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T CELLS AND RHINITIS



In vitro and in vivo experiments have shown that the activation of the T-Lymphocytes are regulated and modulated after administration of HANSI. According to the International Rhinitis Management Working Group, the activated T cells have a crucial central modulatory effect in allergic inflammatory responses both in the early and late phase. In an atopic individual, B cell origin plasma cells produce IgE, which sensitized the mastocytes, the crucial cells of the early phase. T helper (CD4+) cells direct the activation of the B cells. The T system is also responsible for the activation, maturation, life span and tissue migration of the eosinophilic and basophilic cells, which is important in the late phase.

According to reports from Argentina, HANSI "X" as an inhalant was successfully used for asthma and upper respiratory infections. These reports had made HANSI "X" a very desirable therapeutic agent for intranasal delivery for the E.N.T. specialist, since the immune regulatory effect could be exploited for the benefit of the pediatric and adult population suffering from allergic origin E.N.T. diseases.

It is important in every age group to have adequate nasal functions. The nose has a crucial function in the protection of the upper and lower airways. The inspired air is warmed, moistened and filtrated by the large surface area, richly supplied by capillaries and lymphatic vessels of the ciliated nasal mucosa.

Any noxious agent - virus, bacteria, and allergen - may cause rhinitis, which is by definition an inflammatory reaction of the nasal mucosa with congestion, dripping, sneezing and itching. Perennial rhinitis, in most cases, is accompanied by obstructive bronchitis and dermal manifestations, and further complications such as sinusitis and otitis are frequent.

The conventional allopathic medications chromoglycat, the second generation antihistamines cetirizin, loratidin, and the parenteral long acting depot corticosteroids as well as local cortisone preparations budesonid, beclomethasolone all have the well known non-desirable side effects.

The number of patients under 14 years was 33, the number of adult patients 49. 32% of the patients had skin lesions and all patients had accompanying lower respiratory symptoms. HANSI "X" nasal spray was delivered in 2 puffs, 4 times a day to both nasal orifices.

RESULTS:

The symptoms of allergic rhinitis (congestion, itching, dripping, tearing, eye irritation) showed significant improvements, and that was maintained throughout the treatment. Some significant improvements were found in cases of rhinitis due to atopic dermatitis, urticaria. Obstructive airway symptoms (wheezing, coughing at rest and exertion, shortness of breath) improved significantly on symptomatic score index and it was maintained during the whole treatment.

We found 15 pediatric patients with serious exudates in their bilateral middle ears who have had either seasonal or perennial rhinitis. We concluded from their history that these cases were resistant to all conventional treatments before. After treatment with HANSI "X" nasal spray, we experienced dramatic improvement: less exudate was found in the middle ears, hearing improved and at the end of the treatment their tympanogram was in normal range, indicating a well aerated middle ear.

In the above condition, we stress the possibility of allergic origin of middle ear disease and the concomitant treatment with HANSI "X" nasal spray yielded good results.

COMMENT:

After continuous one-month application of HANSI "X" nasal spray, these statements can be made:

  1. After proper application of HANSI "X" nasal spray in likeness to other drugs, "X" has perfect absorption from the nasal mucosa, as an alternative to intravenous application. In this manner local and general immuno-modulatory effect can be achieved.

  2. The symptoms (congestion, sneezing, dripping, itching, tearing and eye irritation) have improved significantly or ceased completely.

  3. Compared to the previously used antiallergenic agents, in only two cases we found the same result. In the rest of the cases, HANSI "X" was preferred.

  4. There were no side effects noted in either adult or pediatric cases.

PROF. GEDEON O. KERESZTI, M.D., Ph.D.
BUDAPEST, HUNGARY