RHODES, GREECETargeted ultraviolet B phototherapythe use of fiber-optic light delivery systemsallows treatment of previously inaccessible body sites such as the scalp and the oral and intranasal mucosa, Dr. Lajos Kemeny said at the 15th Congress of the European Academy of Dermatology and Venereology.
The fiber optics guide delivery of incoherent ultraviolet light to small areas while protecting nonlesional skin from excessive UV exposure. This has further enhanced phototherapy, improving delivery to areas like the scalp and nasal mucosa, and has led to investigation of its use for new applications, namely intranasal treatment for allergic rhinitis, said Dr. Kemeny of the University of Szeged (Hungary).
In a randomized double-blind clinical trial using a novel device for intranasal phototherapy, "rhinophototherapy" significantly reduced the symptoms of hay fever, reported Dr. Kemeny, who is a cofounder of the Rhinolight company, maker of the Rhinolight device used in the study.
In 49 patients, each intranasal cavity was illuminated three times weekly for 3 weeks with 5% UVB, 25% UVA, and 70% visible light (an approach known as mUV/VIS), or with just low-intensity visible light. Scores for sneezing, rhinorrhea, and nasal itching improved significantly in the treated patients but not in the control patients, he said.
Furthermore, scores for nasal obstruction improved slightly in the treated patients and increased significantly in control patients (J. Allergy Clin. Immunol. 2005;115:5417).
In an open-label follow-up study using a similar protocol but with gradual increases in doses of mUV/VIS light, rhinophototherapy significantly inhibited allergic rhinitis symptoms in 90% of 70 treated patients. Significant improvements were seen in sneezing, rhinorrhea, nasal itching, nasal obstruction, and total nasal scores in this study.
Evaluation of nasal lavage in treated patients suggests that the mechanism of action can be at least partially attributed to apoptosis induction of cells that play an important role in the pathogenesis of allergic rhinitis: The mUV/VIS irradiation induces a dose-dependent increase in apoptosis of memory T cells, naive T cells, and eosinophils, Dr. Kemeny noted.
Intranasal phototherapy may represent a novel treatment for allergic rhinitis as well as other inflammatory and immune-mediated mucosal diseases, he said.
The Rhinolight device is available in Europe but has not yet been approved in the United States.