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Biomedical subjects

U Pipkorn

Publications and source records attributed to U Pipkorn.

106 records · Page 6Linked to original sources
PubMed1983

Effect of topical glucocorticoid treatment on nasal mucosal mast cells in allergic rhinitis.

Glucocorticoids were previously considered not to affect the immediate allergic reaction. However, in a nasal allergen challenge, an inhibitory effect on the nasal symptoms induced at the challenge has been shown to occur in patients treated with a recently developed glucocorticoid, budesonide, for 1 week prior to the challenge. This treatment was also found to reduce tissue histamine levels in the nasal mucosa. Mast cells in the mucosa were therefore studied with a view to finding out whether this reduction could be due to a reduction of mast cells. A double-blind study was performed in 14 asymptomatic patients. Nasal biopsies were made before and after 1 week's treatment with either budesonide or placebo. The number of mast cells was counted in two Epon sections after the specimens had undergone specific staining with toluidine blue. No quantitative or qualitative morphological changes in the mast cells were found as a result of treatment.

Administration, Topical↗
PubMed1983

Effect of a topical glucocorticoid, budesonide, on nasal mucosal blood flow as measured with 133Xe wash-out technique.

The "vasoconstrictor" effect of dermally applicated steroids is a widely used parameter when determining the potency of glucocorticoids. A similar effect on the nasal mucosa has been suggested as providing an explanation for the clinical effect of topically administered glucocorticoids in the treatment of nasal disorders such as allergic and vasomotor rhinitis. The recently described 133Xe wash-out method was used for the purpose of blood flow determination in 11 healthy subjects. In a randomized double-blind cross-over study, the effect of topically administered budesonide, a non-halogenated glucocorticoid, for 1 week was compared with that of placebo. No difference was found to occur in the mucosal blood flow after the administration of budesonide, as compared with placebo. It seems likely that a more complex activity than vasoconstriction is responsible for the clinical effect in the treatment of nasal disorders, and further research is required in order to clarify this issue.

Administration, Topical↗
PubMed1983

Hay fever treatment with budesonide and beclomethasone dipropionate twice daily - a clinical comparison.

Fifty-two patients with seasonal allergic rhinitis were admitted to a randomized clinical comparison between budesonide (Rhinocort) and beclomethasone dipropionate (Becotide Nasal). All patients were sensitive to birch pollen, which was confirmed by a skin prick test. The drugs were administered intranasally 200 micrograms b.i.d. Symptoms were assessed over four weeks starting with a run-in period of one week. Daily pollen counts were recorded throughout the trial and showed a rather mild birch pollen season. The patients diary cards revealed a beneficial therapeutic effect of the two drugs. No statistically significant differences between the drugs were seen except with regard to sneezing symptoms, where the Rhinocort-treated patients showed less symptoms (p less than 0.05). Side effects were few and transient with both drugs.

Administration, Topical↗
PubMed1982

Budesonide and nasal allergen challenge testing in man.

In a nasal allergen challenge test, the effect of the glucocorticosteroid, Budesonide, on the pollen allergic type I reaction has been investigated. Placebo and two different dosages of budesonide were administered intranasally for 1 week before the challenge was performed. The study was designed as a double-blind cross-over trial. One week of treatment with the active steroid significantly reduced the nasal secretion compared to placebo as measured with the aid of a symptom score, and significantly reduced the induced nasal blockage measured objectively by means of rhinomanometry. No difference was found between the two dosages of budesonide, 400 micrograms and 100 micrograms daily, used in the study.

Administration, Intranasal↗
PubMed1982

Budesonide and nasal histamine challenge.

The possible mode of action of the lately demonstrated steroid effect on the immediate type allergic reaction was investigated. The influence of a topical steroid, budesonide, on the effects that released mediators have on the nasal mucosa was also studied. A nasal histamine challenge study was performed in a double-blind, cross-over fashion, a 1-week pretreatment with budesonide or placebo preceding the challenge. Symptoms were recorded by means of symptom score as well as objectively via rhinomanometry. In contrast to a previous allergen challenge study, the steroid was found to have minimal effect on the histamine-induced nasal symptoms. It is therefore concluded that other modes of steroid action must also be involved in the steroid effect on the immediate type allergic reaction.

Administration, Topical↗
PubMed1982

Budesonide and nasal mucosal histamine content and anti-IgE induced histamine release.

The possible mode of action of the recently demonstrated steroid effect on the immediate type allergic reaction has been studied. The influence of a topical steroid, budesonide, on the nasal mucosal histamine content and anti-IgE induced histamine release was studied in an open study. A 1-week treatment with budesonide, used locally in the nose, was administered to 22 hay fever patients who were studied out of the pollen season. There was a decrease of histamine content after steroid treatment and also a blockade of the anti-IgE mediated histamine release, as shown in an in vitro release procedure. This steroid effect may partly explain the effect of steroids on the immediate reaction, as it has been demonstrated in allergen challenge studies.

Adolescent↗
PubMed1982

The effect of budesonide on the immediate reaction to allergen challenge - a rhinomanometric study.

In a nasal allergen challenge test, the effect of the glucocorticosteroid budesonide on the pollen allergic type I reaction was investigated. Placebo and two different doses of budesonide were given intranasally for one week before the challenge. The study was designed as a double-blind cross-over trial. Treatment for one week with the active steroid significantly reduced the nasal secretion compared with placebo, as measured with the aid of a symptom score, and significantly reduced the induced nasal blockage measured objectively by rhinomanometry. No difference was found between the two doses of budesonide, 400 micrograms and 100 micrograms daily, used in the study.

Adolescent↗
PubMed1982

Budesonide and beclomethasone dipropionate in hay fever - a single blind comparison.

