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Ali MM, Ellison M, Iweala OI, Spector AR. A sleep clinician's guide to runny noses: evaluation and management of chronic rhinosinusitis to improve sleep apnea care in adults. J Clin Sleep Med 2023; 19:1545-1552. [PMID: 37082825 PMCID: PMC10394352 DOI: 10.5664/jcsm.10608] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/22/2023]
Abstract
STUDY OBJECTIVES The treatment of obstructive sleep apnea is often impeded by intolerance of positive airway pressure therapy, which is frequently attributed to the inability to breathe through the nose. Providers caring for patients with sleep apnea need a working knowledge of nasal passage disease and available treatments to better manage this common comorbidity. METHODS This review examines the literature connecting rhinosinusitis to adverse sleep and sleep apnea outcomes. It explores the different types of nasal and sinus diseases a sleep apnea provider might encounter, focusing on the medications used to treat them and indications for referral to otolaryngology. RESULTS Chronic rhinosinusitis can be either allergic or nonallergic. Both types can interfere with sleep and sleep apnea therapy. The successful management of chronic rhinosinusitis can improve positive airway pressure tolerance and adherence. A wide range of over-the-counter and prescription pharmacotherapy is available, with data supporting intranasal over oral treatment. Surgical treatment for chronic rhinosinusitis in obstructive sleep apnea addresses nasal obstruction, often with inferior turbinate reduction and septoplasty. CONCLUSIONS Sleep specialists should have a working knowledge of the available options to treat chronic rhinosinusitis. These options are often safe, effective, and readily accessible. Otolaryngologists and allergists/immunologists provide additional treatment options for more complicated patients. Providing treatment for chronic rhinosinusitis should be included as part of comprehensive sleep apnea care. CITATION Ali MM, Ellison M, Iweala OI, Spector AR. A sleep clinician's guide to runny noses: evaluation and management of chronic rhinosinusitis to improve sleep apnea care in adults. J Clin Sleep Med. 2023;19(8):1545-1552.
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Affiliation(s)
- Mir M. Ali
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | - Matthew Ellison
- Department of Otolaryngology, Duke University School of Medicine, Durham, North Carolina
| | - Onyinye I. Iweala
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina
| | - Andrew R. Spector
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina
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Bohn A, Blumenstiel J. Update Anaphylaxie – wenig Neues, aber weiter wichtig. NOTARZT 2022. [DOI: 10.1055/a-1961-9717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Andreas Bohn
- Berufsfeuerwehr, Stadt Münster, Munster, Deutschland
| | - Jonas Blumenstiel
- Abteilung Anästhesie, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Deutschland
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Chiang CH, Chiang CH, Peng CY, Hsia YP, See XY, Horng CS, Chang YC, Shen XE, Wang SS, Tsai TC, Chen YJ, Ma KSK, Chen BS, Luan YZ, Tay ST, Shen CH, Chung KC, Chiang CH, Peng CM. Efficacy of cationic amphiphilic antihistamines on outcomes of patients treated with immune checkpoint inhibitors. Eur J Cancer 2022; 174:1-9. [PMID: 35964360 DOI: 10.1016/j.ejca.2022.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/27/2022] [Accepted: 07/07/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Cationic amphiphilic antihistamines have been shown to improve patient outcomes in immunogenic tumours, but whether they can augment and improve response to immunotherapy is unknown. We aim to evaluate the effect of cationic amphiphilic antihistamines in patients receiving immune checkpoint inhibitors (ICIs). METHODS We conducted a retrospective propensity score-matched cohort study at two tertiary referral centres in Taiwan between January 2015 and December 2021. Patients who received desloratadine, cyproheptadine, and ebastine were classified as cationic amphiphilic antihistamine users. The primary outcome was overall survival, and the secondary outcomes were progression-free survival and clinical benefit rate. Patients treated with cationic amphiphilic antihistamines were matched to patients who received non-cationic amphiphilic antihistamines based on variables including age, cancer type, stage, and history of allergic diseases. RESULTS A total of 734 ICI-treated patients were included. After matching, 68 cationic amphiphilic antihistamine and non-cationic amphiphilic antihistamine users remained for analysis. Compared with non-cationic amphiphilic antihistamine users, patients who received cationic amphiphilic antihistamines had a significantly longer median overall survival (24.8 versus 10.4 months; Log-rank, p = 0.018) and progression-free survival (10.6 versus 4.93 months; Log-rank, p = 0.004). The use of cationic amphiphilic antihistamines was associated with an approximately 50% lower risk of all-cause mortality (HR, 0.55 [95% CI: 0.34-0.91]). Survival benefits were not seen in patients who received cationic amphiphilic antihistamines before immune checkpoint blockade. These survival benefits were observed regardless of the generation of cationic amphiphilic antihistamines. CONCLUSION The use of cationic amphiphilic antihistamines was associated with improved survival among patients treated with immunotherapy.
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Affiliation(s)
- Cho-Han Chiang
- Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Boston, MA, USA
| | - Cho-Hung Chiang
- Division of General Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; Division of Hematology and Oncology, Department of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Chun-Yu Peng
- Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yuan Ping Hsia
- Department of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Xin Ya See
- Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chuan-Sheng Horng
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Cheng Chang
- Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Xuan-Er Shen
- Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shih-Syuan Wang
- Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tien-Chi Tsai
- Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yuan-Jen Chen
- Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer, National Taiwan University, Taipei, Taiwan; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Yu-Ze Luan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Soon-Tzeh Tay
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Chin-Hsuan Shen
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Katharine Ching Chung
- Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan
| | | | - Cheng-Ming Peng
- Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Abstract
Post-burn pruritus is the pruritus that occurs after burn during the rehabilitation and healing process of burn wounds. The post-burn pruritus is a common and serious complication of burn injury, which severely lowers the quality of life of the patient. Many potential treatments are available for pruritus but there is no consensus of the best single treatment yet. The precise mechanism of post-burn pruritus has not been elucidated, but it appears to have pruritogenic and neuropathic aspects. Clinically, post-burn pruritus tends to be intractable to conventional treatment but rather responds to neuroleptic agents, such as gabapentin and pregabalin. During wound healing, various neuropeptides secreted from the nerves of the skin control epidermal and vascular proliferation and connective tissue cells. When keratinocytes are activated by an itch-inducing substance, they secrete a variety of inflammatory substances that increase the susceptibility of the itch receptor. There are two mechanisms underlying post-burn neuropathic pruritus. The first one is peripheral sensitization. The second one is the intact nociceptor hypothesis. An effective treatment for post-burn pruritus will also be effective in other neuropathic and intractable itching. In this review, we summarized the interaction and mechanism of keratinocytes, immune cells, and nerve fibers related to post-burn pruritus.
