Background and Aim: Allergic rhinitis (AR) is an atopic condition characterized by symptoms such as sneezing, itching, rhinorrhea, and nasal congestion. Recent research has underscored the significance of autophagy in the pathogenesis and modulation of allergic rhinitis. This study aimed to compare the effects of two treatment regimens: fluticasone propionate combined with fexofenadine versus budesonide combined with fexofenadine, on the mRNA expression levels of autophagy-related genes (ATGs) in patients with allergic rhinitis.
Materials and Methods: Fifty-three patients with a history of allergic rhinitis were treated for one month with either fluticasone propionate and fexofenadine (24 patients) or budesonide and fexofenadine (29 patients). After one month of treatment, serum total immunoglobulin E (IgE) levels were measured using the ELISA method. Additionally, the counts of peripheral blood eosinophils and the mRNA expression levels of autophagy-related genes, including ATG14, ATG16L1, ATG5, LC3-II, Beclin-1, and VMP-1, were evaluated in peripheral blood cells using real-time PCR. The severity of clinical manifestations was scored from 0 to 6 according to the Allergic Rhinitis and its Impact on Asthma (ARIA) classification system.
Results: The results of the present study demonstrated that after one month of treatment with fluticasone propionate and fexofenadine, a significant increase in total serum IgE levels was observed (P<0.01). In contrast, patients treated with budesonide and fexofenadine showed no significant changes in total serum IgE levels compared to baseline. Furthermore, while both treatment regimens led to clinical symptom improvement and a reduction in peripheral blood eosinophil counts, the mRNA expression levels of autophagy-related genes, including ATG16L1 (P<0.0001), ATG5 (P<0.0001), LC3-II (P<0.05), Beclin-1 (P<0.0001), and VMP-1 (P<0.0001), were significantly downregulated in patients receiving fluticasone propionate and fexofenadine compared to those treated with budesonide and fexofenadine.
Conclusion: The current study demonstrated that the combination of fluticasone propionate and fexofenadine is significantly more effective in reducing the expression of autophagy-related genes compared to budesonide and fexofenadine.