The inhibitory effect of mometasone and nortriptyline on the production of proinflammatory cytokines by blood mononuclear cells of patients with allergic rhinitis under conditions of stimulated immune response.

Abstract

Allergic rhinitis (AR) is a chronic inflammatory disease of the nasal mucosa; it develops when the immune system reacts to an allergen. Side effects of topical glucocorticosteroids (GCS) used for AR treatment, the development of steroid resistance in patients and the continuing increase in morbidity explain the clear need to search for new approaches for AR treatment. The tricyclic antidepressant nortriptyline has demonstrated anti-inflammatory properties in a number of experimental studies, as well as its ability to complement the action of corticosteroids. The aim of this study was to compare the effects of nortriptyline and the synthetic GCS mometasone on the culture of mononuclear cells (MNC) of AR patients. Blood MNCs from six AR patients were cultured in the presence of nortriptyline or mometasone, and then type 1, type 2, or type 17 immune response (IR) were stimulated by adding recombinant activator proteins (IL-2, IL-25, IL-33, TSLP, IL-12, IL-1β, IL-23). After 3 days, concentrations of proinflammatory cytokines TNF-α, IFN-γ, IL-6, IL-8, and IL-4 were determined in cell supernatants by enzyme immunoassay. Mometasone (10⁻⁸ M final concentration) effectively suppressed the secretion of proinflammatory cytokines TNF-α, IFN-γ, IL-6, and IL-8 under conditions of stimulation of IR of all types. A similar decrease in secretion, although less pronounced, occurred when stimulated cells were cultured in the presence of nortriptyline. The concentration of TNF-α in the culture medium decreased under these conditions both with stimulation of type 1, type 2, and type 17 IR. The level of IFN-γ secretion decreased only in the case of type 1 and type 17 IR as compared to MNCs with the stimulated IR, which were cultured without this inhibitor. The level of IL-6 secretion decreased only in the culture medium of cells with stimulated type 1 and type 2 IR and IL-8 secretion decreased only under conditions of stimulated type 1 IR. This study has shown that mometasone and nortriptyline are able to suppress the secretion of proinflammatory cytokines by blood cells; their effect is selective and depends on the IR type.