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Choi YW, Jung MJ, Kim HO, Chung BY, Park CW. Anaphylaxis to Chlorpheniramine Maleate and Literature Review. Ann Dermatol 2019; 31:438-441. [PMID: 33911623 PMCID: PMC7992761 DOI: 10.5021/ad.2019.31.4.438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/11/2018] [Accepted: 06/15/2018] [Indexed: 11/20/2022] Open
Abstract
Chlorpheniramine maleate is commonly used antihistamine. Since antihistamines are the main therapeutic agents for symptomatic treatment of urticaria, anaphylaxis to antihistamines may lead to errors in diagnosis and treatment. We report a case of anaphylaxis induced by chlorpheniramine maleate confirmed by intradermal test. A 35-year-old female experienced history of anaphylaxis after intramuscular injection of chlorpheniramine maleate. Skin prick test was negative, but intradermal test was positive. Patient also experienced mild dizziness after intradermal test and refused to perform any further evaluation such as oral challenge test. Anaphylaxis for chlorpheniramine maleate is very rare but should be considered.
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Affiliation(s)
- Yong Won Choi
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Min Je Jung
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Hye One Kim
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Bo Young Chung
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Chun Wook Park
- Department of Dermatology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
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Obara I, Telezhkin V, Alrashdi I, Chazot PL. Histamine, histamine receptors, and neuropathic pain relief. Br J Pharmacol 2019; 177:580-599. [PMID: 31046146 PMCID: PMC7012972 DOI: 10.1111/bph.14696] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 02/21/2019] [Accepted: 04/18/2019] [Indexed: 01/06/2023] Open
Abstract
Histamine, acting via distinct histamine H1, H2, H3, and H4 receptors, regulates various physiological and pathological processes, including pain. In the last two decades, there has been a particular increase in evidence to support the involvement of H3 receptor and H4 receptor in the modulation of neuropathic pain, which remains challenging in terms of management. However, recent data show contrasting effects on neuropathic pain due to multiple factors that determine the pharmacological responses of histamine receptors and their underlying signal transduction properties (e.g., localization on either the presynaptic or postsynaptic neuronal membranes). This review summarizes the most recent findings on the role of histamine and the effects mediated by the four histamine receptors in response to the various stimuli associated with and promoting neuropathic pain. We particularly focus on mechanisms underlying histamine‐mediated analgesia, as we aim to clarify the analgesic potential of histamine receptor ligands in neuropathic pain. Linked Articles This article is part of a themed section on New Uses for 21st Century. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.3/issuetoc
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Affiliation(s)
- Ilona Obara
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Vsevolod Telezhkin
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ibrahim Alrashdi
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Paul L Chazot
- Department of Biosciences, Durham University, Durham, UK
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Kim MH, Hong SU, Kim HT, Seo HS, Kim K, Ko SG, Choi I. A multicenter study on the efficacy and safety of So-Cheong-Ryong-Tang for perennial allergic rhinitis. Complement Ther Med 2019; 45:50-56. [PMID: 31331582 DOI: 10.1016/j.ctim.2019.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/15/2019] [Accepted: 05/13/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND So-Cheong-Ryong-Tang (SCRT), also known as Xiao-Qing-Long-Tang or Sho-seiryo-to, is a mixed herbal formula that is used to treat allergic rhinitis, bronchitis, allergic asthma, and common cold in traditional Korean medicine. OBJECTIVE To assess the efficacy and safety of the SCRT for the treatment of allergic rhinitis. METHODS We conducted a double-blind, randomized, placebo-controlled, parallel-group, multicenter study of Korean adults with perennial allergic rhinitis. The trial consisted of a 4-week oral administration of SCRT or placebo, with two visits at 2-week intervals, and an 8-week follow-up period, with two visits at 4-week intervals. The primary outcome was a change in the total nasal symptoms score. The secondary outcomes included changes in the Rhinoconjunctivitis Quality of Life Questionnaire score, total serum immunoglobulin E (IgE), cytokines levels, and nasal endoscopy index. RESULTS SCRT improved nasal symptoms and quality of life in patients with PAR after 4 weeks medication, and these effects did not last 8 weeks after the end of medication. The level of serum IgE, eosinophil counts, and cytokines did not alter after medication. Nasal endoscopy index did not show significant difference. No serious AEs and safety assessment changes were observed in this trial. CONCLUSION SCRT is an effective and safe medication for patients with chronic, perennial, and moderate to severe AR. A clinical study with a >4-week period of medication use, and more participants for immune material test is needed to investigate the long-term efficacy of SCRT in relieving the symptoms of nasal obstruction and identifying the underlying mechanisms of action and indications for traditional Korean medicine.
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Affiliation(s)
- Min Hee Kim
- Department of Ophthalmology, Otorhinolaryngology & Dermatology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - Seung-Ug Hong
- Department of Ophthalmology, Otorhinolaryngology & Dermatology, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea.
| | - Hee-Taek Kim
- Department of Ophthalmology, Otorhinolaryngology & Dermatology, College of Korean Medicine, Semyung University, Jecheon, Republic of Korea.
| | - Hyung-Sik Seo
- Department of Ophthalmology, Otorhinolaryngology & Dermatology, College of Korean Medicine, Pusan National University, Pusan, Republic of Korea.
| | - Kyuseok Kim
- Department of Ophthalmology, Otorhinolaryngology & Dermatology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - Seoung-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - Inhwa Choi
- Department of Ophthalmology, Otorhinolaryngology & Dermatology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Green Analytical Methods for the Separation of Seven Antihistamines: Application in Separation of Azelastine and Related Impurities in Nasal Solution. Int J Anal Chem 2019; 2019:9489723. [PMID: 30886632 PMCID: PMC6388312 DOI: 10.1155/2019/9489723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 01/16/2019] [Indexed: 11/17/2022] Open
Abstract
Antihistamines are widely used to alleviate the symptoms caused by allergic reactions. Most of these drugs have zwitteriónicas and/or amphoteric characteristics, which confer additional analytical challenges. This work aimed to develop a single eco-friendly and efficient chromatographic methods for analysis of seven antihistamines, namely, azelastine HCl, desloratadine, ebastine, fexofenadine HCl, ketotifen, loratadine, and olopatadine HCl. The separations were obtained using RP C-18 LUNA (150x4.6mm, 5 μm) column. The mobile phase consisted of acetonitrile and acidified water (pH 2.1) in the following proportion: 15:85, v/v for desloratadine, 25:75, v/v for ketotifen and olopatadine, 32:68, v/v for fexofenadine, 35:65, v/v for azelastine and loratadine, and 45:55, v/v for ebastine. All separations were obtained in less than 7.0 min. A prototype method was fully validated and applied in the assay of azelastine HCl in nasal solutions. The proposed methods for analysis of seven antihistamines are highly efficient, selective, and sensitive. Moreover, all methods can be considered excellent in terms of greenness, with total organic residue < 2.5 mL/analysis. An improved gradient method is also described for separation of azelastine HCl and its related impurities.
