Liposomes: a new non-pharmacological therapy concept for seasonal-allergic-rhinoconjunctivitis

Abstract

Mucosal barrier disorders play an important role in the pathomechanism of the allergic disease. A new approach for their treatment uses liposomes, which consist of phospholipids that make up 75% of the protective nasal surfactant layer. Our aim was to investigate the efficacy of liposomal-based therapy, as a comprehensive treatment alternative to guideline cromoglycate-based therapy, in the treatment of seasonal allergic rhinoconjunctivitis (SAR). We compared nasal and conjunctival symptom reduction with LipoNasal n nasal spray used as monotherapy (LNM), or LipoNasal n nasal spray and Tears Again eye spray combination therapy (LTC), against standard cromoglycate combination therapy (CGC). This prospective, controlled, open observational study was conducted monocentrically. According to their symptoms and preferences 72 patients with SAR were distributed in three equal groups. The study comprised two visits at an interval of 7 days. The efficacy was examined by daily documenting nasal and conjunctival symptom scores. The Nasal-Spray-Sensory-Scale and the Eye-Drops/Spray-Sensory-Scale were used to investigate the tolerability. Quality of life (QoL) was evaluated, using the RHINASTHMA QoL German adapted version. LNM achieved significant improvement in nasal (p < 0.001) and conjunctival symptoms (p = 0.050). The symptom reduction using CGC was equally significant. LTC led to significant nasal symptom relief (p = 0.045). QoL did not improve significantly in all groups (p > 0.05). The tolerability of all treatments was good and no adverse reactions were observed. In all treatment groups the improvement of the nasal and conjunctival symptom scores exceeds the minimal clinically important difference (MCID). The results demonstrate good tolerability and efficacy of non-pharmaceutical liposomal-based treatment (LipoNasal n and Tears Again), given as monotherapy or combination therapy, for nasal and conjunctival symptoms caused by SAR. This study indicates that liposomal-based treatment for SAR may be a comparable alternative to cromoglycate therapy. Further studies are needed to verify these findings.

Liposomal Eye Spray Is as Effective as Antihistamine Eye Drops in Patients with Allergic Rhinoconjunctivitis Induced by Conjunctival Provocation Testing

“…In both treatment groups, 80% of patients perceived the onset of action within 0–2 min after application, resulting in the first perception of relief of allergy symptoms. This finding goes in line with that of an earlier prospective, controlled, open, observational study conducted by Böhm et al [6], which compared a cromoglycate combination therapy to a liposomal nasal spray, either alone or in combination with an LS. They found that 25% of LS users felt an onset of action within 5 min, whereas only 12.5% of cromoglycate eye drop users perceived an onset of action within the same time frame.…”

“…Overall, previous results from prospective, controlled studies (some of which were randomized and blinded or open-label) suggest that liposomes, in particular in the form of an eye spray, are a promising alternative to standard drug therapy for treating allergic symptoms and should be investigated further [6-12]. Consequently, it was the objective of the present study to gain information on how stabilization of the tear film can influence eye symptoms/irritation during natural allergen exposure in the allergy season.…”

“…According to Wes­ton and Mösges [15], the liposomal nasal spray reduced symptoms and significantly improved quality of life in patients with ARC, showing no difference to standard treatment with an antihistamine and/or glucocorticoid spray, as was shown in a prospective, controlled, open, observational study. To assess the efficacy and tolerability in patients with seasonal ARC, Böhm et al [6] compared in a prospective, controlled, open, observational study the use of a liposomal nasal spray in combination with an LS to that of a standard cromoglycate-based combination therapy. The use of the liposomal products led to significant symptom relief, underlining the potential of liposome-based therapy and warranting further research.…”

“…As an alternative treatment option to local antihistamines, the liposomal eye spray (LS) Tears Again® (Optima Pharmazeutische GmbH, Hallbergmoos, Germany) has been introduced [6]. The liposomes contained in this spray are applied to the closed eyelid and blend with the lipids secreted by the meibomian glands at the rim of the eyelids.…”

Eosinophil-Associated Lung Diseases. A Cry for Surfactant Proteins A and D Help?

“…Indeed, early studies using liposomes, which consist of phospholipids that make up 75% of the nasal surfactant layer, have been found to be comparable to cromoglycolate therapy in the treatment of patients with AR (87). In patients with chronic rhinosinusitis associated with cystic fibrosis, expression of SP-A, SP-B, and SP-D is also increased (88,89).…”