Otrzymano/Received: 9.03.2012. Zaakceptowano/Accepted: 12.03.2012.
Glikokortykosteroidy donosowe u dzieciIntranasal glucocorticosteroids in children Alergoprofil 2012; 1(8): 5-17. DOI:
Allergic rhinitis is the most frequent chronic inflammatory, noninfectious disease in children, with the prevalence increased in pediatric population. The impact of poorly controlled allergic rhinitis on quality of life, psychologic well-being and capacity to function in activities of daily living and school performance can be significant. As well as these psychosocial difficulties, if left untreated, allergic rhinitis appears to increase the risk of developing potentially problematic co-morbid conditions, including asthma, sinusitis, and otitis media. The introduction of modern local intranasal glucocorticosteroids in the beginning of seventies last century was the most important therapeutic progress in the management of inflammatory disorders of the nasal mucosa. A series of studies have shown their multiple effects on the immune inflammatory reaction. Intranasal glucocorticosteroids are highly effective therapeutic modality for long-term therapy of allergic rhinitis, perennial nonallergic rhinitis and nasal polyposis as well as concomitant treatment of chronic rhinosinusitis and acute rhinosinusitis becoming the first-line therapeutic option in most cases. Intranasal preparations eliminate the systemic side effects and equal or exceed the efficacy of their systemic counterparts. The major disadvantage of this treatment is rather slow onset of action. But on the other hand, the main signs and symptoms of rhinitis, such as rhinorrhea, sneezing, obstruction and congestion are very well controlled. This treatment was found not only to reduce nasal symptoms but also to diminished ocular symptoms and improve quality of life of rhinitis patients. The latest studies in children, which evaluated potential systemic effects of newer agents of intranasal glucocorticosteroids have generally found no adverse effects on hypothalamic-pituitary-adrenal axis function or growth. They have a high degree of glucocorticoid receptor affinity, potency and specificity; low systemic availability; high rate of hepatic first-pass clearance and rapid systemic elimination, and what is very important for the compliance – once-daily dosing.