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Allergenspezifische Immuntherapie bei IgE-vermittelten Erkrankungen im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2019. [DOI: 10.1007/s00112-018-0448-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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10
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Kim MH, Ko Y, Ahn JH, Yun Y, Yun MN, Ko SG, Choi I. Efficacy and safety of So-Cheong-Ryong-Tang in treatment of perennial allergic rhinitis: study protocol for a double-blind, randomised, parallel-group, multicentre trial. BMJ Open 2017; 7:e016556. [PMID: 28963290 PMCID: PMC5623494 DOI: 10.1136/bmjopen-2017-016556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION So-Cheong-Ryong-Tang (SCRT) is a herbal medicine widely used in traditional medicine for treating allergic rhinitis (AR). In animal studies, SCRT has suppressed the progression of AR. The main purpose of this study is to assess the efficacy and safety of the SCRT for the treatment of perennial allergic rhinitis (PAR) and discover the underlying mechanisms resulting in anti-inflammatory effects in humans. METHODS AND ANALYSIS We will conduct a double-blind, randomised, placebo-controlled, parallel-group, multicentre trial of Korean adults with PAR. For the study, 156 subjects with PAR will be recruited. The trial will consist of a 4-week oral administration of SCRT or placebo with two visits at 2-week intervals and an 8-week follow-up period with two visits at 4-week intervals. The primary outcome is a change in the total nasal symptoms score. The secondary outcomes include changes in the Rhinoconjunctivitis Quality of Life Questionnaire score, total serum IgE and cytokines levels. ETHICS AND DISSEMINATION This study was approved by the Institutional Review Board at each research centre (name of each centres and approval numbers): Kyung Hee University Hospital at Gangdong (KHNMC-OH-IRB 2015-04-009), Kyung Hee University Medical Centre (KOMCIRB-160321-HRBR-011), Pusan National University Hospital (2016-004), Dongguk University Medical Centre (2016-03) and Semyung University hospital (2016-01). This result will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT03009136; Pre-results.
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Affiliation(s)
- Min-Hee Kim
- Department of Ophthalmology, Otorhinolaryngology, and Dermatology of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
- Department of Clinical Korean Medicine, Graduate school, Kyung Hee University, Seoul, Republic of Korea
| | - Youme Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jin-Hyang Ahn
- Department of Ophthalmology, Otorhinolaryngology, and Dermatology of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
- Department of Clinical Korean Medicine, Graduate school, Kyung Hee University, Seoul, Republic of Korea
| | - Younghee Yun
- Department of Ophthalmology, Otorhinolaryngology, and Dermatology of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Mi-Na Yun
- Department of Clinical Korean Medicine, Graduate school, Kyung Hee University, Seoul, Republic of Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Inhwa Choi
- Department of Ophthalmology, Otorhinolaryngology, and Dermatology of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
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Hyeonggaeyeongyo-Tang for Treatment of Allergic and Nonallergic Rhinitis: A Prospective, Nonrandomized, Pre-Post Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:9202675. [PMID: 27698676 PMCID: PMC5028861 DOI: 10.1155/2016/9202675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/27/2016] [Accepted: 08/07/2016] [Indexed: 12/26/2022]
Abstract
Hyeonggaeyeongyo-tang (HYT) is an ancient formula of oriental medicine traditionally used to treat rhinitis; however, clinical evidence has not yet been established. The aim of this study was to investigate the short-term and long-term efficacy and safety of HYT for chronic rhinitis. Adult subjects with chronic rhinitis symptoms were recruited. The subjects received HYT for 4 weeks and had follow-up period of 8 weeks. Any medicines used to treat nasal symptoms were not permitted during the study. The skin prick test was performed to distinguish the subjects with allergic rhinitis from those with nonallergic rhinitis. After treatment, the total nasal symptoms score and the Rhinoconjunctivitis Quality of Life Questionnaire score significantly improved in the whole subject group, in the allergic rhinitis group, and in the nonallergic rhinitis group, with no adverse events. This improvement lasted during a follow-up period of 8 weeks. Total IgE and eosinophil levels showed no significant difference after treatment in the allergic rhinitis group. HYT improved nasal symptoms and quality of life in patients with allergic rhinitis and nonallergic rhinitis. This is the first clinical study to evaluate the use of HYT to treat patients with rhinitis. This trial has been registered with the ClinicalTrials.gov Identifier NCT02477293.
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An unusual case of inferior acute myocardial infarction associated with advanced second grade atrio-ventricular block secondary to scombroid — fish poisoning. Open Med (Wars) 2013. [DOI: 10.2478/s11536-013-0169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
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13
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Weller K, Soost S, Worm M, Maurer M, Zuberbier T. Atopic dermatitis and allergic rhinitis--do co-effects in therapy exist? J Dtsch Dermatol Ges 2012; 10:221-36; quiz 238-9. [PMID: 22304462 DOI: 10.1111/j.1610-0387.2011.07885.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Atopic dermatitis and allergic rhinitis frequently appear together in the same patients. The pathogenesis of both disorders is complex and still incompletely understood. Nevertheless, pathophysiological overlaps suggest the existence of potential therapeutic co-effects. While data pointing towards a positive effect of allergen elimination for both diseases is still limited, there is now increasing evidence showing beneficial effects of specific immunotherapy in patients suffering from atopic dermatitis and additional type I allergies. H(1)-antihistamines were also found to exert moderate positive effects on the symptoms of atopic dermatitis in single studies. In summary, a limited therapeutic co-effect of the above mentioned treatment options can be expected in case of the parallel existence of atopic dermatitis and allergic rhinitis in the same patient. More studies on this issue during the next years are desirable. In addition, a better understanding of the pathophysiology should have a positive impact on the treatment of atopic manifestations such as atopic dermatitis and allergic rhinitis.
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Affiliation(s)
- Karsten Weller
- Allergy Center Charité, Department of Dermatology, Venereology and Allergology, Charité-University Medicine, Charitéplatz 1, Berlin, Germany.
