1
|
Walker MT, Bloodworth JC, Kountz TS, McCarty SL, Green JE, Ferrie RP, Campbell JA, Averill SH, Beckman KB, Grammer LC, Eng C, Avila PC, Farber HJ, Rodriguez-Cintron W, Rodriguez-Santana JR, Serebrisky D, Thyne SM, Seibold MA, Burchard EG, Kumar R, Cook-Mills JM. 5-HTP inhibits eosinophilia via intracellular endothelial 5-HTRs; SNPs in 5-HTRs associate with asthmatic lung function. FRONTIERS IN ALLERGY 2024; 5:1385168. [PMID: 38845678 PMCID: PMC11153829 DOI: 10.3389/falgy.2024.1385168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
Background Previous research showed that 5-hydroxytryptophan (5HTP), a metabolic precursor of serotonin, reduces allergic lung inflammation by inhibiting eosinophil migration across endothelial monolayers. Objective It is unknown if serotonin receptors are involved in mediating this 5HTP function or if serotonin receptor (HTR) single nucleotide polymorphisms (SNPs) associate with lung function in humans. Methods Serotonin receptor subtypes were assessed by qPCR, western blot, confocal microscopy, pharmacological inhibitors and siRNA knockdown. HTR SNPs were assessed in two cohorts. Results Pharmacological inhibition or siRNA knockdown of the serotonin receptors HTR1A or HTR1B in endothelial cells abrogated the inhibitory effects of 5HTP on eosinophil transendothelial migration. In contrast, eosinophil transendothelial migration was not inhibited by siRNA knockdown of HTR1A or HTR1B in eosinophils. Surprisingly, these HTRs were intracellular in endothelial cells and an extracellular supplementation with serotonin did not inhibit eosinophil transendothelial migration. This is consistent with the inability of serotonin to cross membranes, the lack of selective serotonin reuptake receptors on endothelial cells, and the studies showing minimal impact of selective serotonin reuptake inhibitors on asthma. To extend our HTR studies to humans with asthma, we examined the CHIRAH and GALA cohorts for HTR SNPs that affect HTR function or are associated with behavior disorders. A polygenic index of SNPs in HTRs was associated with lower lung function in asthmatics. Conclusions Serotonin receptors mediate 5HTP inhibition of transendothelial migration and HTR SNPs associate with lower lung function. These results may serve to aid in design of novel interventions for allergic inflammation.
Collapse
Affiliation(s)
- Matthew T. Walker
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jeffrey C. Bloodworth
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Timothy S. Kountz
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Samantha L. McCarty
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Jeremy E. Green
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Ryan P. Ferrie
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jackson A. Campbell
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Samantha H. Averill
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Leslie C. Grammer
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Celeste Eng
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Pedro C. Avila
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Harold J. Farber
- Department of Pediatrics, Section of Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | | | | | - Denise Serebrisky
- Pediatric Pulmonary Division, Jacobi Medical Center, Bronx, NY, United States
| | - Shannon M. Thyne
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Max A. Seibold
- Center for Genes, Environment, and Health and the Department of Pediatrics, National Jewish Health, Denver, CO, United States
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado, Denver, CO, United States
| | - Esteban G. Burchard
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Rajesh Kumar
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Division of Allergy and Clinical Immunology, Ann and Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, United States
| | - Joan M. Cook-Mills
- Allergy-Immunology Division, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Herman B Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, United States
| |
Collapse
|
2
|
Ino H, Shiramoto M, Eto T, Haranaka M, Irie S, Terao T, Ogura H, Wakamatsu A, Hoyano K, Nakano A. Levocetirizine Oral Disintegrating Tablet: A Randomized Open-Label Crossover Bioequivalence Study in Healthy Japanese Volunteers. Clin Pharmacol Drug Dev 2020; 9:805-812. [PMID: 32196954 PMCID: PMC7586835 DOI: 10.1002/cpdd.791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 02/12/2020] [Indexed: 11/13/2022]
Abstract
Levocetirizine is classified as a second‐generation antihistamine. Levocetirizine is available for the treatment of allergic disorders such as allergic rhinitis and chronic idiopathic urticaria. This was a single‐center, single‐dose, open‐label, randomized, 2‐way crossover study in healthy Japanese male subjects consisting of 2 parts. Part 1 compared the bioavailability of levocetirizine oral disintegrating tablet (ODT) and levocetirizine immediate‐release tablet (IRT) taken with water in the fasted state in 24 subjects; all subjects completed this part of the trial. In part 2, the bioavailability of levocetirizine ODT without water was compared with that of levocetirizine IRT with water in the fasted state in 48 subjects; 47 subjects completed this part of the trial. Bioequivalence was demonstrated between levocetirizine IRT 5 mg and ODT 5 mg. The safety profiles were generally similar between levocetirizine ODT and levocetirizine IRT, with no serious adverse events, deaths, or adverse events leading to withdrawal reported during the study.
Collapse
Affiliation(s)
- Hiroko Ino
- Clinical Pharmacology Office, Japan Development Division, GlaxoSmithKline KK, Tokyo, Japan
| | | | | | | | - Shin Irie
- Souseikai Hakata Clinic, Fukuoka, Japan
| | - Takumi Terao
- Biomedical Data Sciences Department, Japan Development Division, GlaxoSmithKline KK, Tokyo, Japan
| | - Hirofumi Ogura
- Clinical Pharmacology Office, Japan Development Division, GlaxoSmithKline KK, Tokyo, Japan
| | - Akira Wakamatsu
- Pre-Clinical Development Department, Japan Development Division, GlaxoSmithKline KK, Tokyo, Japan
| | - Keiko Hoyano
- Biomedical Data Sciences Department, Japan Development Division, GlaxoSmithKline KK, Tokyo, Japan
| | - Atsushi Nakano
- Immuno-Inflammation Therapeutic Office, Medicines Development, Japan Development, GlaxoSmithKline KK, Tokyo, Japan
| |
Collapse
|
3
|
Yonekura S, Okamoto Y, Sakurai D, Iinuma T, Sakurai T, Yoneda R, Kurita J, Hanazawa T, Kawasaki Y. Efficacy of Desloratadine and Levocetirizine in Patients with Cedar Pollen-Induced Allergic Rhinitis: A Randomized, Double-Blind Study. Int Arch Allergy Immunol 2019; 180:274-283. [PMID: 31618733 DOI: 10.1159/000503065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/02/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND No comparative study of antihistamines that differ in structural system has been conducted in allergic rhinitis. OBJECTIVE This was a randomized, double-blind, crossover comparative study to verify the efficacy of antihistamines that differ in structural system. METHODS A total of 50 patients with moderate or more severe Japanese cedar pollen-induced allergic rhinitis were randomized to receive either placebo, desloratadine 5 mg (a tricyclic), or levocetirizine 5 mg (a piperazine). One dose of the study drug was orally administered at 9 pm on the day before a pollen exposure test, which was performed for 3 h (9 a.m. to 12 p.m.) to assess symptoms in an environmental challenge chamber (ECC). Nasal and ocular symptoms were compared at an airborne pollen level of 8,000 grains/m3. The primary endpoint was mean total nasal symptom score (TNSS) from 120 to 180 min in the ECC. Subjects with a difference of ≥1 in TNSS between 2 drugs were extracted to the relevant drug-responsive group. RESULTS The difference in TNSS from placebo was -2.42 (p < 0.0001) with levocetirizine and -1.66 (p < 0.01) with desloratadine, showing that both drugs were significantly more effective than placebo in controlling symptoms, but with no statistically significant difference between the 2 drugs. There were 12 subjects in the desloratadine-responsive group and 24 subjects in the levocetirizine-responsive group, with no contributor to response was detected. CONCLUSION Levocetirizine tended to control nasal symptoms more effectively than desloratadine. However, the response to each antihistamine varied among individuals and the predictors to the response are unknown. CLINICAL TRIAL REGISTRATION NUMBER UMIN ID: UMIN000029653.
