alergia

Foi feito um estudo randomizado, duplo-cego  em 49 pacientes com febre de feno. O estudo foi realizado durante a estação de polinização.  Cada cavidade intranasal foi iluminada três vezes por semana durante três semanas com mUV/VIS ou com luz visível de baixa intensidade. Os escores dos sintomas,  células inflamatórias e seus mediadores foram avaliados nos lavados nasais. Os efeitos in vitro da irradiação mUV/VIS sobre as células T e apoptose de eosinófilos bem como seu efeito inibitório sobre a liberação do mediador de basófilos foram avaliados.

A rinoterapia foi bem tolerada e resultou em uma significante melhora dos sintomas clínicos para sibilância (P < .016),  rinorréia (P < .007), prurido nasal (P < .014) e escore total nasal (P < .004). Nenhum dos escores melhorou significativamente no grupo controle. Os escores para obstrução nasal melhorou levemente após o tratamento com mUV/VIS e aumentou significativamente no grupo controle (P < .017). 

No lavado nasal, a fototerapia reduziu significantemente o número de eosinófilos e o nível de proteína catiônica eosinofílica e IL-5. A irradiação in vitro de células T e de eosinófilos com luz mUV/VIS dependentemente da dose induziu a apoptose. Além do mais,  a irradiação com mUV/VIS  inibiu a liberação do  mediador de basófilos RBL-2H3.

Rhinophototherapy: A new therapeutic tool for the management of allergic rhinitis - The Journal of Allergy and Clinical Immunology – 2005; 115(3):541

Rhinophototherapy: A new therapeutic tool for the management of allergic rhinitis

Andrea I. Koreck, MD, PhD a * [MEDLINE LOOKUP] Zsanett Csoma, MD a [MEDLINE LOOKUP] Laszlo Bodai a [MEDLINE LOOKUP] Ferenc Ignacz b [MEDLINE LOOKUP] Anna Szabo Kenderessy a [MEDLINE LOOKUP] Edit Kadocsa, MD, PhD c [MEDLINE LOOKUP] Gabor Szabo, DSc b [MEDLINE LOOKUP] Zsolt Bor, DSc b [MEDLINE LOOKUP] Anna Erdei, DSc d [MEDLINE LOOKUP] Barnabas Szony, MD, PhD a [MEDLINE LOOKUP] Bernhard Homey, MD e [MEDLINE LOOKUP] Attila Dobozy, MD, DSc a f [MEDLINE LOOKUP] Lajos Kemeny, MD, DSc a f [MEDLINE LOOKUP]

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Abstract

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Background Phototherapy has a profound immunosuppressive effect and is able to inhibit hypersensibility reactions in the skin.

Objective We evaluated whether phototherapy using a combination of UV-B (5%), UV-A (25%), and visible light (70%), referred to as mUV/VIS, is effective in treating allergic rhinitis.

Methods We conducted a randomized, double-blind study, in 49 patients with hay fever. The study was performed during the ragweed season. Each intranasal cavity was illuminated 3 times a week for 3 weeks with mUV/VIS or with low-intensity visible light. Symptom scores, inflammatory cells, and their mediators were assessed in nasal lavages. In vitro effects of mUV/VIS irradiation on T-cell and eosinophil apoptosis and its inhibitory effect on mediator release from basophils were examined.

Results Rhinophototherapy was tolerated well and resulted in a significant improvement of clinical symptoms for sneezing (P < .016), rhinorrhea (P < .007), nasal itching (P < .014), and total nasal score (P < .004). None of the scores improved significantly in the control group. Scores for nasal obstruction slightly improved after mUV/VIS treatment and significantly increased in the control group (P < .017). In the nasal lavage, phototherapy significantly reduced the number of eosinophils and the level of eosinophil cationic protein and IL-5. In vitro irradiation of T cells and eosinophils with mUV/VIS light dose-dependently induced apoptosis. Furthermore, mUV/VIS irradiation inhibited the mediator release from RBL-2H3 basophils.

Conclusion These results suggest that phototherapy is an effective modality to treat allergic rhinitis and offer new options for the treatment of immune-mediated mucosal diseases.

Publishing and Reprint Information

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• ^aFrom the Departments of Dermatology and Allergology
• ^bOptics and Quantum Electronics
• ^cOto-Rhino-Laryngology, Head and Neck Surgery, University of Szeged
• ^dDepartment of Immunology, L. Eotvos University, Budapest
• ^eDepartment of Dermatology, Research Laboratory for Dermato-Immunology and Oncology, Heinrich-Heine University, Duesseldorf
• ^fDermatological Research Group of the Hungarian Academy of Sciences, Szeged
• Supported by a grant of the Hungarian Ministry of Health (ETT-419/2003) and a grant of the Hungarian Ministry of Education (OMFB-01620) to Dr Kemeny.Disclosure of potential conflict of interest: Lajos Kemeny, Attila Dobozy, Zsolt Bor, Gabor Szabo, and Ferenc Ignacz are cofounders of a company that will produce the light source for treatment and have submitted a patent application on this topic (patent pending).
• ^*Reprint requests: Andrea I. Koreck, MD, PhD, Department of Dermatology and Allergology, University of Szeged, 6720 Szeged, Koranyi Fasor 6, Hungary.
• Email address: akoreck@yahoo.com (Andrea I. Koreck)
• Szeged and Budapest, Hungary, and Duesseldorf, Germany
• Submitted June 8, 2004.
• Revision submitted November 3, 2004.
• Accepted November 4, 2004.
• Copyright © 2005 by American Academy of Allergy, Asthma and Immunology
• doi: 10.1016/j.jaci.2004.11.005