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

Gelayol Asadi; Parisa Feizollahi; Misagh Rajabinejad; Sara Falahi; Fatemeh Rezaei Varmaziar; Elham Faryadi; Ali Gorgin Karaji; Farhad Salari; Alireza Rezaiemanesh

doi:10.1016/j.heliyon.2023.e22924

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

Heliyon. 2023 Nov 28;10(1):e22924. doi: 10.1016/j.heliyon.2023.e22924. eCollection 2024 Jan 15.

Authors

Gelayol Asadi^{1

2}, Parisa Feizollahi², Misagh Rajabinejad^{3

4}, Sara Falahi^{1

2}, Fatemeh Rezaei Varmaziar^{1

2}, Elham Faryadi^{1

2}, Ali Gorgin Karaji², Farhad Salari², Alireza Rezaiemanesh²

Affiliations

¹ Student Research Committee, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
² Department of Immunology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
³ Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
⁴ Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Abstract

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 SEMA4A, SEMA4C, SEMA4D, Plexin-B2, and Plexin-D1 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 SEMA4A (P = 0.011), 4C (P = 0.017), Plexin-B2 (P = 0.0005), and Plexin-D1 (P = 0.008) remarkably increased in AR patients treated with B/F. Our results show a significant reduction in the gene expression levels of SEMA4A (P = 0.002), 4C (P = 0.014), 4D (P = 0.003), Plexin-B2 (P = 0.033), and Plexin-D1 (P = 0.035) after treatment with FP/F. The serum levels of IgE increased in FP/F treated group (P = 0.017) and conversely decreased in the treated group with B/F (P = 0.019). Moreover, the percentages of eosinophils were reduced in both FP/F and B/F groups (P = 0.015 and P = 0.0001, respectively).

Conclusion: In conclusion, concomitant use of fexofenadine and fluticasone propionate reduced SEMA4A, 4C, 4D, Plexin-B2, and Plexin-D1, while the SEMA4A, 4C, Plexin-B2, and Plexin-D1 gene expression levels were increased in the patient group treated with B/F.

Keywords: Allergic rhinitis; Budesonide; Class 4 semaphorins; Fexofenadine; Fluticasone propionate; Plexin.