [13]. However, previous studies were limited by the relatively short duration of clinical observations and only patients’ subjective rating being assessed.…”

Section: Introductionmentioning

confidence: 94%

Effect of Cellulose Powder on Human Nasal Epithelial Cell Activity and Ciliary Beat Frequency

Zhou

Zuo

et al. 2018

Int Arch Allergy Immunol

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Background: Cellulose powder (CP) has been reported as a safe and effective complementary treatment for allergic rhinitis (AR). Currently, CP has gained increasing application for clinical management worldwide, particularly in China. However, studies focusing on the effect of CP on normal human nasal epithelial cells (hNECs) and ciliary function are lacking. Here, we aimed to explore the adverse effects of CP on the activity and ciliary function of hNECs. Methods: We biopsied ethmoid sinus or middle turbinate tissues during surgical resection from control subjects who underwent endoscopic sinus surgery for diseases other than AR. Cells were isolated and passaged, followed by differentiation in an air-liquid interface (ALI). Flow cytometry and cell viability test (cell counting kit-8) were performed to detect the cytotoxicity of CP (effects on cell proliferation) on normal hNECs. By using the ALI culture model, we investigated the effects of CP on ciliary beat frequency (CBF). Results: There was a significant reduction in hNEC count at high concentrations of CP (2.5 mg/mL) at days 3 and 7 (both p < 0.05). As the concentration increased, cell death increased progressively from day 3 to day 7. However, these effects were not evident at low concentrations (0.25 mg/mL, p > 0.05). High-dose CP (2.5 mg) significantly reduced the CBF (p < 0.05). At lower concentrations (0.25–2.5 mg/mL), CP initially increased but subsequently reduced the CBF of hNECs compared with control group. Conclusions: Cytotoxicity and the suppression of ciliary beat at high concentrations justify more prudent use of CP for the management of AR.

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Section: Introductionmentioning

confidence: 94%

Effect of Cellulose Powder on Human Nasal Epithelial Cell Activity and Ciliary Beat Frequency

Zhou

Zuo

et al. 2018

Int Arch Allergy Immunol

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“…Before NPT, participants were asked to discontinue topical nasal corticosteroids for 2 weeks, antihistamine medication for a week, and oral or topical decongestants for a day. NPT protocol was modified using our previous report 10 and a recent study in chidren 11 as follows. Firstly, baseline nasal symptom scores were recorded, then nasal airway resistance (NAR) and nasal airflow patency were assessed using anterior rhinomanometry analyzes (Multifunctional Spirometer HI-801, Chest M.I, Inc., Tokyo, Japan) and peak nasal inspiratory flows (PNIF) (In-Check Nasal, Clement Clark, Harlow, UK).…”

Section: Hdm Nasal Provocation Testmentioning

confidence: 99%

Skin Prick Test Versus Phadiatop as a Tool for Diagnosis of Allergic Rhinitis in Children

Traiyan

Manuyakorn

Kanchongkittiphon

et al. 2020

Am J Rhinol�Allergy

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Background Skin prick test (SPT) or Phadiatop, a multi-allergen IgE screening test, was used as a tool for detecting aeroallergen sensitization. Objective To compare SPT and Phadiatop as a tool for diagnosis allergic rhinitis (AR) using the nasal provocation test (NPT) as a comparative standard. Methods Children aged 5-18 years with rhinitis symptoms more than 6 times in the past year were enrolled. SPT to 13 common aeroallergens, serum for Phadiatop, and NPT to Dermatophagoides pteronyssinus (Der p) were performed. NPT to mixed cockroach (CR) were performed in children who had CR sensitization and negative NPT to Der p. Children who had a disagreement between the result of SPT and Phadiatop or having negative results were evaluated for specific IgE (sIgE) to common aeroallergens. Results One hundred-forty children were enrolled with the mean age of 9.8 ± 3 years, 56% were male. Of 92 children (65.7%) with positive SPT to any aeroallergens, 88 children (95.6%) were sensitized to house dust mite (HDM). NPT showed positive results in 97 children (69.3%). Of 48 children who showed negative SPT, 4 children (8.3%) had sIgE to aeroallergens but NPT was positive in 1 child. Eighty-eight children (62.9%) had positive tests for Phadiatop and 4 (4.5%) of them had negative results for NPT to Der p. Among 52 children who had negative results for Phadiatop, 4 children (7.6%) had sIgE to aeroallergens but NPT was positive in 2 children (3.8%). SPT and Phadiatop showed 94.2% agreement: with Kappa 0.876, p < 0.001. Using NPT as a comparative standard for diagnosis for AR, SPT showed a sensitivity of 89.6% and specificity of 88.3% and Phadiatop provided the sensitivity of 88.6% and specificity of 95.3%. Conclusions SPT to aeroallergen and Phadiatop have good and comparable sensitivity and specificity for the diagnosis of AR in children.

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“…Further scientific evidences have become available owing to more recent clinical trials that investigated the efficacy of these products in adults and children (Åberg et al, 2014, 2011). However, contrasting data have been just published following a randomized, double-blind trial in 60 dust mite-sensitized AR children comparing the nasal cellulose powder with placebo (Manuyakorn et al, 2017). The placebo was a lactose powder having the same particle size and appearance as the cellulose powder.…”

Section: Non-pharmacologically Active Substancesmentioning

confidence: 99%

Opportunity and challenges of nasal powders: Drug formulation and delivery

Fasiolo

Manniello

Tratta

et al. 2018

European Journal of Pharmaceutical Sciences

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In the field of nasal drug delivery, among the preparations defined by the European Pharmacopoeia, nasal powders facilitate the formulation of poorly water-soluble active compounds. They often display a simple composition in excipients (if any), allow for the administration of larger drug doses and enhance drug diffusion and absorption across the mucosa, improving bioavailability compared to nasal liquids. Despite the positive features, however, nasal products in this form still struggle to enter the market: the few available on the market are Onzetra Xsail® (sumatriptan) for migraine relief and, for the treatment of rhinitis, Rhinocort® Turbuhaler® (budesonide), Teijin Rhinocort® (beclomethasone dipropionate) and Erizas® (dexamethasone cipecilate). Hence, this review tries to understand why nasal powder formulations are still less common than liquid ones by analyzing whether this depends on the lack of (i) real evidence of superior therapeutic benefit of powders, (ii) therapeutic and/or commercial interest, (iii) efficient manufacturing methods or (iv) availability of suitable and affordable delivery devices. To this purpose, the reader's attention will be guided through nasal powder formulation strategies and manufacturing techniques, eventually giving up-to-date evidences of therapeutic efficacy in vivo. Advancements in the technology of insufflation devices will also be provided as nasal drug products are typical drug-device combinations.

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Efficacy of Nasal Cellulose Powder in the Symptomatic Treatment of Allergic Rhinitis: A Randomized, Double-Blind, Placebo-Controlled Trial

Cited by 9 publications

References 20 publications

Effect of Cellulose Powder on Human Nasal Epithelial Cell Activity and Ciliary Beat Frequency

Effect of Cellulose Powder on Human Nasal Epithelial Cell Activity and Ciliary Beat Frequency

Skin Prick Test Versus Phadiatop as a Tool for Diagnosis of Allergic Rhinitis in Children

Opportunity and challenges of nasal powders: Drug formulation and delivery

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