Comparison of the efficacy of combined budesonide and fexofenadine versus combined fluticasone propionate and fexofenadine on the expression of class-4 semaphorins and their receptors in the peripheral blood cells of patients with allergic rhinitis.

Background: Allergic rhinitis (AR) is a common immunoglobulin (Ig) E-mediated disease. This study aimed to evaluate the gene expression levels of class 4 semaphorins and their receptors in AR patients before and after treatment with budesonide and fexofenadine (B/F) compared to fluticasone propionate and fexofenadine (FP/F).

Methods: In this study, 29 AR patients (age 34.4 ± 1.2 years, 18 men and 11 women) were treated with B/F, and 24 AR patients (age 32.8 ± 1.9 years, 15 men and 9 women) were treated with FP/F for one month. Before and after treatment, peripheral blood samples were taken from patients. The expression levels of , , , , and genes were measured using the qPCR method. In addition, the serum levels of IgE were measured using an enzyme-linked immunosorbent assay (ELISA).

Results: The expression levels of ( = 0.011), 4C ( = 0.017), ( = 0.0005), and ( = 0.008) remarkably increased in AR patients treated with B/F. Our results show a significant reduction in the gene expression levels of ( = 0.002), 4C ( = 0.014), 4D ( = 0.003), ( = 0.033), and ( = 0.035) after treatment with FP/F. The serum levels of IgE increased in FP/F treated group ( = 0.017) and conversely decreased in the treated group with B/F ( = 0.019). Moreover, the percentages of eosinophils were reduced in both FP/F and B/F groups ( = 0.015 and  = 0.0001, respectively).

Conclusion: In conclusion, concomitant use of fexofenadine and fluticasone propionate reduced , 4C, 4D, , and , while the , 4C, , and gene expression levels were increased in the patient group treated with B/F.