93 patients with seasonal allergic rhinitis took part in a single blind randomized clinical comparison of budesonide and beclomethasone dipropionate (Becotide Nasal). All patients were sensitive to either birch or grass pollen, their sensitivity being confirmed by a skin prick test. The total daily dose was 400 micrograms for both drugs. Budesonide was administered twice a day and Becotide Nasal four times a day. Symptoms were assessed over a four-week period starting with a run-in period of one week. There was no placebo control group. Daily pollen counts were measured throughout the trial. The patients' diary cards revealed that both drugs had a beneficial therapeutic effect, and that budesonide was significantly more active than Becotide Nasal. The side effects of both drugs were few and transient.

Adolescent↗
PubMed1980

Budesonide - a new nasal steroid.

39 patients with seasonal rhinitis entered a double-blind study comparing nasal sprays of budesonide 400 micrograms/day and placebo. Symptoms were assessed over a treatment of of three weeks. There were statistically significant differences in favour of the active spray on all measures of assessment. Side effects were mild and the incidence was negligible.

Adolescent↗
PubMedDate not supplied

Long-term treatment with budesonide in vasomotor rhinitis.

Twelve patients entered a long-term study of budesonide treatment in vasomotor rhinitis. The efficacy of the treatment was studied. Possible systemic side effects were studied via an ACTH stimulation test prior to and during treatment. The local effect in the nasal mucosa was studied by means of a nasal biopsy before and after one year of treatment. The treatment has proved effective, while producing no systemic or local side effects during a one-year treatment period.

Administration, Topical↗
PubMedDate not supplied

Effects of glypressin on human nasal mucosa.

The effect of intravenous and topical glypressin, a triglycyl hormonogen of vasopressin, on the nasal mucosa was evaluated in healthy subjects. A dose-dependent reduction of nasal blood flow resulted from both intravenous and topical glypressin. The effect of the latter in gel form lasted 2 hours. Glypressin was also found to decongest the nasal mucosa. Topical application of glypressin gel might be an alternative to conventional treatment with intranasal packing in nose-bleed.

Administration, Intranasal↗
PubMedDate not supplied

Reflex activation in allergen-induced nasal mucosal vascular reactions.

Subjects with allergic rhinitis were challenged unilaterally with diluent and increasing doses of allergen. Challenge with the highest dose of allergen was also carried out after topical anesthesia of the nasal cavity using lidocaine. In the contralateral, unprovoked nasal cavity the mucosal blood flow was determined using the 133Xenon wash-out technique and the nasal airway resistance was determined by rhinomanometry before and after challenge. Nasal symptom scores were estimated 15 min after each challenge. Blood flow in the nasal mucosa in the unprovoked right nasal cavity decreased in a dose-dependent manner for th two highest doses of allergen where a reduction of 21% (p less than 0.05) and 26% (p less than 0.01) was obtained. Nasal airway resistance increased somewhat after the highest dose (p greater than 0.05). Topical anesthesia in the provoked nasal cavity inhibited the decrease in blood flow in the unchallenged nasal cavity. These findings suggest that the changes in the tone of the resistance vessels, but not the capacitance vessels, which are induced by allergen, are largely reflex-mediated.

Adult↗
PubMedDate not supplied

Allergen-induced specific and non-specific nasal reactions. Reciprocal relationship and inhibition by topical glucocorticosteroids.

The correlation between allergen-induced specific and non-specific (histamine) nasal reactions was studied, especially as regards topical glucocorticosteroid effects on the non-specific reactions. Thirteen patients with strictly seasonal allergic rhinitis participated. A nasal challenge with histamine and three increasing doses of allergen was performed on the first day. The patients were rechallenged 24 h later with the same histamine dose and the lowest allergen dose from the previous day. The same 2-day challenge was also performed after pretreatment for one week with budesonide in 8 of these patients. Symptom scores were recorded. The N-alpha-tosyl-L-arginine-methyl-esterase (TAME esterase) activity in nasal lavages was determined. The nasal symptoms and the TAME-esterase activity increased at rechallenge for both histamine and allergen, compared with the initial challenge. The mean ( +/- SE) composite nasal symptom score after histamine increased from 3.5 +/- 0.49 to 4.9 +/- 0.35 (p less than 0.01) and after allergen from 1.62 +/- 0.3 to 3.2 +/- 0.5 (p less than 0.01) at rechallenge. Similar increases were recorded for the TAME-esterase activity. A close correlation between the allergen-induced increase in specific (allergen) and non-specific (histamine) reactivity was found (r = 0.7, p less than 0.01, composite nasal symptom score). Treatment with topical glucocorticosteroids abolished the allergen-induced increase in both specific (p less than 0.001) and non-specific (histamine) (p less than 0.01) nasal reactivity.

Administration, Topical↗
PubMedDate not supplied

Topical terlipressin (Glypressin) gel reduces nasal mucosal blood flow but leaves ongoing nose-bleeding unaffected.

Nasal bleeding where the lesion cannot clearly be localized is today usually treated with different forms of nasal packings which are traumatizing to the nasal mucosa and often causes the patient discomfort. In an attempt to develop a more convenient form of treatment the effect of two vasoconstrictor gels on nasal mucosal blood flow was evaluated. Terlipressin gel was shown to reduce nasal blood flow in a dose-dependent way. Therefore, this gel was chosen in a double-blind comparison with placebo in the treatment of 44 patients with posterior epistaxis. Although 50% of the patients did stop bleeding after topical gel administration into the nose there was no statistically significant difference in effect between those who received terlipressin gel and those who received placebo gel. We cannot disregard the fact, however, that the gel in itself has a beneficial effect on nose-bleeding.

Administration, Topical↗