Effects of the common cold and intranasal fluticasone propionate treatment on mucosal host defense assessed by human saliva()()()

Lenander-Lumikari, Marianne; Puhakka, Tuomo; Mäkelä, Mika J.; Vilja, Pekka; Ruuskanen, Olli; Tenovuo, Jorma

Objective. The purpose of this investigation was to study the effect of a potent topical steroid, fluticasone propionate, on patients with early signs and symptoms of the common cold. To characterize the mucosal inflammatory response, salivary defense factors and flow rate in these patients were analyzed. Study Design. Forty patients with symptoms of the common cold were randomized into 2 groups to receive either high-dose fluticasone propionate (100 μg per nostril) or placebo 4 times daily for 6 days. Paraffin-stimulated whole saliva was collected on day 1 (before the onset of medication), day 7 (posttreatment), and day 21 (follow-up). Results. Salivary flow rate, innate host defense factors, and total protein content were not affected by the common cold. IgA increased between day 7 and day 21 (P ≤ .01; Student 2-tailed t test), and the relative proportions of salivary peroxidase and IgA increased on day 7 (P = .01) and day 21 (P = .05). In patients receiving fluticasone, saliva flow rate was lower on day 21 (P ≤ .05) than on days 1 and 7. The innate salivary defense factors were not affected, but IgA increased both on day 7 (P ≤ .001) and on day 21 (P ≤ .001) in comparison with day 1. Conclusions. Of the oral mucosal defense factors, only IgA is activated during the common cold. Intranasally administrated fluticasone propionate does not have a suppressive effect on salivary antimicrobial capacity. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87:695-9)