Effect of a thromboxane A₂ receptor antagonist, ramatroban (BAY u 3405), on inflammatory cells, chemical mediators and non-specific nasal hyperreactivity after allergen challenge in patients with perennial allergic rhinitis

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In some clinical studies performed in patients with perennial allergic rhinitis, ramatroban, a new thromboxane A₂ receptor antagonist, significantly improved nasal symptoms. As yet the mechanism of action of this drug has not been fully elucidated. In the present study we investigated the effects of ramatroban on changes in nasal reactivity and levels of inflammatory cells and mediators in nasal lavage fluid after allergen challenge. Ramatroban was administered orally at a daily dose of 150 mg (b.i.d.) for 4 weeks to 11 patients with perennial allergic rhinitis exhibiting positive responses to nasal allergen challenge with house dust mite. Analysis of variance revealed that there was a significant decrease in eosinophil counts and eosinophil cationic protein levels in nasal lavage fluid when compared with values immediately before allergen challenge before and after ramatroban treatment. Histamine, tryptase and albumin levels were significantly decreased in analysis of variance before and after ramatroban treatment. The degree of nasal reactivity to histamine was also significantly decreased after the ramatroban treatment. These findings indicate that ramatroban decreases important pathogenic factors in allergic rhinitis, resulting in an improvement in nasal symptoms.