Collapse
Affiliation(s)
- Syuji Yonekura
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshitaka Okamoto
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan, .,Chiba Rosai Hospital, Chiba, Japan,
| | - Daiju Sakurai
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tomohisa Iinuma
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshioki Sakurai
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.,Chiba Cancer Center, Chiba, Japan
| | - Riyo Yoneda
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Junya Kurita
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toyoyuki Hanazawa
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| |
Collapse
|
4
|
|
5
|
Eosinophilic inflammation in spontaneous coronary artery dissection: A potential therapeutic target? Med Hypotheses 2018; 121:91-94. [DOI: 10.1016/j.mehy.2018.09.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 09/06/2018] [Accepted: 09/22/2018] [Indexed: 12/16/2022]
|
6
|
The effect of levocetirizine and montelukast on clinical symptoms, serum level and skin expression of COX-1 and COX-2 enzymes in patients suffering from chronic autoimmune urticaria - a pilot study. Postepy Dermatol Alergol 2018; 37:73-80. [PMID: 32467688 PMCID: PMC7247068 DOI: 10.5114/ada.2018.79731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/08/2018] [Indexed: 11/24/2022] Open
Abstract
Introduction Chronic autoimmune urticaria (CAU) lasts over 6 weeks and is characterized by circulating IgE autoantibodies or IgG against IgE or IgE receptor. Aim To assess the clinical, laboratory and histological effects of 4-week levocetirizine and montelukast therapy in patients suffering from CAU. Material and methods Of 296 tested patients with chronic urticaria 40 had a positive ASST test. Only 17 (16 female/1 male; medium age: 44 years) fulfilled all study inclusion/exclusion criteria. The study was designed as an open, randomized trial with two arms: levocetirizine or montelukast treatment for 4 weeks following a 2-week wash-out period. All participants completed urticaria activity score (UAS) and visual analogue scale (VAS) questionnaires before and after both therapies. Blood samples and skin bioptats were obtained before and after treatment to evaluate COX-1 and COX-2 serum concentrations and skin expression. Results Clinical response to therapy measured with the UAS and VAS was better in the levocetirizine group. Both drugs caused a significant decrease in COX-1 and COX-2 serum level. COX-1 and COX-2 expression in epidermal and dermal inflammatory infiltration did not change significantly in either study group, but a significant decrease of COX-1 expression was observed when the groups were combined for analysis, and the decrease in COX-2 expression in the epidermis was of borderline significance. Conclusions The effectiveness of levocetirizine and montelukast in treating CAU may be partly related to the reduction of COX-1 and COX-2 serum level and tissue expression, but further studies on a larger group of patients are needed to support this observation.
Collapse
|
7
|
Yanov YK, Ryazantsev SV, Artyushkin SA, Fanta IV, Pavlova SS. [Allergic rhinitis: the modern aspects of therapy]. Vestn Otorinolaringol 2018; 83:56-60. [PMID: 29953057 DOI: 10.17116/otorino201883356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The main objectives of the present article were to systematize the modern views of the causes and risk factors of allergic rhinitis, to clarify the manner of its development, to define the leading etiological mechanism underling the pathogenesis of this condition, to consider the methods used for the diagnostics and the treatment of this disease, and to sum up the clinical experience with the use of Levocetirizine (Allerwey) for the management of allergic rhinitis. Special attention is given to the achievement and the maintenance of control of the persistent or intermittent forms of allergic rhinitis and to approaches to its treatment based on the medications registered in the Russian Federation.
Collapse
Affiliation(s)
- Yu K Yanov
- Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Ministry of Heath of the Russian Fderation, Saint Petersburg, Russia, 190013
| | - S V Ryazantsev
- Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Ministry of Heath of the Russian Fderation, Saint Petersburg, Russia, 190013
| | - S A Artyushkin
- I.I. Mechnikov North-Western State Medical University, Ministry of Heath of the Russian Federation, Saint Petersburg, Russia, 191015
| | - I V Fanta
- Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Ministry of Heath of the Russian Fderation, Saint Petersburg, Russia, 190013
| | - S S Pavlova
- Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Ministry of Heath of the Russian Fderation, Saint Petersburg, Russia, 190013
| |
Collapse
|
8
|
Katz Sand I, Fabian MT, Telford R, Kraus TA, Chehade M, Masilamani M, Moran T, Farrell C, Ebel S, Cook LJ, Rose J, Lublin FD. Open-label, add-on trial of cetirizine for neuromyelitis optica. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2018; 5:e441. [PMID: 30426035 PMCID: PMC6201737 DOI: 10.1212/nxi.0000000000000441] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/12/2017] [Indexed: 12/19/2022]
Abstract
Objective This pilot study preliminarily examined the efficacy and tolerability of cetirizine as an add-on to standard therapy for neuromyelitis optica (NMO). Methods Eligible participants met the Wingerchuk 2006 diagnostic criteria or had a single typical episode along with positive NMO immunoglobulin G. After baseline clinical and laboratory assessments, participants began treatment with cetirizine 10 mg orally daily, in addition to their usual disease-modifying therapy for NMO, and continued for 1 year. The primary end point was the annualized relapse rate (ARR) while on the same disease-modifying therapy before starting cetirizine compared with after taking cetirizine. Additional end points included disability (Expanded Disability Status Scale [EDSS]), relapse severity, tolerability, especially with respect to drowsiness measured by the Epworth Sleepiness Scale (ESS), and laboratory parameters. Results The ARR before cetirizine was 0.4 ± 0.80 and after cetirizine was 0.1 ± 0.24 (p = 0.047). There was no statistically significant difference in the EDSS (mean 3.9 ± 2.18 before the start of the study and 3.2 ± 2.31 at the conclusion of the study, p = 0.500). The ESS remained fairly consistent throughout the study (mean 6.5 ± 5.33 at baseline and 6.9 ± 4.50 at month 12, p = 0.740). Laboratory studies were unrevealing. Conclusions In this pilot study, cetirizine was well tolerated, and the prespecified primary efficacy end point was satisfied. However, the open-label design and the small sample size of this pilot study preclude definitive conclusions. Further research is needed. Classification of evidence This study provides Class IV evidence that in patients with NMO, the addition of cetirizine to standard therapy is safe, well tolerated, and reduces relapses.
