Butterbur, a herbal remedy, protects against allergen-sensitized mast cell priming in seasonal allergic rhinitis

Abstract

2 Butterbur, a Herbal Remedy, Protects Against Allergen-Sensitized Mast Cell Priming in Seasonal Allergic Rhinitis I. J. Carstairs 1, D. K. C. Lee 2, K. Haggart 2, C. M. Jackson 2, G. E Currie 2, B. J. Lipworth2; IAsthma and Allergy Research Group, Dundee, UNITED KINGDOM, 2Asthma and Allergy Research Group, Ninewells Hospital and Medical School, UNITED KINGDOM. BACKGROUND: Butterbur (BB) or Petasites hybridus, an herbal remedy, exhibits in vitro inhibition of cysteinyl leukotrienes biosynthesis and has been shown to be as effective as Hi-antihistamines on symptomatic control in seasonal allergic rhinitis (SAR). However, no placebo controlled studies have been performed to evaluate the effectiveness of BB on objective outcomes in SAR. METHODS: 20 patients with grass pollen sensitized SAR were randomized in double blind, cross over fashion to receive for 2 weeks either BB 50 mg twice daily or placebo (PL) twice daily during the grass pollen season. Nasal adenosine monophosphate (AMP) challenge (the primary outcome) was administered as a single 400 mg/ml dose after each randomized treatment, in order to evaluate in vivo allergen sensitized mast cell priming. RESULTS: Spontaneous recovery following AMP challenge (area under the response time profile curve as % 9 min) was significantly attenuated (p=0.028) with BB (584 __ 289) compared to PL (1438 _+ 240); mean difference: 854 (95% CI 95-1614), and lhe maximum % PNIF fall from baseline following AMP challenge was significantly blunted (p=0.036) with BB (30 _+ 4) compared to PL (43 + 5); mean difference: 13 (95% CI 1-25). SUMMARY: BB exhibited protection against allergen sensitized mast cell priming which may explain its clinical efficacy in patients with SAR. Funding: Universi~ of Dundee 3 Large Particle Nebulized Saline Therapy for Chronic Nasal Obstruction: A Prospective Evaluation