Nasal Eosinophilia and Serum Soluble Intercellular Adhesion Molecule 1 in Patients with Allergic Rhinitis Treated with Montelukast Alone or in Combination with Desloratadine or Levocetirizine
Restricted accessResearch articleFirst published online March, 2013
Nasal Eosinophilia and Serum Soluble Intercellular Adhesion Molecule 1 in Patients with Allergic Rhinitis Treated with Montelukast Alone or in Combination with Desloratadine or Levocetirizine
Because intercellular adhesion molecule (ICAM) 1 and recruitment of eosinophils are crucial in supporting allergic inflammation, their down-regulation may bring additional benefits in patients’ recovery. We have assessed nasal eosinophilia and serum soluble ICAM-1 (sICAM-1) concentrations in relation to nasal symptoms in patients with persistent allergic rhinitis (AR) treated for 6 weeks with either desloratadine, levocetirizine, montelukast alone, or in combination.
Methods
In this single-center, randomized, double-blind, placebo-controlled, crossover, two-arm study, 40 patients with persistent AR were randomized to receive either montelukast and/or levocetirizine or placebo (n = 20) or to receive treatment with montelukast and/or desloratadine or placebo (n = 20). Nasal eosinophilia and concentration of sICAM-1 in peripheral blood were assessed before and on the last day of each treatment period.
Results
All active treatments in both arms of the study resulted in the decrease of sICAM-1 and nasal eosinophilia, which correlated with the severity of nasal symptoms. In the montelukast/levocetirizine arm, montelukast decreased nasal eosinophilia more significantly than levocetirizine, whereas in reduction of sICAM-1 all active treatment options were equally effective. However, in the desloratadine/montelukast arm, the resulting improvement of combination therapy of sICAM-1 and the influx of eosinophils was not statistically significant.
Conclusion
The improvement of nasal symptoms in patients with AR treated with antihistamines, with or without montelukast, may additionally result from the reduction of sICAM-1 and nasal eosinophilia. Because the combination therapy may bring inconclusive benefits in this area there is a strong need of further studies to find mechanisms that favor combination therapy.
Get full access to this article
View all access options for this article.
References
1.
CotranRS and Mayadas-NortonT.Endothelial adhesion molecules in health and disease. Pathol Biol46:164–170, 1998.
2.
TsakadzeNLZhaoZ and D'SouzaSE. Interactions of intercellular adhesion molecule-1 with fibrinogen. Trends Cardiovasc Med12:101–108, 2002.
3.
GearingAJ and NewmanW.Circulating adhesion molecules in disease. Immunol Today14:506–512, 1993.
4.
RieckmannPMichelUAlbrechtM, Soluble forms of intercellular adhesion molecule-1 (ICAM-1) block lymphocyte attachment to cerebral endothelial cells. J Neuroimmunol60:9–15, 1995.
5.
RothleinRMainolfiEACzajkowskiM and MarlinSD. A form of circulating ICAM-1 in human serum. J Immunol147:3788–3793, 1991.
6.
SethRRaymondFD and MakgobaMW. Circulating ICAM-1 isoforms: Diagnostic prospects for inflammatory and immune disorder. Lancet1:83–84, 1991.
7.
van de StolpeA and van der SaagPT. Intercellular adhesion molecule-1. J Mol Med74:13–33, 1996.
8.
OhashiYNakaiY and TanakaA.Soluble intercellular adhesion molecule-1 level in sera is elevated in perennial allergic rhinitis. Laryngoscope107:932–935, 1997.
9.
PitschT and RogalaB.Stężenie cząsteczki sICAM 1 w surowicy chorych z alergią atopową. Alergia Astma Immunologia8:39–44, 2003.
10.
Peric PopadicABogicMJovicicZ, The influence of atopy on sICAm-1 serum levels in patients with allergic rhinitis and bronchial asthma. Med Biochem23:355–359, 2004.
11.
StelmachIJerzynskaJ and KunaP.A randomized, double-blind trial of the effect of treatment with montelukast on bronchial hyperresponsiveness and serum eosinophilic cationic protein (ECP), soluble interleukin 2 receptor (sIL-2R), IL-4, and soluble intercellular adhesion molecule 1 (sICAM-1) in children with asthma. J Allergy Clin Immunol109:257–263, 2002.
12.
KramerMFOstertagPPfrognerE and RaspG.Nasal interleukin-5, immunoglobulin E, eosinophilic cationic protein, and soluble intercellular adhesion molecule-1 in chronic sinusitis, allergic rhinitis, and nasal polyposis. Laryngoscope110:1056–1062, 2000.
13.
PelikanZ.Delayed asthmatic response: A new phenotype of bronchial response to allergen challenge and soluble adhesion molecules in the serum. Ann Allergy Asthma Immunol106:119–130, 2011.
14.
MullolJde Borja CallejasFMartínez-AntónMA, Mometasone and desloratadine additive effect on eosinophil survival and cytokine secretion from epithelial cells. Respir Res27:12–23, 2011.
15.
CaproniMVolpiWGiomiB, Cellular adhesion molecules in chronic urticaria: Modulation of serum levels occurs during levocetirizine treatment. Br J Dermatol155:1270–1274, 2006.
16.
FasceLCiprandiGPronzatoC, Cetirizine reduces ICAM-I on epithelial cells during nasal minimal persistent inflammation in asymptomatic children with mite-allergic asthma. Int Arch Allergy Immunol109:272–276, 1996.
17.