Collapse
Affiliation(s)
- Ilana Katz Sand
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - Michelle T Fabian
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - Russell Telford
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - Thomas A Kraus
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - Mirna Chehade
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - Madhan Masilamani
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - Thomas Moran
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - Colleen Farrell
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - Shelly Ebel
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - Lawrence J Cook
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - John Rose
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| | - Fred D Lublin
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis (I.K.S., M.F., C.F., S.E., F.L.), Department of Neurology, Icahn School of Medicine at Mount Sinai, NY; Department of Pediatrics (R.T., L.C.), University of Utah, Salt Lake City; Drug Discovery Institute (T.A.K.), Mount Sinai Center for Eosinophilic Disorders (M.C.), Jaffe Food Allergy Institute (M.M.), Department of Pediatrics, and Department of Microbiology (T.M.), Icahn School of Medicine at Mount Sinai, NY; Department of Neurology (J.R.), University of Utah, Salt Lake City
| |
Collapse
|
9
|
Cain CL, Bradley CW, Mauldin EA. Clinical and histologic features of acute-onset erythroderma in dogs with gastrointestinal disease: 18 cases (2005–2015). J Am Vet Med Assoc 2017; 251:1439-1449. [DOI: 10.2460/javma.251.12.1439] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
10
|
Gallard C, Law-Ping-Man S, Darrieux L, Tisseau L, Safa G. Syndrome de Wells mimant une cellulite infectieuse de la face : trois observations. Ann Dermatol Venereol 2017; 144:284-289. [DOI: 10.1016/j.annder.2016.09.676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/22/2016] [Accepted: 09/14/2016] [Indexed: 10/20/2022]
|
11
|
Cormerais M, Poizeau F, Darrieux L, Tisseau L, Safa G. Wells' Syndrome Mimicking Facial Cellulitis: A Report of Two Cases. Case Rep Dermatol 2015; 7:117-22. [PMID: 26120307 PMCID: PMC4478307 DOI: 10.1159/000432392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Wells’ syndrome (WS), or eosinophilic cellulitis, is an uncommon inflammatory dermatosis of unknown etiology that typically presents with pruritic cellulitis-like plaques on the extremities. Therefore, WS is often misdiagnosed as bacterial cellulitis due to its similarity in presentation. Here, we report two cases of WS that masqueraded as bacterial facial cellulitis. Under treatment with oral prednisone and/or a combination therapy with levocetirizine and hydroxyzine, both patients showed a dramatic improvement of the skin lesions. These cases highlight the need for clinicians to consider WS in the differential diagnosis when evaluating a patient with facial cellulitis that does not respond to an initial antimicrobial regimen. In addition, our cases suggest that combination therapy with levocetirizine and hydroxyzine may be successfully used as corticosteroid-sparing treatment or to prevent relapse after the discontinuation of corticosteroid treatment.
Collapse
Affiliation(s)
- Maxence Cormerais
- Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, Armor Pathology Laboratory, Plérin, France
| | - Florence Poizeau
- Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, Armor Pathology Laboratory, Plérin, France
| | - Laure Darrieux
- Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, Armor Pathology Laboratory, Plérin, France
| | | | - Gilles Safa
- Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, Armor Pathology Laboratory, Plérin, France
| |
Collapse
|
12
|
Ino H, Hara K, Honma G, Doi Y, Fukase H. Comparison of levocetirizine pharmacokinetics after single doses of levocetirizine oral solution and cetirizine dry syrup in healthy Japanese male subjects. J Drug Assess 2014; 3:38-42. [PMID: 27536452 PMCID: PMC4937632 DOI: 10.3109/21556660.2014.928302] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2014] [Indexed: 11/13/2022] Open
Abstract
Objective Levocetirizine, the R-enantiomer of cetirizine, is classified as a second generation antihistamine used for the treatment of allergic disorders. This study aimed to compare exposure to levocetirizine when given as levocetirizine oral solution (OS) 5 mg to that when given as cetirizine dry syrup (DS) 10 mg, which contains equal proportions of levocetirizine and dextrocetirizine, in healthy Japanese male subjects. Methods The study was conducted in an open-label, single dose, randomized and two-way cross-over design. Eligible subjects were allocated to one of two groups and received either levocetirizine OS 5 mg or cetirizine DS 10 mg under fasting conditions, and the alternate treatment after a 7-days washout period. Serial blood samples were taken after each administration, and plasma levocetirizine concentrations were determined using a validated LC-MS/MS method. Pharmacokinetic parameters were calculated by using non-compartmental analysis. Comparisons of levocetirizine pharmacokinetics were conducted with maximum concentration (Cmax) and the area under the plasma concentration-time curve from dosing until 48 h post-dose (AUC0–48) after each treatment. Clinical Trial registration number ClinicalTrials.gov identifier is NCT01622283 Results The mean Cmax and AUC0–48 of levocetirizine after a single dose of levocetirizine OS 5 mg and cetirizine DS 10 mg were 203.3 ± 42.49 ng/mL and 1814.9 ± 304.22 ng.hr/mL, and 196.5 ± 31.31 ng/mL and 1710.5 ± 263.31 ng hr/mL, respectively. The ratios and the 90% CIs of the geometric least squares means ratios of Cmax and AUC0–48 were 1.027 (0.968–1.091) and 1.059 (1.024–1.094), respectively. Limitation The small sample size and single dose design of this study prevent definitive conclusions regarding the pharmacokinetics and safety of levocetirizine OS in a Japanese patient population being made. Study limitations include conducting the study in adult males, not in children. Conclusions Levocetirizine exposure in plasma was equivalent when given as levocetirizine OS 5 mg and as cetirizine DS 10 mg. Both preparations were safe and well-tolerated in healthy Japanese male subjects.
Collapse
Affiliation(s)
- Hiroko Ino
- Medicines Development (Clinical Pharmacology), Development & Medical Affairs Division, GlaxoSmithKline K.K., TokyoJapan
| | - Katsutoshi Hara
- Medicines Development (Clinical Pharmacology), Development & Medical Affairs Division, GlaxoSmithKline K.K., TokyoJapan
| | - Gosuke Honma
- Biomedical Data Sciences Department, Development & Medical Affairs Division, GlaxoSmithKline K.K., TokyoJapan
| | - Yohei Doi
- Medicines Development (Clinical Pharmacology), Development & Medical Affairs Division, GlaxoSmithKline K.K., TokyoJapan
| | - Hiroyuki Fukase
- CPC Clinical Trial Hospital, Medipolis Medical Research Institute, KagoshimaJapan
| |
Collapse
|
13
|
Abstract
Allergic rhinitis (AR) is a chronic disease with an increasing trend in most of the Western Countries. It may significantly impair the individual quality of life (QoL) and also represents a social burden for its economic costs. Levocetirizine (XYZAL; UCB Pharma) as a second generation, nonsedating H1-antihistamine, has been shown to be clinically effective in patients with AR in different randomized controlled trials. The XPERT (XYZAL in Persistent Rhinitis Trial) is the first large, long-term clinical study involving patients with persistent rhinitis as defined by ARIA (Allergic Rhinitis and its Impact on Asthma). The XPERT was a 6-month double-blind, placebo-controlled, multicenter, multinational trial in 551 subjects. Adults with persistent rhinitis sensitized to both grass pollen and house dust mites were randomized to receive levocetirizine 5 mg/d or placebo. Two primary objectives were considered: comparison of the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) overall score and Total 5 Symptoms Score (rhinorrhea, sneezing, nasal congestion, and nasal and ocular pruritus) (T5SS) between active and control group over a period of 4 weeks. As secondary endpoints, similar evaluations at 1 week and 3, 4, 5, and 6 months, summary scores for a general health status questionnaire (Medical Outcomes Survey Short Form 36), comorbidities, pharmacoeconomic and safety evaluations. Levocetirizine significantly improved both the RQLQ overall score and the T5SS from week 1 to 6 months (P <.001). Medical Outcomes Survey Short Form 36 summary scores were also improved in the group treated with levocetirizine with respect to placebo. Treatment cessation because of lack of efficacy, comorbidities, and overall costs of disease, and comorbidities per working patient per month (160.27 vs 108.18) were lower in the levocetirizine group. In conclusion, levocetirizine resulted to improve the quality of life and the symptoms related to AR and also to reduce the overall costs of the disease after 6 months treatment.