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Ahmadi A, Khalili M, Hajikhani R, Safari N, Nahri-Niknafs B. Anti-inflammatory effects of two new methyl and morpholine derivatives of diphenhydramine on rats. Med Chem Res 2011. [DOI: 10.1007/s00044-011-9891-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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15
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Procopiou PA, Browning C, Buckley JM, Clark KL, Fechner L, Gore PM, Hancock AP, Hodgson ST, Holmes DS, Kranz M, Looker BE, Morriss KML, Parton DL, Russell LJ, Slack RJ, Sollis SL, Vile S, Watts CJ. The Discovery of Phthalazinone-Based Human H1 and H3 Single-Ligand Antagonists Suitable for Intranasal Administration for the Treatment of Allergic Rhinitis. J Med Chem 2011; 54:2183-95. [DOI: 10.1021/jm1013874] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Panayiotis A. Procopiou
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Christopher Browning
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Jennifer M. Buckley
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Kenneth L. Clark
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Lise Fechner
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Paul M. Gore
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Ashley P. Hancock
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Simon T. Hodgson
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Duncan S. Holmes
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Michael Kranz
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Brian E. Looker
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Karen M. L. Morriss
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Daniel L. Parton
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Linda J. Russell
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Robert J. Slack
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Steven L. Sollis
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Sadie Vile
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
| | - Clarissa J. Watts
- Departments of Medicinal Chemistry, ‡Respiratory Biology, §Drug Metabolism and Pharmacokinetics, and ∥Cheminformatics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, United Kingdom
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Prévention du risque allergique. Choix de la technique et des agents anesthésiques. ACTA ACUST UNITED AC 2011; 30:305-11. [DOI: 10.1016/j.annfar.2010.12.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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17
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Clinical practice: Allergen-specific immunotherapy in children: facts and FAQs. Eur J Pediatr 2011; 170:137-48. [PMID: 21153032 DOI: 10.1007/s00431-010-1348-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 11/04/2010] [Indexed: 10/18/2022]
Abstract
Allergen-specific immunotherapy (SIT) in its various application forms represents the main treatment approach of IgE-mediated allergic diseases in adults and children. Despite this clear recommendation, many particularities of products, patient characteristics, and product availability in different countries hamper the use of allergen-specific immunotherapy in particular in children. The frequently asked questions by parents, patients, and physicians are the backbone of this review. Thus, the potentials and limitations of allergen-specific immunotherapy in children and adolescents will be highlighted. IgE-mediated allergic diseases are affecting about 20% of the population. They manifest commonly early in life, and hence, the use of SIT should be considered also early in the course of the disease.
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Beaton G, Moree WJ. The expanding role of H1antihistamines: a patent survey of selective and dual activity compounds 2005 – 2010. Expert Opin Ther Pat 2010; 20:1197-218. [DOI: 10.1517/13543776.2010.510516] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Bachert C. Levocetirizine: a modern H1-antihistamine for the treatment of allergic rhinitis. Expert Rev Clin Immunol 2010; 1:495-510. [PMID: 20477594 DOI: 10.1586/1744666x.1.4.495] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Levocetirizine is the latest of the H(1)-antihistamines indicated for adults and children (as young as 2 years old) suffering from allergic rhinitis and chronic idiopathic urticaria. Currently, it is the only therapy registered for treatment of persistent allergic rhinitis, as defined by the Allergic Rhinitis & its Impact on Asthma guidelines. Pharmacologic studies have shown levocetirizine to have a more favorable pharmacokinetic/pharmacodynamic profile than other commonly employed H(1)-antihistamines. This reflects its superiority in controlling the symptoms of seasonal, perennial and persistent allergic rhinitis in well-controlled trials. Clinical trials and postmarketing surveillance have indicated that levocetirizine is safe and well tolerated, and leads to clinically significant improvements in the quality of life of patients. It is also reported to reduce comorbidities as well as overall treatment costs when administered continuously over the longterm.
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Affiliation(s)
- Claus Bachert
- Department of Oto-Rhino-Laryngology, Univerisity Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
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20
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An unusual cause of hypotension and abnormal electrocardiogram (ECG) — scombroid poisoning. Open Med (Wars) 2010. [DOI: 10.2478/s11536-010-0003-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractScombroid fish or histamine food poisoning is an illness typically associated with fish consumption, rarely encountered and reported in Europe. Symptoms develop quickly and resemble an allergic reaction. This paper reports three cases of severe scombroid poisoning in previously healthy patients, which presented diffuse macular erythema, hypotension, palpitations, and abnormal electrocardiogram (ECG). All patients required intensive care, with a complete resolution of symptoms and ECG changes within 24 hours. This is the first Romanian report of scombroid poisoning, emphasizing that medical personnel should be aware of this condition, because symptoms and ECG changes often lead to confusion with other diseases.
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21
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H4 receptor antagonism exhibits anti-nociceptive effects in inflammatory and neuropathic pain models in rats. Pharmacol Biochem Behav 2010; 95:41-50. [DOI: 10.1016/j.pbb.2009.12.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 11/25/2009] [Accepted: 12/02/2009] [Indexed: 01/07/2023]
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22
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Goutos I. Burns pruritus—A study of current practices in the UK. Burns 2010; 36:42-8. [DOI: 10.1016/j.burns.2009.06.196] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2009] [Revised: 06/21/2009] [Accepted: 06/24/2009] [Indexed: 12/01/2022]
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Comparative Evaluation of Antipruritic Protocols in Acute Burns. The Emerging Value of Gabapentin in the Treatment of Burns Pruritus. J Burn Care Res 2010; 31:57-63. [DOI: 10.1097/bcr.0b013e3181cb8ecf] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Szépfalusi Z, Emminger W, Eitelberger F, Götz M, Grillenberger A, Horak E, Huttegger I, Koller D, Litscher H, Schmitzberger R, Varga EM, Riedler J. [Allergen-specific Immunotherapy for children and adolescents - a review on available products in Austria]. Wien Klin Wochenschr 2009; 121:648-60. [PMID: 19921133 DOI: 10.1007/s00508-009-1258-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Accepted: 09/30/2009] [Indexed: 11/25/2022]
Abstract
A pediatric consensus report on allergen-specific immunotherapy for children and adolescents is presented for Austria. Products on the market in Austria are presented and categorised according to studies performed on the target population of children and adolescents, their effectiveness and indication. In general, more clinical studies on children and adolescents are mandatory for most of the available allergen-specific immunotherapeutics. In addition, the use of allergen-specific immunotherapy in general should be promoted as the exclusive treatment with long-lasting effects in type I allergies in particular in children.
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Abstract
Pruritus represents a common and distressing feature of burn wounds. Over the last decades, significant advances in neuroanatomical and neurophysiological knowledge have resulted in the elucidation of the mediators and pathways involved in the transmission of pruritic impulses. A plethora of therapeutic approaches have been evaluated mostly in small-scale studies involving burns patients targeting both the peripheral and the central components of the neurologic pathway. Antihistamines, doxepin, massage therapy, and transcutaneous electrical nerve stimulation are effective strategies to combat pruritus in burns patients. Recent studies have provided preliminary evidence regarding the effectiveness of gabapentin and ondansetron. The area of burns pruritus is under-researched and large-scale studies are required to reinforce the armamentarium of specialists with evidence-based regimens for the treatment of this highly distressing symptom.
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Jones BL, Abdel-Rahman SM, Simon SD, Kearns GL, Neville KA. Assessment of histamine pharmacodynamics by microvasculature response of histamine using histamine iontophoresis laser Doppler flowimetry. J Clin Pharmacol 2009; 49:600-5. [PMID: 19318525 DOI: 10.1177/0091270009332247] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Bridgette L Jones
- Department of Pediatrics, University of Missouri-Kansas City, Children's Mercy Hospitals and Clinics, Kansas City, MO 64079, USA.
