Rhinophototherapy May Offer Promise to Allergic Rhinitis Patients

Investigators illuminated each intranasal cavity three times a week for three weeks.

Researchers found that rhinophototherapy resulted in a significant improvement of clinical symptoms for sneezing (p < 0.016), rhinorrhea (p < 0.007), nasal itching (p < 0.014), and total nasal score (p < 0.004) compared to baseline. None of the scores improved significantly in the control group.

The treatment also reduced the number of inflammatory cells and the level of mediators that cause allergic rhinitis and other diseases of the airway such as nasal polyps. For example, in nasal lavage, rhinophototherapy significantly reduced the number of eosinophils and the levels of eosinophilic cationic protein and interleukin-5. In vitro irradiation of T cells and eosinophils with mUV/VIS light dose-dependently induced apoptosis.

The therapy was also well tolerated. All patients in the mUV/VIS group experienced dryness of the nasal mucosa; however, all but one described this side effect as mild. Six patients in the control group reported dryness of the nasal mucosa. This side effect, can easily be managed by using Vitamin A oil, said one of the study coauthors, Lajos Kemeny, MD, PhD, who is also a cofounder of Rhinolight in Szeged, Hungary, which produces the rhinophototherapy device for distribution in Europe.

Although not reported in the study, patients can theoretically experience irritation of the nasal membranes similar to sunburn, said Dr. Hadley. To avoid this problem, further research needs to determine the timing and delivery of the therapy and how it is going to affect the cells produced inside the nose, he said.

Until the Hungarian data can be reproduced in other studies, the evidence to date does not support inclusion of phototherapy to treat symptoms of allergic rhinitis into the standards of care, said Ms. Rogers in a March 2006 interview with ENToday.

The European Experience

Rhinophototherapy was approved for medical treatment in Hungary in 2003 and is indicated there for patients with seasonal and perennial allergic rhinitis. Patients who tend to benefit the most from the therapy are those with allergic rhinitis who are resistent to pharmacotherapy, and in cases when medicine treatment cannot be applied or there is a contraindication of drugs, said Dr. Kemeny, who is also Professor in the Department of Dermatology and Allergology at the University of Szeged.

In Europe, Rhinolight treatment is recommended on two successive weeks, and depending on the severity of the symptoms, four to six treatments are required (two to three treatments per week).