Collapse
|
14
|
Yonekura S, Okamoto Y, Yamamoto H, Sakurai T, Iinuma T, Sakurai D, Hanazawa T. Randomized Double-Blind Study of Prophylactic Treatment with an Antihistamine for Seasonal Allergic Rhinitis. Int Arch Allergy Immunol 2013; 162:71-8. [DOI: 10.1159/000350926] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 03/20/2013] [Indexed: 11/19/2022] Open
|
15
|
Bautista AP, Eisenlohr CP, Lanz MJ. Nasal nitric oxide and nasal eosinophils decrease with levocetirizine in subjects with perennial allergic rhinitis. Am J Rhinol Allergy 2012; 25:383-7. [PMID: 22185740 DOI: 10.2500/ajra.2011.25.3668] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Allergic rhinitis is commonly treated with antihistamines. Monitoring improvement of airway inflammation noninvasively using nasal nitric oxide (nNO) would be clinically useful. To determine the anti-inflammatory effect of oral levocetirizine dihydrochloride (LC), we measured nNO and nasal eosinophils (nEos) in perennial allergic rhinitis (PAR) subjects. METHODS A randomized double-blind placebo-controlled crossover design was used. Inclusion criteria consisted of subjects having a PAR history, exam and diary scores consistent with active symptoms, and positive skin testing. Subjects taking allergy medications 1 month before the study were not enrolled. After consenting, 31 subjects (24 female subjects; mean age, 29 years) were randomized to either oral LC (5 mg) or matching placebo for 2 weeks. After 2 week washout, subjects started the other 2-week treatment. At each visit, nNO was measured by aspiration at each nare using a nasal kit from NIOX (Aerocrine, Sweden) in parts per billion; nEos was collected from nasal smears and measured by microscopy using the scoring system (0-4+) and symptoms were self-reported using the allergic Rhinitis Quality of Life Questionnaire (RQLQ). Daily allergy symptom scores (total symptom score [TSS] 4) were collected at each visit. RESULTS During LC, mean baseline nNO was 807 ± 317 parts per billion (ppb; left) and 831 ± 332 ppb (right) and decreased significantly to 688 ± 266 ppb and 702 ± 286 ppb, respectively (p < 0.05). No significance was found during placebo treatment (778 ± 270 ppb, 808 ± 299 ppb to 802 ± 271 ppb, 813 ± 273 ppb). The mean nNO change was also significant compared with placebo (-125 ppb versus +14 ppb; p < 0.05). There was a significant decrease in nEos with LC compared with placebo (3.1-2.5 versus 2.9-2.6; p < 0.05). RQLQ scores were significantly improved with LC only. In TSS-4 scoring, a trend toward improvement during LC and significant worsening during placebo was found. Baseline nNO predicted changes in nasal eosinophils (nEos) and RQLQ. CONCLUSION We showed that oral LC therapy decreased objective markers of rhinitis inflammation, nNO and nEos, in patients with PAR. Improvement in symptom scoring was also found with LC treatment.
Collapse
Affiliation(s)
- Angela P Bautista
- Department of Allergy, Asthma, and Rhinosinusitis, AAADRS Clinical Research Center, Coral Gables, Florida 33134, USA
| | | | | |
Collapse
|
16
|
Ciebiada M, Gorska-Ciebiada M, Barylski M, Kmiecik T, Gorski P. Use of montelukast alone or in combination with desloratadine or levocetirizine in patients with persistent allergic rhinitis. Am J Rhinol Allergy 2011; 25:e1-6. [PMID: 21711959 DOI: 10.2500/ajra.2011.25.3540] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND We assessed the course of treatment in patients with persistent allergic rhinitis (AR) treated with montelukast, levocetirizine, or desloratadine alone or combinations of antihistamine and montelukast. METHODS A 32-week randomized, double-blind, placebo-controlled, crossover, double-armed study in 40 adult patients with history of persistent AR, clinical allergy to house-dust mites, and a total nasal symptom score of at least 5 (congestion of at least 2) has been performed. Patients with asthma, chronic obstructive pulmonary disease, nonallergic rhinitis with clinical allergy associated with seasonal allergens, and other serious diseases were excluded. There were four 6-week treatment periods separated by 2-week washout periods. Twenty patients received either montelukast or antihistamine, a combination of montelukast and antihistamine, or placebo. The sequence of treatment was randomly assigned. Nasal symptoms were assessed using a 4-point scale at baseline, daily during the 1st week and on days 14, 21, 28, 35, and 42 of treatment. RESULTS Montelukast alone, levocetirizine alone, desloratadine alone, and the montelukast/antihistamine combinations significantly improved nasal symptoms during the first 24 hours. Improvement gradually increased during the 6 weeks of treatment, especially in patients receiving montelukast alone or in combination therapy with the antihistamine in both arms. Improvement at 42 days of treatment was significantly greater than that achieved on the 1st day of therapy in patients treated with the combination of montelukast and levocetirizine. CONCLUSION Montelukast alone or in combination with antihistamines gave a gradual increase in nasal symptom improvement within 6 weeks of treatment in patients with persistent AR.
Collapse
Affiliation(s)
- Maciej Ciebiada
- Department of Pneumology and Allergy, Medical University of Lodz, Poland.
| | | | | | | | | |
Collapse
|
17
|
Kobayashi M, Tokura Y. Downmodulatory effects of cetirizine and levocetirizine on cytokine/chemokine production and CD54 expression in keratinocytes. J Dermatol 2011; 38:717-9. [PMID: 21352306 DOI: 10.1111/j.1346-8138.2010.01061.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
18
|
Park CS, Cho JH, Kang JM, Kim BK, Han MA. Levocetrizine has anti-inflammatory effects against Toll-like receptor (TLR)3 through the inhibition of Toll-IL-1 receptor (TIR)-domain-containing adapter inducing IFN-beta (TRIF) and receptor-interacting protein (RIP). Auris Nasus Larynx 2011; 38:474-9. [PMID: 21330073 DOI: 10.1016/j.anl.2010.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2010] [Revised: 12/13/2010] [Accepted: 12/13/2010] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To investigate the anti-inflammatory effect of levocetrizine (LCEZ) on the intracellular adhesion molecule-1 (ICAM-1) in human nasal epithelial cells stimulated by TLR3 and further analyze the anti-inflammatory mechanism of LCEZ in the MyD88-independent pathway before NF-κB is activated. METHODS A primary culture of human nasal epithelial cells (HNECs) was generated from nasal polyps. After stimulation of epithelial cells with LTA, double-stranded RNA (dsRNA), and LPS, reverse transcription-polymerase chain reaction (RT-PCR) was performed at 1, 6, and 24 h to clarify the optimal stimulation of ICAM-1 in HNECs. To investigate the anti-inflammatory effects of LCEZ, HNECs were pretreated with three different concentrations of LCEZ (500, 50, and 5 nM) for 2 h. HNECs were washed and then stimulated with dsRNA. At 1, 6, and 24 h after stimulation, the level of ICAM-1 was measured by RT-PCR and ELISA. Western blots for TRIF and RIP were performed. RESULTS The level of ICAM-1 was significantly elevated by dsRNA. Pretreatment with LCEZ decreased the secretion of ICAM-1, which was observed in RT-PCR and Western blots but not in ELISA analyses. The expression of TRIF and RIP, measured by Western blot, was decreased by pretreatment with LCEZ. CONCLUSION The activation of HNECs by TLRs (especially TLR3) could trigger an inflammatory process, which might be inhibited by LCEZ through the suppression of TRIF and RIP proteins.
Collapse
Affiliation(s)
- Chan-Soon Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | | | | | | |
Collapse
|
19
|
|
20
|
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.