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Bizikova P, Papich MG, Olivry T. Hydroxyzine and cetirizine pharmacokinetics and pharmacodynamics after oral and intravenous administration of hydroxyzine to healthy dogs. Vet Dermatol 2008; 19:348-57. [DOI: 10.1111/j.1365-3164.2008.00697.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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28
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de Benedictis FM, de Benedictis D, Canonica GW. New oral H1 antihistamines in children: facts and unmeet needs. Allergy 2008; 63:1395-404. [PMID: 18782118 DOI: 10.1111/j.1398-9995.2008.01771.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Second-generation antihistamines differ from first-generation ones because of their elevated specificity and affinity for peripheral H1-receptors and because of their lower penetration to the central nervous system, having fewer sedative effects as a result. Over the last few years, new compounds with different pharmacokinetic properties have been synthesized. More recent improvements of the molecules, generally in the form of active metabolites, led to the synthesis of new-generation antihistamines. METHODS Recommendations on the minimum criteria that would have to be met for compounds to be classified as new-generation antihistamines have been recently established by a consensus statement. In the past, the pharmacokinetics and pharmacodynamics of H1 antihistamines have not been optimally investigated in the pediatric population, especially in infants and young children. RESULTS The pharmacology of second-generation H1 antihistamines has been investigated relatively deeper than old antihistamines in children. In the pediatric population, clinical studies with new-generation antihistamines are still limited in number and, with rare exceptions, of brief duration. Comparative trials on the efficacy and safety between different compounds are also lacking. CONCLUSIONS Properly designed, long-term trials with new-generation H1 antihistamines need to be performed in single age groups, in order to better define the effects of these drugs in all pediatric population.
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Time-dependent inhibition of histamine-induced cutaneous responses by oral and intramuscular diphenhydramine and oral fexofenadine. Ann Allergy Asthma Immunol 2008; 100:452-6. [PMID: 18517077 DOI: 10.1016/s1081-1206(10)60470-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Diphenhydramine is often the treatment of choice for acute urticarial or allergic reactions despite its adverse effects of sedation and impairment. Second- and third-generation histamine1-antihistamines are generally devoid of these adverse effects but are typically not used because of a perceived slower onset of action. OBJECTIVE To examine the time-dependent effects of oral fexofenadine and oral and intramuscular diphenhydramine to reduce histamine-induced wheal-and-flare responses. METHODS Eighteen healthy patients were included in a double-blind, placebo-controlled, 3-way, randomized, crossover study with oral fexofenadine (180 mg) and oral and intramuscular diphenhydramine (50 mg). Histamine-induced skin tests were performed before and more than 6 hours subsequent to dosing. The primary end point was time to induce a 50% reduction in histamine-induced flare. Secondary end points included change from baseline at each time point in wheal-and-flare responses and area under the curve at more than 6 hours for flare. RESULTS No significant differences were found in the 50% inhibitory responses of histamine-induced flares among the 3 groups (P = .09). No significant differences were found among the 3 groups in change from baseline at each time point except for 30 minutes during which fexofenadine had no inhibitory effect. Area under the curve analyses for wheal-and-flare responses revealed no differences among treatments at more than 6 hours. CONCLUSION Diphenhydramine tended to work more rapidly than fexofenadine, but the differences were not statistically significant. Given the adverse effect profile of diphenhydramine, but only marginal onset of action advantage, the risk-to-benefit ratio may be more favorable for oral fexofenadine when treating an acute urticarial or allergic reaction.
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Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8-160. [PMID: 18331513 DOI: 10.1111/j.1398-9995.2007.01620.x] [Citation(s) in RCA: 3022] [Impact Index Per Article: 188.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Asthma/therapy
- Child
- Global Health
- Humans
- Prevalence
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
- World Health Organization
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Affiliation(s)
- J Bousquet
- University Hospital and INSERM, Hôpital Arnaud de Villeneuve, Montpellier, France
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Procopiou PA, Ancliff RA, Bamford MJ, Browning C, Connor H, Davies S, Fogden YC, Hodgson ST, Holmes DS, Looker BE, Morriss KML, Parr CA, Pickup EA, Sehmi SS, White GV, Watts CJ, Wilson DM, Woodrow MD. 4-Acyl-1-(4-aminoalkoxyphenyl)-2-ketopiperazines as a Novel Class of Non-Brain-Penetrant Histamine H3 Receptor Antagonists. J Med Chem 2007; 50:6706-17. [DOI: 10.1021/jm0708228] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Panayiotis A. Procopiou
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Rachael A. Ancliff
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Mark J. Bamford
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Christopher Browning
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Helen Connor
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Susannah Davies
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Yvonne C. Fogden
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Simon T. Hodgson
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Duncan S. Holmes
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Brian E. Looker
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Karen M. L. Morriss
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Christopher A. Parr
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Elizabeth A. Pickup
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Sanjeet S. Sehmi
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Gemma V. White
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Clarissa J. Watts
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - David M. Wilson
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
| | - Michael D. Woodrow
- Departments of Chemistry, Pharmacology, Drug Metabolism and Pharmacokinetics, GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K., and GlaxoSmithKline New Frontiers Science Park South, Third Avenue, Harlow, Essex, CM19 5AW, U.K
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Abstract
OBJECTIVES To describe emergency department management of acute urticaria in children and to determine factors associated with management strategies and adherence to practice guidelines. METHODS Self-administered cross-sectional survey mailed to all Section of Emergency Medicine members of the American Academy of Pediatrics (n = 1190) and 1000 randomly selected members of the American College of Emergency Physicians. Main outcome measure was proportion of respondents adhering to published guidelines. Factors associated with management strategies were analyzed using bivariate and logistic regression analyses. RESULTS Of 2190 surveys sent, 1137 (52.5%) were available for analysis. Respondents included 44.6% pediatric emergency physicians, 36.4% emergency physicians, and 15.3% pediatricians. First-generation histamine (H)1 antagonists alone were the most common therapy used on initial presentation of acute urticaria, followed by corticosteroids, H2 antagonists, and second-generation H1 antagonists, used by only 7.8%, despite their recommendation as first-line therapy. Physicians working in an emergency department as opposed to an urgent or primary care setting were less likely to use second-generation H1 antagonists (odds ratio [OR], 0.3 [0.1-0.7]). General emergency physicians were 2.6 times more likely to use H2 antagonists and more than 3 times as likely to use corticosteroids. Only 14.2% of physicians overall were familiar with guideline recommendations. CONCLUSIONS Minimal awareness and use of existing guidelines, and low concordance with published recommendations exist. Management practices vary and are influenced by training, practice setting, and clinical experience.
