Ashley asked
What are the 6 inflammatory mediators that Flonase blocks? The commercial says it blocks 6 while oral antihistamines only block one.
Answer
Television commercials for Flonase state that it blocks "6 key inflammatory mediators". This refers to the following:
- Histamine
- Cytokines
- Leukotrienes
- Chemokines
- Prostaglandins
- Tryptases
While histamine is perhaps the most well-known molecule when it comes to an allergic response, the "allergic cascade" is complex and involves a variety of molecules, all of which have varying effects on the body.
Leukotrienes for example, are involved in increased airway edema (i.e. swelling), smooth muscle contraction, and the secretion of thick, viscous mucus. Leukotrienes have been noted to be particularly involved in asthma pathophysiology. Singular, a prescription medication for allergies and asthma induced bronchospasm, is leukotriene receptor antagonist.
In addition, stating that Flonase blocks 6 inflammatory mediators is still a very simplified explanation of how it works. As an example, a "Cytokine" is a broad classification for certain proteins that are very important for cell signaling and function of the immune system. TNF (tumor necrosis factor) and IL-4 (interleukin-4) are two examples of cytokines that are common drug targets.
Antihistamines, as the Flonase commercial notes, block only histamine.
Most medical guidelines recommend intranasal corticosteroids, such as Flonase, as a first-line treatment for allergic rhinitis (i.e. seasonal allergies).
