EFFECT OF NASAL CORTICOSTEROIDS ON OXIDATIVE STRESS PARAMETERS IN CHILDREN WITH ALLERGIC RHINITS
Oxidative stress (OS) is a result of an imbalance between the production of free radicals and the antioxidant defense mechanisms in the organism. Allergic rhinitis (AR) is characterized by chronic inflammation and increased presence of eosinophils, basophils and mast cells in nasal secretions and mucosa. Stimulation of these cells results in production of free radicals (reactive oxygen metabolites). The aim of this study was to determine the level of OS and antioxidant capacity in children with AR after 8 weeks treatment with nasal corticosteroid (NCS). Thirty children with AR (mean age 8.3 ± 2.9 years) were included. The FRAS 5 Bravo system was used to determine the OS parameters. Demographic characteristics, medical history, children's living conditions and eating habits were obtained from the questionarrie. Anthropometric measurements, absolute number of eosinophils in the peripheral smear and eosinophils in nasal smear were performed in each child. The mean value of blood concentration of serum peroxides (d-ROMs) was 403.4 ± 91.3 U. Carr, while the mean value of OS index was 95.1 ± 45.9. After 8 weeks of treatment with NCS, the mean values were 337.6 ± 71.9 U. Carr, and 53.6 ± 28.3, respectively. Both parameters had significantly lower values (p<0.05) compared to those before the initiation of NCS therapy. After treatment, a significant improvement in the symptoms score of AR was detected (p<0.05). NCS therapy makes asignificant improvement of the symptoms and a considerable reduction in the OS in children with AR.
Keywords: allergic rhinitis, children, oxidative stress, d-ROMs, PAT, OSI
2. Babusikova E, Jurecekova J, Evinova A, Jesenak M, Dobrota D. Oxidative damage and bronchial asthma. In: Ghanei M, eds. Respiratory Diseases. Rijeka: InTech; 2012. p. 151–76.
3. Erzurum SC. New insights in oxidant biology in asthma. Ann Am Thorac Soc. 2016;13 Suppl 1:S35–9.
4. Babusikova E, Jesenak M, Rennerova Z, Dobrota D, Banovcin P. Importance of oxidative damage in the pathogenesis of bronchial asthma in children. Acta Pneumol Allergol Pediatr 2010;13:13–7.
5. Holgiun F. Oxidative stress in airway diseases. Ann Am Thorac Soc. 2013; 10 Suppl:S150–7.
6. Iyer D, Mishra N, Agrawal A. Mitochondrial function in allergic disease. Curr Allergy Asthma Rep. 2017;17(5):29.
7. Global atlas of Allergic Rhinitis and Chronic Rhinosinusitis Published by the European Academy of Allergy and Clinical Immunology 2015.
8. Lalwani AK, eds. Current Diagnosis & Treatment in Otolaryngology-Head and Neck Surgery. New York:McGraw-Hill; 2004: 278.
9. Dykewicz MS, Fineman S, Skoner DP, et al. Diagnosisand management of rhinitis: Complete guidelines of the Joint Task Force on practice parameters in allergy, asthma and immunology. Ann Allergy Asthma Immunol. 1998; 81(5 Pt 2):478–518.
10. Bowler RP, Crapo JD. Oxidative stress in allergic respiratory diseases. J Allergy Clin Immunol 2002;110(3):349–56.
11. Kahveci ОК, Kuzu S, Altıntas M, Vurmaz A, Celik S. The effect of nasal steroid and antihistamine use on total oxidative stress and antioxidant status in the treatment of allergic rhinitis. Am J Rhinol Allergy 2021;35(1):52–8.
12. Gratziou C, Rovina N, Makris M, Simoes DC, Papapetropoulos A, Roussos C. Breath markers of oxidative stress and airway inflammation in seasonal allergic rhinitis. Int J Immunopathol Pharmacol 2008;21(4):949-57.
13. Failla M, Biondi G, Pistorio M Provvidenza, Gili E, Mastruzzo C, Vancheri C, Crimi N. Intranasal steroid reduces exhaled bronchial cysteinyl leukotrienes in allergic patients. Clin Exp Allergy. 2006; 36(3):325–30.
14. Sandrini A, Ferreira M, Jardim JR, Zamel N, Chapman KR. Effect of nasal triamcinolone acetonide on lower airway inflammation markers in patients with allergic rhinitis. J Allergy Clin Immunol. 2003; 111(2):313-20
15. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320(7244):1240–3.
17. Bousquet J, Van Cauwenberge P, Khaltaev N; Aria Workshop Group; World Health Organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001;108(5 Suppl):S147–334.
18. Serafini M, Del Rio D. Understanding the association between dietary antioxidants, redox status and disease: is the total antioxidant capacity the right tool? Redox Rep 2004;9(3):145–52.
19. Brozek JL, Bousquet J, Baena-Cagnani CE, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol 2010;126(3):466–76.
20. Nathan RA. Management of patients with allergic rhinitis and asthma: literature review. South Med J. 2009;102(9):935–41.
21. Bousquet J, van Cauwenberge P, Ait Khaled N, et al. Pharmacologic and anti-IgE treatment of allergic rhinitis ARIA update (in collaboration with GA2LEN). Allergy. 2006;1(9):1086–96.