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Kemény L, Koreck A. Ultraviolet light phototherapy for allergic rhinitis. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2007; 87:58-65. [PMID: 17329119 DOI: 10.1016/j.jphotobiol.2007.01.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2006] [Revised: 01/09/2007] [Accepted: 01/09/2007] [Indexed: 11/28/2022]
Abstract
Phototherapy has a profound immunosuppressive effect and is widely used for the treatment of immune mediated skin diseases. Phototherapy is able to inhibit immediate type hypersensitivity reaction in the skin. Intranasal phototherapy is a new approach for treatment of allergic rhinitis. In two open studies, 308 nm excimer laser and topical PUVA therapy efficiently inhibited clinical symptoms of allergic rhinitis. In a randomized, double-blind study combined low dose UVB, low dose UVA and visible light proved to be effective in reducing symptom scores for sneezing, rhinorrhea, nasal itching and the total nasal score in ragweed allergic patients. Mechanism of action of phototherapy is complex, it reduces the antigen presenting capacity of dendritic cells, induces apoptosis of immune cells and inhibits synthesis and release of pro-inflammatory mediator from several cell types. Therefore, intranasal phototherapy may represent an alternative treatment of allergic rhinitis and other inflammatory and immune mediated mucosal diseases.
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Affiliation(s)
- Lajos Kemény
- Department of Dermatology and Allergology, University of Szeged, Koranyi fasor 6, 6720 Szeged, Hungary.
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Borade PS, Ballary CC, Lee DKC. A fishy cause of sudden near fatal hypotension. Resuscitation 2006; 72:158-60. [PMID: 17084013 DOI: 10.1016/j.resuscitation.2006.05.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2005] [Revised: 05/10/2006] [Accepted: 05/30/2006] [Indexed: 11/17/2022]
Abstract
Seafood-borne illnesses are a common but under recognised source of morbidity. We report the case of an 80-year-old woman who presented to hospital after collapsing in a restaurant following lunch consisting of mackerel fish. A detailed food history and clinical exclusion helped diagnose the condition as scombroid poisoning. The patient made a complete recovery following antihistamine therapy.
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Affiliation(s)
- P S Borade
- Department of Internal Medicine, Ipswich Hospital, Heath Road, Ipswich, IP4 5PD Suffolk, United Kingdom.
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Zhang M, Venable JD, Thurmond RL. The histamine H4 receptor in autoimmune disease. Expert Opin Investig Drugs 2006; 15:1443-52. [PMID: 17040202 DOI: 10.1517/13543784.15.11.1443] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Histamine exerts its actions through four known receptors. The recently cloned histamine receptor, H4R, has been shown to have a role in chemotaxis and mediator release in various types of immune cells including mast cells, eosinophils, dendritic cells and T cells. H4R antagonists have been shown to have anti-inflammatory properties and efficacy in a number of disease models, such as those for asthma and colitis in vivo. Recently, H4R antagonists have been developed with high receptor affinity and specificity, which make them good tools for further characterisation of the receptor in animal models and, eventually, in humans. Histamine and the cells that produce it, such as mast cells and basophils, have long been thought to be involved in allergic conditions but there has recently been recognition that they may also play a role in various autoimmune diseases. Given this and the fact that the H4R has function in mast cells, dendritic cells and T cells, antagonists for the receptor may be useful in treating autoimmune diseases in addition to allergy.
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Affiliation(s)
- Mai Zhang
- Johnson & Johnson Pharmaceutical Research & Development, L.L.C., 3210 Merryfield Row, San Diego, CA 92121, USA
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Walter Canonica G, Bousquet J, Van Hammée G, Bachert C, Durham SR, Klimek L, Mullol J, Van Cauwenberge PB. Levocetirizine improves health-related quality of life and health status in persistent allergic rhinitis. Respir Med 2006; 100:1706-15. [PMID: 16723217 DOI: 10.1016/j.rmed.2006.03.039] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2005] [Revised: 03/28/2006] [Accepted: 03/31/2006] [Indexed: 11/25/2022]
Abstract
BACKGROUND Allergic rhinitis is a chronic respiratory disorder with a detrimental impact on health-related quality of life (HRQOL) and health status. Enhancement and maintenance of patient function and well-being are therefore considered as essential. OBJECTIVE To determine whether long-term treatment with levocetirizine 5mg improves HRQOL and health status in persistent allergic rhinitis (PER) patients assessed with RQLQ and SF-36 scales over a 6-month period. METHODS The Xyzal in PER Trial (XPERT) was a multi-center, double-blind, parallel-group study. A total of 551 patients were randomized to receive levocetirizine 5mg or placebo once daily for 6 months and assessed for symptoms, HRQOL (Rhinoconjunctivitis Quality of Life Questionnaire: RQLQ) and health status (SF-36). Sensitivity of the RQLQ and SF-36 to disease severity was tested to ensure their suitability for use in PER patients. Treatment effect was assessed by means of repeated measures analyses. RESULTS Over the 6-month treatment period, levocetirizine showed statistically significant improvements over placebo in HRQOL (P < 0.001 for all RQLQ domains and overall scores) and health status (P < or = 0.004 for SF-36 physical and mental summary scores; P < 0.05 for all SF-36 scales). The relative improvement of levocetirizine over placebo exceeded the predefined clinically meaningful threshold of 30% for all RQLQ scores and the improvement from baseline was 3 times the established MID for RQLQ. CONCLUSION The RQLQ and SF-36 could be used to measure HRQOL and health status in PER patients. Long-term treatment with levocetirizine provides sustained improvement of HRQOL and reduces disease burden in PER patients.
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Affiliation(s)
- G Walter Canonica
- Allergy & Respiratory Diseases Clinic, DIMI, Genoa University, Pad. Maragliano, L.go R. Benzi 10, 16132 Genoa, Italy.
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Venkatesh S, Sizemore SP, Byrne ME. Biomimetic hydrogels for enhanced loading and extended release of ocular therapeutics. Biomaterials 2006; 28:717-24. [PMID: 17007923 DOI: 10.1016/j.biomaterials.2006.09.007] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2006] [Accepted: 09/06/2006] [Indexed: 11/24/2022]
Abstract
We have applied the principles of biomimesis by incorporating a natural receptor-based rational design strategy in the synthesis of novel recognitive soft contact lenses. We have demonstrated the potential of biomimetic carriers to load significant amounts of ocular medication such as H(1)-antihistamines, as well as to release a therapeutic dosage of drug in vitro in a controlled fashion for 5 days, with an even further extension in the presence of protein. Gels of multiple complexation points with varying functionalities outperformed gels formed with less diverse functional monomers and showed superior loading with a six-fold difference over control gels and a three-fold difference over less biomimetic gels. Moreover, mechanical and optical properties of these hydrogels agreed with conventional lenses, and increased loading was reflected in a reduced propagation of polymer chains. This approach can be extended to a wider biological spectrum in the design of novel, controlled and modulated delivery devices to alleviate ocular disorders and provide an alternative to topical therapy.
