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Around 40% of the world’s population is now impacted by allergies, which continue to rise. Allergies arise from complex interactions between genetic and environmental factors and exposure to allergens such as dust mites and pollen. As well, as air pollutants such as diesel exhaust particulates, can alter the ability of critical genes to be expressed appropriately — a process known as epigenetic modification. The epigenetic modifications induced by allergens and pollutants appear to be reversible. Budesonide (Rhinocort®) is a corticosteroid nasal spray commonly used to treat allergy symptoms arising from allergic rhinitis. While the anti-inflammatory and other pharmacological aspects of budesonide are well understood, recent studies have suggested that budesonide may also work by reversing the epigenetic modifications caused by allergen exposure, although this has not been examined in the context of real-world exposures in humans.

The project team, comprising members from the University of British Columbia and Kenvue (formerly Johnson & Johnson Consumer Inc.), undertook a real-world trial to delve deeper into this phenomenon. Participants were administered either budesonide or a placebo (no drug) subsequent to exposure to allergens and diesel exhaust within a controlled environment. Through this trial, the team found evidence suggesting that budesonide can improve nasal symptoms, mitigate inflammatory effects and influence epigenetic modification following exposure to allergens and diesel exhaust. These findings will help inform patients and providers about the optimal utilization of budesonide in managing allergic rhinitis. Moving forward, the team intends to integrate and analyze the epigenetic, physiological and clinical data collected to gain a comprehensive understanding of budesonide's impact during allergic reactions.