ParkCSChoJHKangJM, Levocetirizine has anti-inflammatory effects against Toll-like receptor (TLR)3 through the inhibition of Toll-IL-1 receptor (TIR)-domain-containing adapter inducing IFN-beta (TRIF) and receptor-interacting protein (RIP). Auris Nasus Larynx38:474–479, 2011. (Epub Feb 16, 2011.)
18.
CiebiadaMGorska-CiebiadaMBarylskiM, Use of montelukast alone or in combination with desloratadine or levocetirizine in patients with persistent allergic rhinitis. Am J Rhinol Allergy25:e1–e6, 2011.
19.
SchäperCGustavusBKochB, Effects of fexofenadine on inflammatory mediators in nasal lavage fluid in intermittent allergic rhinitis. J Investig Allergol Clin Immunol19:459–464, 2009.
20.
CiebiadaMGórska-CiebiadaMDuBuskeLM and GórskiP.Montelukast with desloratadine or levocetirizine for the treatment of persistent allergic rhinitis. Ann Allergy Asthma Immunol97:664–671, 2006.
21.
CiebiadaMCiebiadaMGKmiecikT, Quality of life in patients with persistent allergic rhinitis treated with montelukast alone or in combination with levocetirizine or desloratadine. J Investig Allergol Clin Immunol18:343–349, 2008.
22.
Kosik-BogackaDIKalisinskaEHenszelL and Kuzna-GrygielW.Seasonal dynamics of house dust mites in dust samples collected from sleeping places in north-western Poland. Zoonoses Public Health59:8–15, 2012.
23.
BousquetJKhaltaevNCruzAA, Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy63(Suppl 86):8–160, 2008.
24.
CockroftDWKillianDNMellonJJ and HargreaveFE. Bronchial reactivity to inhaled histamine: A method and clinical survey. Clin Allergy7:235–243, 1977.
25.
MeltzerEOMalmstromKLuS, Concomitant montelukast and loratadine as treatment for seasonal allergic rhinitis: A randomized, placebo-controlled clinical trial. J Allergy Clin Immunol105:917–922, 2000.
26.
KurowskiMKunaP and GórskiP.Montelukast plus cetirizine in the prophylactic treatment of seasonal allergic rhinitis: Influence on clinical symptoms and nasal allergic inflammation. Allergy59:280–288, 2004.
27.
YamamotoHYamadaTSakashitaM, Efficacy of prophylactic treatment with montelukast and montelukast plus add-on loratadine for seasonal allergic rhinitis. Allergy Asthma Proc33:e17–e22, 2012.
28.
LagosJA and MarshallGD. Montelukast in the management of allergic rhinitisTher Clin Risk Manag3:327–332, 2007.
29.
SardanaNSantosCLehmanE and CraigT.A comparison of intranasal corticosteroid, leukotriene receptor antagonist, and topical antihistamine in reducing symptoms of perennial allergic rhinitis as assessed through the Rhinitis Severity Score. Allergy Asthma Proc31:5–9, 2010.
30.
LeonardiADeFranchisGDe PaoliM, Histamine-induced cytokine production and ICAM-1 expression in human conjunctival fibroblasts. Curr Eye Res25:189–196, 2002.
31.
ProfitaMSalaABonannoA, Cysteinyl leukotriene-1 receptor activation in a human bronchial epithelial cell line leads to signal transducer and activator of transcription 1-mediated eosinophil adhesion. J Pharmacol Exp Ther325:1024–1030, 2008.
32.
KushiyaMSaitoKKikuchiI, Differential effects of salbutamol and montelukast on eosinophil adhesion and superoxide anion generation. Int Arch Allergy Immunol140:17–22, 2006.
33.
YangCMLuoSFHsiehHL, Interleukin-1beta induces ICAM-1 expression enhancing leukocyte adhesion in human rheumatoid arthritis synovial fibroblasts: Involvement of ERK, JNK, AP-1, and NF-kappaB. J Cell Physiol224:516–526, 2010.
34.
LiH and NordEP. IL-8 amplifies CD40/CD154-mediated ICAM-1 production via the CXCR-1 receptor and p38-MAPK pathway in human renal proximal tubule cells. Am J Physiol Renal Physiol296:438–445, 2009.
35.
CiebiadaMGorska-CiebiadaM and GorskiP.sICAM-1 and TNF-α in asthma and rhinitis: Relationship with the presence of atopy. J Asthma48:660–666, 2011.
36.
AnderssonKShebaniEBMakeevaN, Corticosteroids and montelukast: Effects on airway epithelial and human umbilical vein endothelial cells. Lung188:209–216, 2010.
37.
CiebiadaMGorska-CiebiadaM and GorskiP.Fexofenadine with either montelukast or a low-dose inhaled corticosteroid (fluticasone) in the treatment of patients with persistent allergic rhinitis and newly diagnosed asthma. Arch Med Sci5:564–569, 2009.
38.
JangYJWangJHKimJS, Levocetirizine inhibits rhinovirus-induced ICAM-1 and cytokine expression and viral replication in airway epithelial cells. Antiviral Res81:226–233, 2009.
39.
PapiAPapadopoulosNGStanciuLA, Effect of desloratadine and loratadine on rhinovirus-induced intercellular adhesion molecule 1 upregulation and promoter activation in respiratory epithelial cells. J Allergy Clin Immunol108:221–228, 2001.
40.
MelitonAYMunozNM and LeffAR. Blockade of avidity and focal clustering of beta 2-integrin by cysteinyl leukotriene antagonism attenuates eosinophil adhesion. J Allergy Clin Immunol120:1316–1323, 2007.