Collapse
Affiliation(s)
- Claus Bachert
- Department of Oto-Rhino-Laryngology, Univerisity Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
| |
Collapse
|
21
|
Singh-Franco D, Ghin HL, Robles GI, Borja-Hart N, Perez A. Levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria in adults and children. Clin Ther 2009; 31:1664-87. [PMID: 19808127 DOI: 10.1016/j.clinthera.2009.08.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND Levocetirizine (LCZ) is a second-generation antihistamine that was approved in January 2008 for the relief of symptoms of seasonal allergic rhinitis (SAR), perennial allergic rhinitis (PAR), and chronic idiopathic urticaria (CIU) in adults and children aged > or = 6 years. OBJECTIVES This article reviews the available literature on the pharmacokinetics and pharmacodynamics, clinical efficacy and tolerability, and effect on quality of life (QoL) of LCZ. METHODS A search of the English-language literature was performed using the following databases: MEDLINE (1966-February 2009), International Pharmaceutical Abstracts (19 70-February 2009), Database of Abstracts of Reviews of Effectiveness, Cochrane Database of Systematic Reviews, EMBASE Drugs & Pharmacology (1991-February 2009), Blackwell Synergy, CINAHL Plus with Full Text, EBSCOhost, ScienceDirect, and Wiley Interscience. The search terms were levocetirizine, allergic rhinitis, chronic idiopathic urticaria, antihistamine, pharmacokinetics, quality of life, drug interactions, case reports, and cost. Publications describing studies of > or = 2 weeks' duration that concerned the efficacy, tolerability, pharmacoeconomics, and/or QoL effects of LCZ were included in the review. RESULTS In 4 studies in adult patients with moderate to severe PAR, LCZ 5 mg/d was associated with significant improvements in symptom scores for sneezing, rhinorrhea, and ocular/nasal pruritus at 4 to 6 weeks compared with placebo (P < or = 0.05). In 3 studies, nasal congestion scores were significantly improved within 4 to 6 weeks compared with placebo (P < 0.001). LCZ 5 mg/d was associated with improvements compared with placebo in scores for the ability to do housework, complete work activities, and engage in outdoor activities at 6 months (P < or = 0.011). In a 6-week study in children with moderate to severe SAR, LCZ 5 mg/d was associated with significant improvements compared with placebo in sneezing, rhin-orrhea, and itchy nose (P < 0.004); significant improvements in symptoms from baseline were also seen in a 4-week study in adults with SAR (P < 0.001). One study in patients with SAR reported no significant difference between LCZ and fluticasone compared with fluticasone monotherapy in terms of improvement in QoL, nasal airflow obstruction, sneezing, or pruritus. In a 6-week study in patients with moderate to severe CIU, LCZ 5 mg/d was significantly more effective than placebo in reducing overall CIU symptoms (P < 0.05). In two 4-week studies, one comparing LCZ 5 mg/d with placebo and the other comparing it with desloratadine (DSL), LCZ was significantly more effective than either comparator in terms of improvement in scores for pruritus severity (P < or = 0.001 vs placebo; P < 0.004 vs DSL) and duration (P < or = 0.001 vs placebo; P = 0.009 vs DSL). LCZ was significantly more effective than placebo (but not DSL) in reducing the number and size of wheals (both, P = 0.001). In a 12-week, open-label, crossover study, patients reported significantly longer symptom relief with cetirizine than LCZ (P < 0.005). The most commonly reported adverse events in two 6-month studies in adults with PAR treated with LCZ 5 mg/d included headache (23.8%), pharyngitis (19.4%), influenza (14.6%), fatigue (8.3%), and somnolence (8.3%). There is serious concern about the possibility of febrile seizures in infants treated with LCZ. Three pharmacoeconomic studies of LCZ 5 mg/d were identified, one comparing it with placebo in patients with PAR, one comparing it with placebo in patients with CIU, and another comparing it with second-generation antihistamines and montelukast in patients with PAR. Because of design limitations and differences in comparators in these studies, it was not possible to determine the cost-effectiveness of LCZ in the treatment of PAR or CIU. CONCLUSIONS In the studies reviewed, LCZ 5 mg/d was effective in reducing symptoms of PAR, SAR, and CIU and improving QoL, with an acceptable tolerabili-ty profile. There is a need for studies of longer durations, head-to-head comparisons against other anti-histamines, drug-interaction studies, safety studies in infants, and cost-effectiveness analyses.
Collapse
Affiliation(s)
- Devada Singh-Franco
- Health Professions Division, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, Florida 33328, USA.
| | | | | | | | | |
Collapse
|
22
|
Walsh GM. The anti-inflammatory effects of levocetirizine--are they clinically relevant or just an interesting additional effect? Allergy Asthma Clin Immunol 2009; 5:14. [PMID: 20066054 PMCID: PMC2804563 DOI: 10.1186/1710-1492-5-14] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Accepted: 12/17/2009] [Indexed: 12/11/2022] Open
Abstract
Levocetirizine, the R-enantiomer of cetirizine dihydrochloride has pharmacodynamically and pharmacokinetically favourable characteristics, including rapid onset of action, high bioavailability, high affinity for and occupancy of the H1-receptor, limited distribution, minimal hepatic metabolism together with minimal untoward effects. Several well conducted randomised clinical trials have demonstrated the effectiveness of levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria in adults and children. In addition to the treatment for the immediate short-term manifestations of allergic disease, there appears to be a growing trend for the use of levocetirizine as long-term therapy. In addition to its being a potent antihistamine, levocetirizine has several documented anti-inflammatory effects that are observed at clinically relevant concentrations that may enhance its therapeutic benefit. This review will consider the potential or otherwise of the reported anti-inflammatory effects of levocetirizine to enhance its effectiveness in the treatment of allergic disease.
Collapse
Affiliation(s)
- Garry M Walsh
- School of Medicine, University of Aberdeen, Aberdeen, UK.
| |
Collapse
|
23
|
Scordamaglia F, Compalati E, Baiardini I, Scordamaglia A, Canonica GW. Levocetirizine in the treatment of allergic diseases. Expert Opin Pharmacother 2009; 10:2367-77. [PMID: 19663743 DOI: 10.1517/14656560903193086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Levocetirizine, the R-enantiomer of cetirizine dihydrochloride, is a new molecule with a potent and selective antihistamine activity. OBJECTIVE To investigate the evidence that levocetirizine is an effective therapy for allergic disease. METHODS Evaluation of published articles in English, or having an English abstract. RESULTS Clinical trials indicate that levocetirizine is safe and effective for the treatment of allergic rhinitis and chronic idiopathic urticaria. The compound shows a rapid onset of action, high bioavailability and affinity for the H1 receptor. Moreover, this molecule demonstrates many anti-inflammatory effects that enhance the clinical therapeutic benefit not only in short-term but also in long-term treatments, as reported in recent trials utilizing levocetirizine for several months. CONCLUSION Levocetirizine confirms its safe effective activity for treatment of allergic disease in both adults and children.
Collapse
Affiliation(s)
- Francesca Scordamaglia
- Genoa University, Department of Internal Medicine, Allergy and Respiratory Diseases, Genoa, Italy
| | | | | | | | | |
Collapse
|
24
|
Abstract
Urticaria is often classified as acute, chronic, or physical based on duration of symptoms and the presence or absence of inducing stimuli. Urticarial vasculitis, contact urticaria, and special syndromes are also included under the broad heading of urticaria. Recent advances in our understanding of the pathogenesis of chronic urticaria include the finding of autoantibodies to mast cell receptors in nearly half of patients with chronic idiopathic urticaria. These patients may have more severe disease and require more aggressive therapies. Extensive laboratory evaluation for patients with chronic urticaria is typically unrevealing and there are no compelling data that associate urticaria with chronic infections or malignancy. Pharmacologic therapy consists primarily of the appropriate use of first- and second-generation histamine H(1) receptor antihistamines. Additional therapy may include leukotriene receptor antagonists, corticosteroids, and immunomodulatory agents for severe, unremitting disease. Despite our greater understanding of the pathogenesis of urticaria, the condition remains a frustrating entity for many patients, particularly those with chronic urticaria.
