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Mechanism of topical glucocorticoid treatment of hay fever: IL-5 and eosinophil activation during natural allergen exposure are suppressed, but IL-4,

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Presentation on theme: "Mechanism of topical glucocorticoid treatment of hay fever: IL-5 and eosinophil activation during natural allergen exposure are suppressed, but IL-4,"— Presentation transcript:

1 Mechanism of topical glucocorticoid treatment of hay fever: IL-5 and eosinophil activation during natural allergen exposure are suppressed, but IL-4, IL-6, and IgE antibody production are unaffected  Hirohito Kita, MD, Ronald K. Jorgensen, MD, Charles E. Reed, MD, Sandra L. Dunnette, BA, Mark C. Swanson, BA, Kathleen R. Bartemes, BA, Diane Squillace, BA, Judy Blomgren, RN, Kay Bachman, RN, BSN, Gerald J. Gleich, MD  Journal of Allergy and Clinical Immunology  Volume 106, Issue 3, Pages (September 2000) DOI: /mai Copyright © 2000 Mosby, Inc. Terms and Conditions

2 Fig. 1 Short ragweed pollen counts in Rochester, Minnesota, during the 1995 ragweed hay fever season (gray area) . Mean daily nasal symptom scores of the placebo-treated (solid black line , n = 14) and budesonide-treated (dashed line , n = 10) patients are represented from July 24, 1995, through October 26, 1995 (weeks 1-14). Statistical analysis comparing nasal symptoms between the placebo and budesonide groups was performed on symptom scores recorded from August 20, 1995, through September 10, 1995 (arrows) . Journal of Allergy and Clinical Immunology  , DOI: ( /mai ) Copyright © 2000 Mosby, Inc. Terms and Conditions

3 Fig. 2 Comparison of nasal fluid EDN levels. A, Changes in EDN levels (nanograms per milliliter) in the nasal lavage fluid of the placebo (closed circles) and budesonide (open circles) groups during the ragweed hay fever season. The geometric mean values for each group are shown. Asterisks indicate significant differences compared with week 1 (*P < .05, **P < .01). B, Nasal EDN levels (in nanograms per milliliter) preseason (week 1), at peak season (week 6), and off-season (week 27) were compared for each patient group. Each dot represents a patient, and the values for each patient are connected by a line . The geometric mean values are represented by solid bars . C, EDN levels (in nanograms per milliliter) in the nasal lavage fluid of the placebo-treated (n = 14) and budesonide-treated (n = 10) patients obtained at the peak of the ragweed season (week 6). The geometric mean values for each group are represented (solid bars) . Journal of Allergy and Clinical Immunology  , DOI: ( /mai ) Copyright © 2000 Mosby, Inc. Terms and Conditions

4 Fig. 3 Comparison of cytokine levels between groups at the peak of the ragweed season. A, IL-5 levels (in picograms per milliliter) in the nasal lavage fluid of the placebo-treated (n = 14) and budesonide-treated (n = 10) patients at the peak of the ragweed season (week 6). B, IL-4 levels (in picograms per milliliter) in the nasal lavage fluid of the placebo-treated (n = 14) and budesonide-treated (n = 10) patients at the peak of the ragweed season (week 6). C, IL-6 levels (in picograms per milliliter) in the nasal lavage fluid of the placebo-treated (n = 14) and budesonide-treated (n = 10) patients at the peak of the ragweed season (week 6). Geometric mean values for each group are represented by solid bars . Values below the lowest limits of detection are reported as zero. Journal of Allergy and Clinical Immunology  , DOI: ( /mai ) Copyright © 2000 Mosby, Inc. Terms and Conditions

5 Fig. 4 Soluble ICAM-1 (sICAM-1) levels in the nasal lavage fluid of the placebo-treated (n = 14) and budesonide-treated (n = 10) patients at the peak of the ragweed season (week 6). The geometric mean values for each group are represented by solid bars . Journal of Allergy and Clinical Immunology  , DOI: ( /mai ) Copyright © 2000 Mosby, Inc. Terms and Conditions

6 Fig. 5 Comparison of nasal fluid markers of inflammation and symptoms. A, Correlation of EDN with nasal symptoms in the placebo group. B, Correlation of IL-5 with nasal symptoms in the placebo group. C, Correlation of IL-5 with EDN in the placebo group. Journal of Allergy and Clinical Immunology  , DOI: ( /mai ) Copyright © 2000 Mosby, Inc. Terms and Conditions

7 Fig. 6 Cellular activation markers CD11b and CD69 on eosinophils and CD25 on lymphocytes. Cells from nonallergic control subjects, the budesonide group, and the placebo group were analyzed at the ragweed season peak (week 6). The results are expressed as the change in mean fluorescence intensity (ΔMFI) . The change in mean fluorescence intensity was calculated from the specific fluorescence intensity with mAb minus the background fluorescence intensity with control antibody. Mean values for each group are represented by solid bars . A, For CD11b, the budesonide group’s mean change in mean fluorescence intensity of 74 and the placebo group’s change in mean fluorescence intensity of 102 were increased compared with the normal value (P < .05 and P < .005, respectively). B, For CD69, the budesonide group’s mean change in mean fluorescence intensity of 21.7 and the placebo group’s change in mean fluorescence intensity of 20.9 were increased compared with the normal value (P < .001 and P < .005, respectively). C, For CD25, the budesonide group’s mean change in mean fluorescence intensity of 84 and the placebo group’s change in mean fluorescence intensity of 89 were increased compared with the normal value (P < .01 and P < .005, respectively). Journal of Allergy and Clinical Immunology  , DOI: ( /mai ) Copyright © 2000 Mosby, Inc. Terms and Conditions

8 Fig. 7 Comparison of serum ragweed-specific IgE and IgA levels. A, Serum ragweed-specific IgE levels (in nanograms per milliliter) in the placebo (solid circle , n = 14) and budesonide (open circle , n = 10) treatment groups as measured during and several weeks after the ragweed hay fever season. Statistical analysis comparing the two groups was performed on week 11 of the ragweed season, which corresponds with the end of the season. Geometric mean values for each group are represented by solid bars . B, Nasal lavage fluid ragweed-specific IgA levels (in units per milliliter) in the placebo (solid circles , n = 14) and budesonide (open circles , n = 10) treatment groups as measured throughout the ragweed hay fever season. Statistical analysis comparing the two groups was performed at week 11 at the end of the ragweed season and the week with the greatest difference between the two groups. Geometric mean values for each group are represented by solid bars . Journal of Allergy and Clinical Immunology  , DOI: ( /mai ) Copyright © 2000 Mosby, Inc. Terms and Conditions

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