The researchers reported neutrophil-associated tissue damage in cedar pollinosis subjects with refractory nasal symptoms before pollinosis season. The leukotriene receptor antagonist, montelukast, can inhibit neutrophil recruitment and activation; the researchers investigated its effects on symptom relief and nasal neutrophilia in pollinosis subjects in the preseason.

Symptomatic and asymptomatic subjects were prophylactically treated, and in-season symptomatic subjects were treated. Individuals were assigned to 1 of 2 treatment protocols: administration of Cet-Flu or montelukast, fexofenadine, and fluticasone nasal spray. Differences in symptom relief and inflammatory cell infiltration in nasal swabs were investigated.

Fifty-nine percent of PreSyP subjects were given Cet-Flu, and eighty-eight percent of those treated with Mo-Fex-Flu had none or mild symptoms. In PreAsP issues in season, seventy-one percent of Cet-Flu and ninety-eight percent of Mo-Fex-Flu recipients had none to mild symptoms. In PreSyP, a significant reduction in the percentage of subjects with mast cells >1+ was seen following both Cet-Flu and Mo-Fex-Flu treatments.

The study concluded that in PreSyP and PreAsP subjects, treatments with Mo-Fex-Flu were more effective than Cet-Flu to reduce nasal symptom scores. These effects were associated with a reduction in the number of neutrophils and mast cells in nasal swabs.