The Effect Of Desloratadine On Levels Of Interleukin-4, Thromboxane B2, Leukotrienes In Patients Suffering From Atopic Rhinitis

Objective AR (Atopic rhinitis) was regarded as a systemic disease with atopic-inflammation. We must pay more attention on systemic status of AR because the inflammation exists in not only mucous membrane but also systems. Desloratadine (DL) is a new H1 receptor antagonist used widely to treat patients with AR which play a role not only hi-efficient anti-histamine but also react on more mediators. The mechanism is not clear current. The anti-inflammatory effects of DL depend on its dosage. DL with high dosage maybe expresses better anti-inflammatory effects in vivo. The purpose of our study was to research the anti-inflammatory effect of DL in vivo with different dosage by observing its influence on levels of IL-4, TXB2 and LTs in sera of AR patients.Method 120 subjects suffering from AR with hypersensitivity to House dust mite were included into the study and divided into 4 different groups (negative control group, 5mg DL group, 10mg DL group and 15mg group) with same 30 samples for evaluating the systemic anti-inflammatory efficiency of the DL on AR. None of them was taking any H1 receptor antagonist and other drug maybe influence the expression of inflammation level 30 days before inclusion into the study. Samples of peripheral blood were taken before and after 12 weeks of treatment. Levels of cytokines were determined using the ELISA method.Results After treatment with 12 weeks, the mean level of all 3 mediators in 15mg DL and 10mg DL groups decreased remarkably(P<0.01), but have no obvious decrease in 5mg DL group(P>0.05 ). Negative control group have no change on IL-4(p=0.45), TXB2(p>0.05) and LTs (P=0.55) after treated with placebo. Before treatment, the mean level of 3 mediators in all groups have no difference (p>0.05). After treatment, the level of all mediators in 4 groups appeared remarkable difference (P<0.01). The level of all mediators in 15mg DL group are lower than other groups (p<0.01 and p<0.05 TXB2 of 15mg DL vs. 10mg DL group), 10mg DL group are lower than 5mg DL and negative control groups (p<0.01 and p<0.05 TXB2 of 10mg DL group vs. 5mg DL group) ; The level of all mediators in 5mg DL group have no obvious difference compared with negative control group(p > 0.05) except TXB2(P< 0.05).Conclusion After treatment, DL with higher dosage can decreased the level of IL-4, TXB2 and LTs of AR patients, 15mg DL is strongest and 10mg DL take 2^nd place. 5mgDL is not enough to influence the level of IL-4 and LTs, but have weak influence to TXB2 in AR patients. The result in this study indicates that higher dosage DL have systemic remarkable anti-inflammatory effects as in vitro, higher DL can play more important roles in treatment strategy of Atopic rhinitis.