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Affiliation(s)
- Siddarth Venkatesh
- Biomimetic & Biohybrid Materials, Biomedical Devices, and Drug Delivery Laboratories, Department of Chemical Engineering, Auburn University, Auburn, Alabama 36849, USA
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Simoen V, Christophe B. Effect of levocetirizine on the contraction induced by histamine on isolated rabbit bronchioles from precision-cut lung slices. Pharmacology 2006; 78:61-5. [PMID: 16943691 DOI: 10.1159/000095508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2006] [Accepted: 07/30/2006] [Indexed: 11/19/2022]
Abstract
The present experiments were designed to study the effects of levocetirizine (a potent selective histamine H(1) antagonist) on the contraction induced by histamine on isolated rabbit bronchioles using the precision-cut lung slice technology. Histamine induced a concentration-dependent contraction of isolated rabbit bronchioles (pD(2) value of 5.6). Mepyramine (0.01-1 micromol/l) induced a shift to the right without any decrease in the concentration-response curve to histamine (pA(2) value of 8.2). Levocetirizine (0.03-0.1 micromol/l) induced both a shift to the right and a decrease in the maximal amplitude of the concentration-response curve to histamine (pA(2) and pD'(2) values of 7.9 and 7.0, respectively). The difference between both compounds could be explained in terms of the difference in the dissociation rate from the histamine H(1) receptor coupled to a putative low receptor reserve present in the rabbit bronchioles.
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Affiliation(s)
- V Simoen
- Department of General Pharmacology, UCB SA, Chemin du Foriest, BE-1420 Braine l'Alleud, Belgium
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Spangler DL, Brunton S. Efficacy and central nervous system impairment of newer-generation prescription antihistamines in seasonal allergic rhinitis. South Med J 2006; 99:593-9. [PMID: 16800414 DOI: 10.1097/01.smj.0000221631.98056.87] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Allergic rhinitis is a highly prevalent disorder and oral antihistamines are often used to manage patient symptoms. Older-generation antihistamines, such as diphenhydramine and chlorpheniramine, are effective at relieving the symptoms of seasonal allergic rhinitis (SAR); however, they are associated with adverse events, including sedation and impairment, at, or above, the recommended dose. Newer-generation antihistamines, such as desloratadine, cetirizine and fexofenadine, were developed to minimize adverse events. In this article, studies examining newer-generation antihistamines in adults and children were reviewed. The clinical evidence confirms that desloratadine, cetirizine and fexofenadine are effective at managing the symptoms of SAR in adults and children; however, cetirizine is more likely to cause sedation. Physician intervention is paramount to SAR symptom management. It is essential that appropriate treatment relieves SAR symptoms with absent or minimal adverse events. This is particularly important for those patients involved in skilled and cognitive activities or safety-critical jobs.
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Affiliation(s)
- Dennis L Spangler
- Atlanta Allergy and Asthma Clinic, 1965 N. Park Place, N.W., Atlanta, GA 30339, USA.
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Abstract
Antihistamines that bind to the histamine 1 receptor (H1) serve as important therapeutic agents to counter the effects of histamine in the skin. Two generations of antihistamines exist; however, second-generation agents are more advantageous because they cause less sedation, have a longer half life and are more selective for the H1 receptor. While H1 antihistamines have proven to be effective at reversing the pruritus and cutaneous lesions of chronic urticaria, their ability to treat pruritus associated with other cutaneous and systemic diseases is unproven.
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Affiliation(s)
- Michael O'Donoghue
- Department of Dermatology, Rush University Medical Center, Chicago, Illinois 60612, USA
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Whitebread S, Hamon J, Bojanic D, Urban L. Keynote review: in vitro safety pharmacology profiling: an essential tool for successful drug development. Drug Discov Today 2006; 10:1421-33. [PMID: 16243262 DOI: 10.1016/s1359-6446(05)03632-9] [Citation(s) in RCA: 239] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Broad-scale in vitro pharmacology profiling of new chemical entities during early phases of drug discovery has recently become an essential tool to predict clinical adverse effects. Modern, relatively inexpensive assay technologies and rapidly expanding knowledge about G-protein coupled receptors, nuclear receptors, ion channels and enzymes have made it possible to implement a large number of assays addressing possible clinical liabilities. Together with other in vitro assays focusing on toxicology and bioavailability, they provide a powerful tool to aid drug development. In this article, we review the development of this tool for drug discovery, its appropriate use and predictive value.
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Affiliation(s)
- Steven Whitebread
- PreClinical Profiling, Lead Discovery Center, Novartis Institutes for BioMedical Research, Cambridge, MA 02139, USA
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Shimizu T, Kanai K, Asano K, Hisamitsu T, Suzaki H. Suppression of matrix metalloproteinase production in nasal fibroblasts by tranilast, an antiallergic agent, in vitro. Mediators Inflamm 2006; 2005:150-9. [PMID: 16106101 PMCID: PMC1526475 DOI: 10.1155/mi.2005.150] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Allergic rhinitis is an inflammatory disease characterized by nasal wall remodeling with intense infiltration of eosinophils and mast cells/basophils. Matrix metalloproteinases (MMPs), MMP-2 and MMP-9, are the major proteolytic enzymes that induce airway remodeling. These enzymes are also important in the migration of inflammatory cells through basement membrane components. We evaluated whether tranilast (TR) could inhibit MMP production from nasal fibroblasts in response to tumor necrosis factor-alpha (TNF-alpha) stimulation in vitro. Nasal fibroblasts (NF) were established from nasal polyp tissues taken from patients with allergic rhinitis. NF (2 x 10(5) cells/mL) were stimulated with TNF-alpha in the presence of various concentrations of TR. After 24 hours, the culture supernatants were obtained and assayed for MMP-2, MMP-9, TIMP-1, and TIMP-2 levels by ELISA. The influence of TR on mRNA expression of MMPs and TIMPs in cells cultured for 12 hours was also evaluated by RT-PCR. TR at more than 5 x 10(-5) M inhibited the production of MMP-2 and MMP-9 from NF in response to TNF-alpha stimulation, whereas TIMP-1 and TIMP-2 production was scarcely affected. TR also inhibited MMP mRNA expression in NF after TNF-alpha stimulation. The present data suggest that the attenuating effect of TR on MMP-2 and MMP-9 production from NF induced by inflammatory stimulation may underlie the therapeutic mode of action of the agent in patients with allergic diseases, including allergic rhinitis.