Collapse
|
25
|
Mahmoud F, Arifhodzic N, Haines D, Novotney L. Levocetirizine modulates lymphocyte activation in patients with allergic rhinitis. J Pharmacol Sci 2009; 108:149-56. [PMID: 18946193 DOI: 10.1254/jphs.08037fp] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Levocetirizine, a second generation non-sedating antihistamine that blocks the H(1) histamine receptor, may exhibit immunoregulatory properties that augment its primary pharmacological mechanism. To investigate this possibility, 13 Kuwaiti seasonal allergic rhinitis (SAR) patients were treated with levocetirizine for four weeks in comparison with a 7-member placebo-treated control group, followed by clinical evaluation and flow cytometric analysis of peripheral venous blood for inflammatory cell and lymphocyte subpopulation profiles. Relative to the controls, levocetirizine-treated patients exhibited an expected reduction in early phase allergic symptoms, including sneezing (P<0.001), nasal itching (P<0.01), nasal congestion, and running nose (P<0.001); reduced percentages of eosinophils (P<0.05); and three subpopulations of activated T lymphocytes: CD4+CD29+, CD4+CD212+, and CD4+CD54+ (P<0.05). Levocetirizine treatment also correlated with a significant increase in the percentage of CD4+CD25+ T cells (P<0.001). The ability of levocetirizine to reduce percentage representation of cell phenotypes known to contribute to inflammatory tissue damage (eosinophils, CD4+CD29+, CD4+CD212+, and CD4+CD54+) and expand percentages of CD4+CD25+, which may include protective immunoregulatory (Treg) cells, indicates that the drug has pharmacological potential beyond the immediate effects of H(1) histamine-receptor inhibition. Although the present data does not define a therapeutic mechanism, the results reported here establish important trends that may be used to guide future mechanistic examination of immunoregulatory capacity of H(1) inhibitors.
Collapse
Affiliation(s)
- Fadia Mahmoud
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait.
| | | | | | | |
Collapse
|
26
|
Nettis E, Calogiuri GF, Di Leo E, Cardinale F, Macchia L, Ferrannini A, Vacca A. Once daily levocetirizine for the treatment of allergic rhinitis and chronic idiopathic urticaria. J Asthma Allergy 2008; 2:17-23. [PMID: 21437140 PMCID: PMC3048603 DOI: 10.2147/jaa.s3022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Levocetirizine is the pharmacologically active enantiomer of cetirizine. It is a potent histamine H-1 receptor antagonist with anti-inflammatory and antiallergic properties. The review analyses the levocetirizine's properties in terms of safety and efficacy both in allergic rhinitis and urticarioid syndromes.
Collapse
Affiliation(s)
- E Nettis
- Section of Allergology and Clinical Immunology, Department of Internal Medicine and Infectious Diseases
| | | | | | | | | | | | | |
Collapse
|
27
|
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]
|
28
|
Papich MG, Schooley EK, Reinero CR. Pharmacokinetics of cetirizine in healthy cats. Am J Vet Res 2008; 69:670-4. [DOI: 10.2460/ajvr.69.5.670] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
29
|
Walsh GM. A review of the role of levocetirizine as an effective therapy for allergic disease. Expert Opin Pharmacother 2008; 9:859-67. [PMID: 18345961 DOI: 10.1517/14656566.9.5.859] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Levocetirizine is the R-enantiomer of cetirizine dihydrochloride with pharmacodynamically and pharmacokinetically favourable characteristics. OBJECTIVE To review the evidence that levocetirizine is an effective therapy for allergic disease. METHODOLOGY Relevant articles in English or with English abstracts were identified from systematic PubMed searches. RESULTS Levocetirizine has high bioavailability, high affinity for and occupancy of the H1 receptor, rapid onset of action, limited distribution and minimal hepatic metabolism. Clinical trials indicate that it is safe and effective for the treatment of allergic rhinitis and chronic idiopathic urticaria in adults and children with a minimal number of untoward effects. It is also becoming clearer that, in addition to its being a potent antihistamine, levocetirizine has several anti-inflammatory effects that are observed at clinically relevant concentrations that may enhance its therapeutic benefit. Furthermore, there appears to be a growing trend for the use of levocetirizine as long-term therapy in addition to it being used as a treatment for the immediate short-term manifestations of allergic disease. CONCLUSION Levocetirizine is an effective and safe treatment for use in adults and children with allergic disease.
Collapse
Affiliation(s)
- Garry M Walsh
- University of Aberdeen, School of Medicine, Institute of Medical Sciences, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK.
| |
Collapse
|
30
|
Schooley EK, McGee Turner JB, Jiji RD, Spinka CM, Reinero CR. Effects of cyproheptadine and cetirizine on eosinophilic airway inflammation in cats with experimentally induced asthma. Am J Vet Res 2008; 68:1265-71. [PMID: 17975984 DOI: 10.2460/ajvr.68.11.1265] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether oral administration of cyproheptadine or cetirizine blocks the action of serotonin and histamine, respectively, and results in diminished eosinophilic airway inflammation in cats with experimentally induced asthma. ANIMALS 9 cats in which asthma was experimentally induced through exposure to Bermuda grass allergen (BGA) during a 3-month period. PROCEDURES Cats were randomized to receive monotherapy with each of 3 treatments for 1 week: placebo (flour in a gelatin capsule, PO, q 12 h), cyproheptadine (8 mg, PO, q 12 h), or cetirizine (5 mg, PO, q 12 h). A 1-week washout period was allowed to elapse between treatments. Prior to and following each 1-week treatment period, blood and bronchoalveolar lavage fluid (BALF) samples were collected. The percentage of eosinophils in BALF was evaluated to determine treatment efficacy. Serum and BALF BGA-specific immunoglobulin contents and plasma and BALF histamine concentrations were determined via ELISAs. Plasma and BALF serotonin concentrations were measured by use of a fluorometric method. RESULTS The mean +/- SD percentage of eosinophils in BALF did not differ significantly among treatment groups (placebo, 40 +/- 22%; cyproheptadine, 27 +/- 16%; and cetirizine, 31 +/- 20%). Among the treatment groups, BGA-specific immunoglobulin content and histamine and serotonin concentrations were not significantly different. CONCLUSIONS AND CLINICAL RELEVANCE In cats with experimentally induced asthma, cyproheptadine and cetirizine were not effective in decreasing airway eosinophilic inflammation or in altering several other measured immunologic variables. Neither cyproheptadine nor cetirizine can be advocated as monotherapy for cats with allergen-induced asthma.
