A patient with perennial allergic rhinitis is treated with intranasal corticosteroids (INCS) and antihistamines. INCS are considered superior because they address which component that antihistamines do NOT?
- A INCS block H1 histamine receptors more effectively than oral antihistamines at the nasal mucosa
- B INCS suppress the late-phase allergic response, eosinophil recruitment, and cytokine cascade that persist beyond the initial mast cell degranulation ✓
- C INCS reduce the sensitivity of the olfactory epithelium to allergen triggers
- D INCS specifically block leukotriene receptors in the nasal submucosa
Explanation
Antihistamines block H1 receptors and are effective against the EARLY-phase allergic response (sneezing, rhinorrhoea) mediated by histamine release from mast cells. INCS, acting through glucocorticoid receptor-mediated genomic effects, suppress both the early phase AND the late-phase response — which involves eosinophil, basophil, and lymphocyte recruitment driven by IL-4, IL-5, IL-13, and eotaxin. INCS also reduce mucus secretion, vascular permeability, and glandular secretion. This broader suppression of the allergic inflammatory cascade makes INCS the most effective single agent for all four symptoms of allergic rhinitis (sneezing, rhinorrhoea, nasal obstruction, itching).
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.