Nasal sodium cromoglycate (Lomusol) modulates the early phase reaction of mild to moderate persistent allergic rhinitis in patients mono-sensitized to house dust mite: A preliminary study

Abstract

We evaluated the clinical improvement of patients with mild to moderate persistent allergic rhinitis (AR) due to mono-sensitization to house dust mite (HDM) allergen, by sodium cromoglycate nasal spray (Lomusol 4%). Lomusol was used as a single agent treatment, and its anti-inflammatory effects, in the early phase reaction were evaluated. Herein we showed that Lomusol significantly improved the subjective nasal symptom scores especially nasal obstruction. This was associated with significant and specific reduction in neutrophils influx in nasal cytology but had no effect on other cell types. This selective anti-inflammatory effect on nasal cytology was associated with significant reduction in the levels of platelet activating factor (PAF) and histamine in nasal secretions but had no effect on PGD2, LTC4 or CysLt levels. Lomusol was also able to induce significant reduction in eosinophil cationic protein (ECP) levels in nasal secretions without altering the percentage of eosinophil influx in nasal cytology. Taken collectively, we showed the first evidence that nasal sodium cromoglycate possesses a selective inhibition on neutrophil recruitment into nasal cytology in the early phase reaction of AR patients mono-sensitized to HDM. This may be attributed to the ability of Lomusol to significantly reduce the amount of PAF recovered in nasal secretion. These results were associated with significant improvement in subjective symptom scores especially nasal obstruction that may in addition, be due to the ability of Lomusol to down-regulate eosinophil degranulation activity as well.