Collapse
Affiliation(s)
- Elizabeth K Schooley
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
| | | | | | | | | |
Collapse
|
31
|
Devillier P, Roche N, Faisy C. Clinical Pharmacokinetics and Pharmacodynamics of Desloratadine, Fexofenadine and Levocetirizine. Clin Pharmacokinet 2008; 47:217-30. [PMID: 18336052 DOI: 10.2165/00003088-200847040-00001] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Philippe Devillier
- Laboratory of Pharmacology, UPRES EA 220, Université de Versailles Saint-Quentin, Hôpital Foch, Suresnes, France.
| | | | | |
Collapse
|
32
|
Lever R, Hefni A, Moffatt JD, Paul W, Page CP. Effect of tecastemizole on pulmonary and cutaneous allergic inflammatory responses. Clin Exp Allergy 2007; 37:909-17. [PMID: 17517105 DOI: 10.1111/j.1365-2222.2007.02730.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Tecastemizole, a major metabolite of astemizole, is a potent and selective H1 receptor antagonist. Evidence suggests that this and certain other H1 receptor antagonists may possess anti-inflammatory effects that are, in some cases, independent of H1 receptor antagonism. Objective The aim of this study was to investigate the anti-inflammatory effects of tectastemizole in models of allergic inflammation. METHODS Effects of tecastemizole were assessed in a murine model of allergic lung inflammation, in passive cutaneous anaphylaxis (PCA) responses in guinea-pig skin and in in vitro assays measuring endothelial adhesion molecule expression and leucocyte-endothelial adhesion. RESULTS Tecastemizole inhibited antigen-induced eosinophil recruitment to the lungs of allergic mice in a dose-dependent manner. Furthermore, combination of a sub-effective dose of tecastemizole, combined with a sub-effective dose of dexamethasone inhibited eosinophil accumulation in this model. Plasma extravasation in PCA reactions was inhibited by tecastemizole, although by a mechanism that would appear to be H1 receptor-dependent. Cytokine-induced endothelial intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 expression, as well as mononuclear cell adhesion to human umbilical vein endothelial cells was inhibited by tecastemazole in a manner independent of H1 receptor antagonism. CONCLUSION These data suggest that tecastemizole may have H1 receptor-independent effects in inhibiting late-phase inflammatory responses, while acute responses appear to be inhibited in a H1 receptor-dependent manner. Furthermore, our data suggest an important potential steroid-sparing role for such drugs in the treatment of allergic inflammatory conditions.
Collapse
Affiliation(s)
- R Lever
- Department of Pharmacology, The School of Pharmacy, 29-39 Brunswick Square, London, UK
| | | | | | | | | |
Collapse
|
33
|
Hair PI, Scott LJ. Levocetirizine: a review of its use in the management of allergic rhinitis and skin allergies. Drugs 2006; 66:973-96. [PMID: 16740020 DOI: 10.2165/00003495-200666070-00017] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Levocetirizine (Xyzal) is a selective, potent, oral histamine H(1) receptor antagonist of the latest generation that is licensed for the symptomatic treatment of allergic rhinitis (including persistent allergic rhinitis [PER]) and chronic idiopathic urticaria (CIU). Large, well designed trials indicate that levocetirizine is effective and generally well tolerated in the treatment of allergic rhinitis and CIU. Its pharmacological profile offers many positive aspects: a rapid onset and long duration of antihistaminic effect; rapid absorption and high bioavailability; a low potential for drug interactions; a low volume of distribution; and a lack of effect on cognition, psychomotor function and the cardiovascular system. Allergen challenge chamber studies suggest that levocetirizine has better efficacy than desloratadine, loratadine or fexofenadine. Well controlled, long-term studies with other later-generation H(1) receptor antagonists are required to fully define its clinical profile relative to other agents in this class. Overall, levocetirizine is a valuable addition to the oral H(1) receptor antagonists available for the treatment of allergic rhinitis and as first-line therapy in patients with CIU.
Collapse
Affiliation(s)
- Philip I Hair
- Adis International Limited, 51 Centorian Drive, Mairangi Bay, Auckland 1311, New Zealand.
| | | |
Collapse
|
34
|
|
35
|
Patou J, De Smedt H, van Cauwenberge P, Bachert C. Pathophysiology of nasal obstruction and meta-analysis of early and late effects of levocetirizine. Clin Exp Allergy 2006; 36:972-81. [PMID: 16911353 DOI: 10.1111/j.1365-2222.2006.02544.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Nasal obstruction, also referred to as congestion, blockage or stuffiness, is a crucial symptom in allergic rhinitis (AR) and may affect sleep as well as quality of life. Early- and late-phase-allergic reactions both contribute to nasal obstruction, although it primarily represents a major symptom in the chronic allergic reaction. A complex network of inflammatory and neurogenic phenomena relates to chronic nasal obstruction, including the subepithelial accumulation of inflammatory cells, particularly mast cells and eosinophils, and the release of neuropeptides. Nasal obstruction is a difficult-to-treat symptom. Vasoconstrictors (decongestants) and intranasal corticosteroids, due to their anti-inflammatory properties, have mainly been used for relieving the nasal passages from the congested mucosa. However, there is accumulating evidence recently that the latest-generation potent antihistamines have decongestant properties in AR. This paper aims to review the pathophysiologic background of nasal obstruction and the evidence for an antihistamine, levocetirizine, in relieving nasal congestion. A meta-analysis on the early and late effects of levocetirizine on nasal obstruction under artificial and natural allergen exposure conditions is presented, demonstrating convincingly that levocetirizine shows a consistent effect on nasal obstruction as early as over the first 2 h and sustained over 6 weeks.
Collapse
Affiliation(s)
- J Patou
- Department of Otorhinolaryngology, Upper Airways Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | | | | | | |
Collapse
|
36
|
Wu P, Mitchell S, Walsh GM. A new antihistamine levocetirizine inhibits eosinophil adhesion to vascular cell adhesion molecule-1 under flow conditions. Clin Exp Allergy 2006; 35:1073-9. [PMID: 16120090 DOI: 10.1111/j.1365-2222.2005.02290.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND We previously demonstrated that low concentrations of a new antihistamine levocetirizine inhibited eosinophil transmigration through human microvascular endothelial cells. OBJECTIVE Here, the inhibitory effect of levocetirizine on eosinophil adhesion to recombinant human vascular cell adhesion molecule-1 (rhVCAM)-1 was examined under conditions of shear stress using an in vitro model of the post-capillary venules. METHODS Eosinophils isolated from normal subjects were pre-incubated with a concentration range of levocetirizine (10(-6)-10(-10) m) or negative dilution control. Resting or granulocyte macrophage-colony stimulating factor (GM-CSF)-stimulated cells were pumped through rhVCAM-1 (10 microg/mL) coated capillary tubes using a microfluidic syringe pump at a precise and constant flow rate (1 dyn/cm(2)). Images of rolling and firmly adherent eosinophils were captured using real-time video microscopy. RESULTS Levocetirizine significantly inhibited resting eosinophil adhesion to rhVCAM-1 with maximal effect at 10(-8) M with an EC(50) of 10(-9) m. Levocetirizine almost abolished resting eosinophil adhesion by the 15 min time-point. GM-CSF significantly enhanced eosinophil adhesion and their ability to flatten on rhVCAM-1. Both phenomena were inhibited by levocetirizine in a dose-dependent manner, at both 5 and 15 min (optimal concentration of 10(-8) m with an EC(50) of 10(-9) m). Real-time imaging revealed that the effect of levocetirizine on post-adhesion behaviour (detachment, flatness) contributed to its inhibitory action on eosinophil adhesion to rhVCAM-1. In contrast, very late antigen (VLA)-4 mAb inhibited eosinophil adhesion to rhVCAM-1 from the earliest time-points. CONCLUSION Physiologically relevant concentrations of levocetirizine inhibit resting and GM-CSF-stimulated firm eosinophil adhesion to rhVCAM-1 under flow conditions.
