Nasal Rinsing with Hypertonic Solution: An Adjunctive Treatment for Pediatric Seasonal Allergic Rhinoconjunctivitis

Garavello, Werner; Berardino, Federica Di; Romagnoli, Marco; Sambataro, G.; Gaini, Renato Maria

doi:10.1159/000086462

Cited by 74 publications

(76 citation statements)

References 22 publications

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“…This measure was not a true placebo because isotonic (and hypertonic) saline might be effective in allergic rhinitis [5][6][7]. For example, Garavello et al [7] demonstrated that nasal administration of isotonic saline was efficacious in children with seasonal allergic rhinitis. The possibility that saline may exert such effects (even if this is not suggested from the present study: Fig.…”

Section: Resultsmentioning

confidence: 99%

Effects of a Topical Microemulsion in House Dust Mite Allergic Rhinitis

Andersson

Greiff

Wollmer

2010

Basic Clin Pharma Tox

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Abstract:We have previously demonstrated that a topical microemulsion can attenuate symptoms and signs of seasonal allergic rhinitis. This likely reflects that the microemulsion interferes with the interaction between the allergen and the mucosa. Whether or not the finding translates to conditions caused by other inhaled agents such as house dust mite allergen is unknown. Patients with perennial allergic rhinitis caused by house dust mite were subjected to topical microemulsion treatment in a randomized, double-blinded and crossover design with isotonic saline as control. Morning symptoms were monitored, change from baseline was assessed and the treatments were compared. On the first days of the isotonic saline and microemulsion runs, before any treatment was given, total nasal symptoms were scored to 2.8 and 3.1 (range 0-9), respectively. Nasal symptoms were reduced by intervention with the microemulsion: the change from baseline was consistent for the microemulsion and the difference between the microemulsion and isotonic saline reached statistical significance in favour of the former. We conclude that intervention with a microemulsion may reduce symptoms of house dust mite allergic rhinitis at natural allergen exposure. Our findings suggest the possibility that topical microemulsions can be a useful option to reduce nasal mucosal exposure to allergen in perennial allergic rhinitis..

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Section: Resultsmentioning

confidence: 99%

Effects of a Topical Microemulsion in House Dust Mite Allergic Rhinitis

Andersson

Greiff

Wollmer

2010

Basic Clin Pharma Tox

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“…The quantitative variables were compared using the Mann-Whitney test, Wilcoxon's signed rank sum test for paired data or Kruskal-Wallis test for between groups differences. Sample size was not calculated a priori because this type of calculation is determined by the rate of events in the control group, which could vary widely in case ofallergic rhinitis (11)(12)(13)(14), nevertheless we decided to enroll a sample much larger than that usually included in the previous pediatric studies. All of the tests were two sided and a P value of <0.05 was considered statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Hypertonic Saline is More Effective Than Normal Saline in Seasonal Allergic Rhinitis in Children

Marchisio

Varricchio

Baggi

et al. 2012

Int J Immunopathol Pharmacol

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Allergic rhinitis (AR) is a very common childhood disease that is associated with a significant reduction in the patients' quality of life. Its treatment combines educating the patients and their parents, immunotherapy and drug administration. However, even the best approach does not relieve the symptoms of a number of patients. Alternative therapies are particularly needed for children because the fear of adverse events frequently reduces parental compliance to the prescribed drugs, and immunotherapy is less easy to administer than in adults. In this prospective investigator-blinded study we evaluated whether children, with a documented history of seasonal grass pollen-related AR, benefit from nasal irrigation by assessing the effects on nasal signs and symptoms, on middle ear effusion and on adenoidal hypertrophy. We randomized children aged 5 to 9 years (median age 82 months) to normal saline or hypertonic saline (a 2.7% sodium chloride solution), administered twice-daily using a disposable 20 ml syringe, or no treatment. Nasal symptoms (rhinorrhea, itching, sneezing, nasal obstruction), swelling of turbinates, adenoid hypertrophy or middle ear effusion were assessed at baseline and after 4 weeks of treatment. Two hundred and twenty children (normal saline: 80; hypertonic saline: 80; no treatment: 60) completed the study. After four weeks, all the considered items were significantly reduced in the group receiving hypertonic saline (P <0.0001), whereas in the group receiving normal saline only rhinorrhea (P = 0.0002) and sneezing (P = 0.002) were significantly reduced. There was no significant change in any of the items in the control group. The duration of oral antihistamines was significantly lower in the children receiving hypertonic saline than in those treated with normal saline or in controls. No adverse events were reported and parental satisfaction and compliance with the procedure were globally very good, regardless of the solution used. Using our procedure, hypertonic saline is effective, inexpensive, safe, well tolerated and easily accepted by children with seasonal grass pollen-related AR and their parents. Our data suggest that nasal irrigation with hypertonic saline might be included in the wide spectrum of therapies recommended for grass-pollen AR.

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“…Effective in children with seasonal and other forms of AR in combination with conventional treatment [55,57]. Sterile saline eyedrops are a simple, non-toxic and effective addition for seasonal allergic conjunctivitis [58].…”

Section: Place In Therapymentioning

confidence: 99%

BSACI guidelines for the management of allergic and non‐allergic rhinitis

Scadding

Durham

Mirakian

et al. 2007

Clin Experimental Allergy

349

292

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SummaryThis guidance for the management of patients with allergic and non-allergic rhinitis has been prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI). The guideline is based on evidence as well as on expert opinion and is for use by both adult physicians and paediatricians practicing in allergy. The recommendations are evidence graded. During the development of these guidelines, all BSACI members were included in the consultation process using a web-based system. Their comments and suggestions were carefully considered by the SOCC. Where evidence was lacking, consensus was reached by the experts on the committee. Included in this guideline are clinical classification of rhinitis, aetiology, diagnosis, investigations and management including subcutaneous and sublingual immunotherapy. There are also special sections for children, co-morbid associations and pregnancy. Finally, we have made recommendations for potential areas of future research.

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Nasal Rinsing with Hypertonic Solution: An Adjunctive Treatment for Pediatric Seasonal Allergic Rhinoconjunctivitis

Cited by 74 publications

References 22 publications

Effects of a Topical Microemulsion in House Dust Mite Allergic Rhinitis

Effects of a Topical Microemulsion in House Dust Mite Allergic Rhinitis

Hypertonic Saline is More Effective Than Normal Saline in Seasonal Allergic Rhinitis in Children

BSACI guidelines for the management of allergic and non‐allergic rhinitis

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