Abstract
Recently, corticosteroid nasal sprays have been evaluated as being quite effective for treatment of patients with allergic rhinitis and, therefore, are recommended as the first choice of medical treatment in ARIA (Allergic Rhinitis and its Impact on Asthma). On the other hand, we have studied and reported on the importance of vascular endothelial growth factor (VEGF) in the pathophysiology of allergic rhinitis. Two major physiological or pathological functions of VEGF have been well-recognized as angiogenesis and increasing vascular permeability in tumor growth and inflammation. In this study, the effects of a corticosteroid nasal spray, mometasone, on both the clinical symptoms of perennial allergic rhinitis and VEGF production in the nasal mucosa were assessed. After two weeks of mometasone use, sneeze, watery rhinorrhea and nasal obstruction apparently improved and VEGF in nasal lavage after antigen provocation tended to be reduced. According to a cell-culture study using fibroblasts in the inferior turbinate mucosa obtained from the operation for perennial allergic rhinitis cases, the existence of messenger RNA (mRNA) for VEGF receptors was confirmed and mRNA for VEGF which increased after stimulation by VEGF was significantly suppressed by mometasone in a dose dependent manner. An inhibitory effect on VEGF production from fibroblasts was suggested to be one of the important steps of the clinical effect of mometasone on allergic rhinitis.
