Effect of Intranasal Corticosteroids on Systemic Allergen Specific IgE

Inclusion Criteria: * male or female 18-50 years of age * moderate to severe allergic rhinitis to grass and/or birch pollen for at least two seasons according to history * sensitization to rPhl p 5 and rBet v 1 as demonstrated by UniCAP within a range from 3.0-80 kUA/l and a positive (wheal diameter \>= 3 mm larger than the negative control and half of the histamine control) SPT with rPhl p 5 and rBet v 1 at 20 µg/ml * willingness to comply with the study protocol * written informed consent Exclusion Criteria: * perennial allergic rhinitis * history of asthma necessitating treatment * FEV1 \<70% of predicted value * abnormalities at auscultation of heart or lungs * history of anaphylaxis * severe atopic dermatitis * total serum IgE \>2000 kU/l * previous or ongoing immunotherapy (subcutaneous or sublingual) to grass or birch pollen * nasal provocation testing during the previous six month * known allergy/intolerance to fluticasone propionate or loratadine * known allergy/intolerance to cellulose, polysorbate, phenylethyl alcohol, benzalkonium chloride * contraindications for the use of INCS: * acute or chronic infections of the upper respiratory tract * surgery of the nose during the previous year * hypersensitivity to components of the drug * contraindications for nasal provocation test * acute rhinosinusitis * acute allergic reaction of the immediate type at other organs * nasal polyposis or significant nasal anatomical deformities * vasomotor rhinitis * autoimmune disease, chronic or acute infectious disease, malignancy * severe psychological disorder * treatment with systemic or topical (intranasal, inhaled, external) corticosteroids from 3 month prior to the study * treatment with other immunosuppressant drugs from 6 month prior to the study * treatment with antihistamines or disodium cromoglycate from 2 weeks prior to the study * treatment with intranasal adrenergic drugs from 3 days prior to the study * treatment with systemic adrenergic drugs * treatment with psychopharmacological drugs from 2 weeks prior to the study * cardiovascular or pulmonary disease * contraindication for adrenaline * participation in any other clinical trial within the previous 3 month * pregnant, lactating or sexually active women with childbearing potential who are not using a medically accepted birth control method * a mental condition rendering the subject unable to understand the nature, scope and possible consequences of the study, and/or evidence of an uncooperative attitude * known alcohol or drug addiction or abuse * unlikelihood to be able to complete the study