Effect of Intranasal Corticosteroids on Systemic Allergen Specific IgE

Inclusion criteria

• male or female 18-50 years of age
• moderate to severe allergic rhinitis to grass and/or birch pollen for at least two seasons according to history
• sensitization to rPhl p 5 and rBet v 1 as demonstrated by UniCAP within a range from 3.0-80 kUA/l and a positive (wheal diameter >= 3 mm larger than the negative control and half of the histamine control) SPT with rPhl p 5 and rBet v 1 at 20 µg/ml
• willingness to comply with the study protocol
• written informed consent

Exclusion criteria

• perennial allergic rhinitis
• history of asthma necessitating treatment
• FEV1 <70% of predicted value
• abnormalities at auscultation of heart or lungs
• history of anaphylaxis
• severe atopic dermatitis
• total serum IgE >2000 kU/l
• previous or ongoing immunotherapy (subcutaneous or sublingual) to grass or birch pollen
• nasal provocation testing during the previous six month
• known allergy/intolerance to fluticasone propionate or loratadine
• known allergy/intolerance to cellulose, polysorbate, phenylethyl alcohol, benzalkonium chloride
• contraindications for the use of INCS:
• acute or chronic infections of the upper respiratory tract
• surgery of the nose during the previous year
• hypersensitivity to components of the drug
• contraindications for nasal provocation test
• acute rhinosinusitis
• acute allergic reaction of the immediate type at other organs
• nasal polyposis or significant nasal anatomical deformities
• vasomotor rhinitis
• autoimmune disease, chronic or acute infectious disease, malignancy
• severe psychological disorder
• treatment with systemic or topical (intranasal, inhaled, external) corticosteroids from 3 month prior to the study
• treatment with other immunosuppressant drugs from 6 month prior to the study
• treatment with antihistamines or disodium cromoglycate from 2 weeks prior to the study
• treatment with intranasal adrenergic drugs from 3 days prior to the study
• treatment with systemic adrenergic drugs
• treatment with psychopharmacological drugs from 2 weeks prior to the study
• cardiovascular or pulmonary disease
• contraindication for adrenaline
• participation in any other clinical trial within the previous 3 month
• pregnant, lactating or sexually active women with childbearing potential who are not using a medically accepted birth control method
• a mental condition rendering the subject unable to understand the nature, scope and possible consequences of the study, and/or evidence of an uncooperative attitude
• known alcohol or drug addiction or abuse
• unlikelihood to be able to complete the study