Steroids for allergic rhinitis

Corticosteroids for allergic rhinitis

Glucocorticosteroids have marked anti-inflammatory actions. They reduce the number of circulating inflammatory cells, including lymphocytes, mast cells, basophils, eosinophils, macrophages, and neutrophils. This occurs through multiple mechanisms, e.g. by preventing cytokine production and reducing local mechanisms of tissue infiltration. Furthermore, corticosteroids also reduce preformed and newly-generated mediators (e.g. histamine, prostaglandins, and leukotrienes), and inhibit production of cytokines by inflammatory cells (e.g. IL-1 through IL-6, IL-8, TNF-α, and interferon-γ).

Corticosteroids in allergic rhinitis are very effective in low doses when applied locally. Local application by nasal spray can also reduce systemic adverse effects. The effects of corticosteroid treatment are typically seen a week after the onset of therapy.

 

In cases of moderate or severe allergic rhinitis, topical corticosteroids have better effect than antihistamines. Most widely used corticosteroids are fluticasone, budesonide, and eclometasone.

Most prevailing local adverse effects of corticosteroids include nasal irritation and sneezing after application. Atrophy of the nasal mucosa can occur after long-term treatment.

Oral corticosteroids are only prescribed in severe cases of allergic rhinitis.

1

Desensitization as a treatment for a specific allergy utilizes: 

2

The following cytokines are produced by T cells except