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Affiliation(s)
- Toshiyuki Shimizu
- Department of Otolaryngology,
School of Medicine, Showa University, Tokyo 142-8666, Japan
| | - Kenichi Kanai
- Department of Otolaryngology,
School of Medicine, Showa University, Tokyo 142-8666, Japan
| | - Kazuhito Asano
- Department of Physiology, School
of Medicine, Showa University, Tokyo 142-8555, Japan
| | - Tadashi Hisamitsu
- Department of Physiology, School
of Medicine, Showa University, Tokyo 142-8555, Japan
| | - Harumi Suzaki
- Department of Otolaryngology,
School of Medicine, Showa University, Tokyo 142-8666, Japan
- * Harumi Suzaki;
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The authors' reply. Clin Ther 2006. [DOI: 10.1016/s0149-2918(06)80017-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Gillard M, Chatelain P. Changes in pH differently affect the binding properties of histamine H1 receptor antagonists. Eur J Pharmacol 2006; 530:205-14. [PMID: 16388798 DOI: 10.1016/j.ejphar.2005.11.051] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2005] [Revised: 11/14/2005] [Accepted: 11/22/2005] [Indexed: 11/18/2022]
Abstract
We investigated the effect of acidic pH, a condition that can be encountered during inflammation accompanying allergic reaction, on the binding properties of histamine H1 receptor antagonists, including levocetirizine ((2-(4-[(R)-(4-chlorophenyl)(phenyl)methyl]piperazin-1-yl)ethoxy)acetic acid; Xyzal ), fexofenadine (rac-2-[4-[1-Hydroxy-4-[4-(hydroxydiphenylmethyl) piperidin-1-yl]butyl]phenyl]-2-methylpropionic acid hydrochloride; Allegra) and desloratadine (8-Chloro-6,11-dihydro-11-(4-piperidylidene)-5H-benzo[5,6]cyclohepta[1,2-b]pyridine; Clarinex ). Lowering the pH from 7.4 to 5.8 decreased the affinity of [3H]mepyramine for histamine H1 receptors from 1.7 to 7.5 nM while the opposite was observed with [3H]levocetirizine, whose affinity increased from 4.1 to 1.5 nM. Competition curves with [3H]mepyramine indicated that decreasing the pH from 7.4 to 5.8 led to a 2- to 5-fold increase in the affinity of fexofenadine and levocetirizine, no change in affinity for desloratadine and a 5- to 10-fold decrease in affinity for mepyramine and histamine. Kinetic experiments showed that the increase in affinity of levocetirizine and, to a lesser extent, fexofenadine were totally attributable to a lower dissociation rate at acidic pH (t1/2 increasing from 77 to 266 min and from 71 to 135 min, respectively). Although the affinity of desloratadine remained unchanged, lowering the pH caused a decrease in its dissociation rate (t1/2 of 50 and 256 min at pH 7.5 and 5.8, respectively) accompanied by a concomitant 3.5-fold decrease in its association rate constant. The loss of affinity of mepyramine at acidic pH was driven by a decrease in its association rate constant. Interaction between the carboxylic moiety of levocetirizine and Lys191 is responsible for its slow dissociation rate from the receptor. We found that the magnitude of the pH effect on the dissociation rate of levocetirizine was maintained after mutating Lys191 into alanine, suggesting that a tighter interaction of levocetirizine with Lys191 at lower pH is not the cause of its even slower dissociation rate from the receptor. Although these changes may seem limited in amplitude, we show that they may have substantial effects on receptor occupancy in vivo.
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Affiliation(s)
- Michel Gillard
- UCB S.A., In vitro Pharmacology, Building R4, Chemin du Foriest, 1420 Braine L'Alleud, Belgium.
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Koreck AI, Csoma Z, Bodai L, Ignacz F, Kenderessy AS, Kadocsa E, Szabo G, Bor Z, Erdei A, Szony B, Homey B, Dobozy A, Kemeny L. Rhinophototherapy: a new therapeutic tool for the management of allergic rhinitis. J Allergy Clin Immunol 2005; 115:541-7. [PMID: 15753902 DOI: 10.1016/j.jaci.2004.11.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Phototherapy has a profound immunosuppressive effect and is able to inhibit hypersensibility reactions in the skin. OBJECTIVE We evaluated whether phototherapy using a combination of UV-B (5%), UV-A (25%), and visible light (70%), referred to as mUV/VIS, is effective in treating allergic rhinitis. METHODS We conducted a randomized, double-blind study, in 49 patients with hay fever. The study was performed during the ragweed season. Each intranasal cavity was illuminated 3 times a week for 3 weeks with mUV/VIS or with low-intensity visible light. Symptom scores, inflammatory cells, and their mediators were assessed in nasal lavages. In vitro effects of mUV/VIS irradiation on T-cell and eosinophil apoptosis and its inhibitory effect on mediator release from basophils were examined. RESULTS Rhinophototherapy was tolerated well and resulted in a significant improvement of clinical symptoms for sneezing (P < .016), rhinorrhea (P < .007), nasal itching (P < .014), and total nasal score (P < .004). None of the scores improved significantly in the control group. Scores for nasal obstruction slightly improved after mUV/VIS treatment and significantly increased in the control group (P < .017). In the nasal lavage, phototherapy significantly reduced the number of eosinophils and the level of eosinophil cationic protein and IL-5. In vitro irradiation of T cells and eosinophils with mUV/VIS light dose-dependently induced apoptosis. Furthermore, mUV/VIS irradiation inhibited the mediator release from RBL-2H3 basophils. CONCLUSION These results suggest that phototherapy is an effective modality to treat allergic rhinitis and offer new options for the treatment of immune-mediated mucosal diseases.
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Affiliation(s)
- Andrea I Koreck
- Department of Dermatology and Allergology, University of Szeged, Hungary.
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Kawazoe Y, Tanaka S, Uesugi M. Chemical genetic identification of the histamine H1 receptor as a stimulator of insulin-induced adipogenesis. ACTA ACUST UNITED AC 2005; 11:907-13. [PMID: 15271349 DOI: 10.1016/j.chembiol.2004.04.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2004] [Revised: 03/11/2004] [Accepted: 04/07/2004] [Indexed: 11/23/2022]
Abstract
A large collection of bioactive compounds with diverse biological effects can be used as probes to elucidate new biological mechanisms that influence a particular cellular process. Here we analyze the effects of 880 well-known small-molecule bioactives or drugs on the insulin-induced adipogenesis of 3T3-L1 fibroblasts, a cell-culture model of fat cell differentiation. Our screen identified 86 compounds as modulators of the adipogenic differentiation of 3T3-L1 cells. Examination of their chemical and pharmacological information revealed that antihistamine drugs with distinct chemical scaffolds inhibit differentiation. Histamine H1 receptor is expressed in 3T3-L1 cells, and its knockdown by small interfering RNA impaired the insulin-induced adipogenic differentiation. Histamine receptors and histamine-like biogenic amines may play a role in inducing adipogenesis in response to insulin.
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Affiliation(s)
- Yoshinori Kawazoe
- The Verna and Marrs McLean Department of Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, TX 77030, USA
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