Phototherapy for hay fever - a new therapeutic tool for the management of allergic rhinitis

Abstract

Rationale Since phototherapy is successfully used in the treatment of atopic dermatitis, we investigated the effect of a light source containing 90% high intensity visible light, 2% UVB, and 8% UVA1 in allergic rhinitis. Methods We conducted a randomized, double-blind, placebo-controlled study in 28 patients with a history of at least 2 years of moderate to severe ragweed-induced allergic rhinitis that was not controlled by antiallergic drugs. Each intranasal cavity was illuminated 3 times a week for 3 weeks using gradually increasing doses, starting with 16.7J. Evaluation was based on symptom scores and determination of differential cell counts, cytokines and ECP in nasal lavage samples. The effect of phototherapy on T cell apoptosis and antigen-induced histamine release of RBL-2H3 cells was also studied. Results Phototherapy significantly decreased scores for sneezing (p=0.033), rhinorrhea (p=0.017), nasal itching (p=0.011) and total nasal score (p=0.007), the improvement rate correlated with treatment duration. Scores for nasal obstruction improved during treatment but the changes did not reach statistical significance. In nasal lavage samples a significant decrease of eosinophil cell counts (p=0.009), ECP (p=0.04) and IL-5 (p=0.04) levels but no changes of IL-4 levels were detected at the end of treatment period. In the placebo group no improvement was observed. Phototherapy resulted in a dose dependent increase of T cell apoptosis and inhibition of histamine release from RBL-2H3 cells. Conclusions Phototherapy is an effective modality to treat allergic rhinitis, acting at multiple checkpoints of the pathogenic process.