A form of light treatment called rhinophototherapy is being studied in the United States and may one day provide patients with allergic rhinitis and other diseases of the upper airway, such as nasal polyposis, with an alternative to standard therapies.
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March 2007The technology is being developed at Allux Medical in Menlo Park, Calif., to treat hyper-reactive airway mucosa. According to company president and CEO Erica Rogers, the first application of rhinophototherapy may be for allergic rhinitis, although the technology has not yet been approved by the Food and Drug Administration and no therapeutic devices are currently available in the United States.
The experts interviewed for this article agreed that although the technology is intriguing, further research is needed to establish long-term efficacy and safety.
How It Works
The therapy uses a combination of UV-B (5%), UV-A (25%), and visible light (70%), which practitioners shine directly into the intranasal cavity.
We believe it works through a mechanism similar to that of light therapy used for patients with dermatological diseases such as atopic dermatitis and eczema, said James Hadley, MD, Associate Professor of Otolaryngology at the University of Rochester Medical Center. Light therapy induces apoptosis of the inflammatory cells in the organ-whether the skin or nasal mucosa-that cause disease symptoms, he said.
This is an exciting concept that may have potential, commented Bradley F. Marple, MD, Professor and Vice Chairman of Otolaryngology at the University of Texas-Southwestern Medical Center. Most other treatments, with exception of immunotherapy, are directed toward blockage of inflammatory mediators, whereas rhinophototherapy downregulates the cells that generate the allergic response, he said.
Although relatively simple to use, administering the therapy requires physicians to have a background in rhinology and allergic disease management, said Dr. Hadley. Whether they are ENTs, allergists, or family physicians who are trained in this, they need to know the inner workings of nasal anatomy.
The Data
The technology has been studied most extensively in Eastern Europe, where a recent study (J Allergy Clin Immunol 2005;115(3):541-7) indicated strong efficacy in allergic rhinitis patients. The study’s lead author, Andrea I. Koreck, MD, PhD, who at the time was with the Department of Dermatology and Allergology at the University of Szeged in Hungary, is now a researcher at Allux Medical.
Dr. Koreck and her colleagues conducted a randomized, double-blind study during the ragweed season in 49 patients with hay fever who received either rhinophototherapy using a combination of UV-B (5%),UV-A (25%), and visible light (70%), referred to as mUV/VIS, or low-intensity visible light as a control.