Collapse
Affiliation(s)
- P Wu
- School of Medicine, University of Aberdeen, Aberdeen, Scotland, UK
| | | | | |
Collapse
|
37
|
Abstract
Allergic rhinitis (AR) is now recognised as a global health problem that affects 10-30% of adults and up to 40% of children. Each year, millions of patients seek treatment from their healthcare provider. However, the prevalence of AR maybe significantly underestimated because of misdiagnosis, under diagnosis and failure of patients to seek medical attention. In addition to the classical symptoms such as sneezing, nasal pruritus, congestion and rhinorrhoea, it is now recognised that AR has a significant impact on quality of life (QOL). This condition can lead to sleep disturbance as a result of nasal congestion, which leads to significant impairment in daily activities such as work and school. Traditionally, AR has been subdivided into seasonal AR (SAR) or perennial AR (PAR). SAR symptoms usually appear during a specific season in which aeroallergens are present in the outdoor air such as tree and grass pollen in the spring and summer and weed pollens in the autumn (fall); and PAR symptoms are present year-round and are triggered by dust mite, animal dander, indoor molds and cockroaches. Oral histamine H(1)-receptor antagonists (H(1) antihistamines) are one of the most commonly prescribed medications for the treatment of AR. There are several oral H(1) antihistamines available and it is important to know the pharmacology, such as administration interval, onset of action, metabolism and conditions that require administration adjustments. When prescribing oral H(1) antihistamines, the healthcare provider must take into account the clinical efficacy and weigh this against the risk of adverse effects from the agent. In addition to the clinical efficacy, potential for improvement in QOL with a particular treatment should also be considered.
Collapse
MESH Headings
- Administration, Oral
- Cardiovascular System/drug effects
- Central Nervous System/drug effects
- Cetirizine/therapeutic use
- Drug Interactions
- Histamine H1 Antagonists/administration & dosage
- Histamine H1 Antagonists/adverse effects
- Histamine H1 Antagonists/therapeutic use
- Histamine H1 Antagonists, Non-Sedating/administration & dosage
- Histamine H1 Antagonists, Non-Sedating/adverse effects
- Histamine H1 Antagonists, Non-Sedating/therapeutic use
- Humans
- Long QT Syndrome/chemically induced
- Loratadine/analogs & derivatives
- Loratadine/therapeutic use
- Piperazines/therapeutic use
- Practice Guidelines as Topic
- Quality of Life
- Rhinitis, Allergic, Perennial/drug therapy
- Rhinitis, Allergic, Perennial/physiopathology
- Rhinitis, Allergic, Seasonal/drug therapy
- Rhinitis, Allergic, Seasonal/physiopathology
- Terfenadine/analogs & derivatives
- Terfenadine/therapeutic use
- Treatment Outcome
Collapse
Affiliation(s)
- Jeffrey M Lehman
- Department of Pediatrics, Division of Clinical Allergy and Immunology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | | |
Collapse
|
38
|
|
39
|
Ciprandi G, Cirillo I, Vizzaccaro A, Civardi E, Barberi S, Allen M, Marseglia GL. Desloratadine and levocetirizine improve nasal symptoms, airflow, and allergic inflammation in patients with perennial allergic rhinitis: a pilot study. Int Immunopharmacol 2005; 5:1800-8. [PMID: 16275616 DOI: 10.1016/j.intimp.2005.05.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2004] [Revised: 12/15/2004] [Accepted: 05/26/2005] [Indexed: 11/16/2022]
Abstract
BACKGROUND Nasal obstruction is the main symptom in patients with perennial allergic rhinitis. Some new antihistamines have been demonstrated to be capable of improving this symptom. OBJECTIVE The aim of this pilot study was to evaluate nasal symptoms, nasal airflow, eosinophils, and IL-4 in patients with perennial allergic rhinitis, before and after treatment with two new antihistamines: desloratadine and levocetirizine. METHODS Thirty patients with perennial allergic rhinitis were evaluated, 26 males and 4 females (mean age 26+/-7.1 years). All of them received either desloratadine (5 mg/daily) or levocetirizine (5 mg/daily) or placebo for 4 weeks. The study was double-blind, parallel-group, placebo-controlled, and randomized. Total symptom score (including: rhinorrhea, nasal itching, sneezing, and nasal obstruction) was assessed before and after treatment. Rhinomanometry and decongestion test, nasal lavage, and nasal scraping were performed in all subjects before and after treatment. Eosinophils were counted by conventional staining; IL-4 was measured by immunoassay of fluids recovered from nasal lavage. RESULTS Desloratadine and levocetirizine treatment induced significant symptom relief and significant reduction of IL-4. Both antihistamines significantly affected all parameters in comparison with placebo. CONCLUSIONS This pilot study demonstrates the effectiveness of antihistaminic treatment in: i) relieving nasal symptoms, including obstruction, ii) improving nasal airflow, iii) exerting decongestant activity, iv) reducing eosinophil infiltration, and v) diminishing IL-4 levels.
Collapse
Affiliation(s)
- Giorgio Ciprandi
- Allergologia-U.O. ORL, Dipartimento Regionale Testa-Collo, Padiglione Specialità (piano terzo), Ospedale San Martino, Largo R. Benzi 10, 16132, Genoa, Italy.
| | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
Nasal congestion is a common and troublesome symptom of allergic rhinitis. Because it impairs the natural human drive for nasal breathing, it -- in addition -- leads to lower self-esteem and to impaired quality of life. It is a symptom that is difficult to treat. Traditionally, intranasal steroids, because of their potent anti-inflammatory properties, and vasoconstrictors have been utilized for relieving the nasal passages from the inflamed and congested mucosal tissues. Recent studies with the last-generation antihistamines have demonstrated the decongestant properties of these antihistamines in both the more acute seasonal allergic rhinitis and the more chronic and lasting perennial allergic rhinitis. This study aims to review the efficacy of the potent antihistamine, levocetirizine, in relieving nasal congestion as reported in various studies and settings. Comparisons with placebo and with other antihistamines have been presented in order to help general medical practitioners differentiate between the properties of the various available antihistamines.
Collapse
Affiliation(s)
- L Klimek
- Centre for Rhinology and Allergology, Mannheim University, Wiesbaden, Germany.
| |
Collapse
|
41
|
Hyo S, Fujieda S, Kawada R, Kitazawa S, Takenaka H. The efficacy of short-term administration of 3 antihistamines vs placebo under natural exposure to Japanese cedar pollen. Ann Allergy Asthma Immunol 2005; 94:457-64. [PMID: 15875527 DOI: 10.1016/s1081-1206(10)61116-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Japanese cedar pollinosis, a common disease with morbidity of approximately 20% in the Japanese population, is characterized by subjectively irritating symptoms during an annual 3-month period. OBJECTIVE To investigate the effectiveness of cetirizine hydrochloride, loratadine, and fexofenadine hydrochloride in reducing pollinosis symptoms induced while walking in a park during the pollen season. METHODS A randomized, double-masked, placebo-controlled trial was conducted in 113 individuals with Japanese cedar pollinosis during 2 days in March 2003 in Osaka Expo Park, Osaka, Japan. Participants (aged 20-57 years) were divided into 4 groups according to treatment assignment: cetirizine hydrochloride, 10 mg/d; fexofenadine hydrochloride, 120 mg/d; loratadine, 10 mg/d; and placebo (lactose), twice daily. Symptoms were recorded hourly during the study. Furthermore, all the patients completed the Japanese version of the Rhinoconjunctivitis Quality of Life Questionnaire before and after the trial. RESULTS Self-evaluated symptom scores in all 3 active treatment groups showed significant improvements compared with the placebo group. Furthermore, the cetirizine group showed significant improvement in the domains of frequency of nose blowing and nasal obstruction compared with placebo. In addition, improvement in Japanese Rhinoconjunctivitis Quality of Life Questionnaire scores was higher in the cetirizine group than in the loratadine and placebo groups. CONCLUSION Cetirizine seems to be more effective than fexofenadine and loratadine at reducing subjective symptoms in this study population.
Collapse
Affiliation(s)
- Sawako Hyo
- Department of Otorhinolaryngology, Osaka Medical College, Osaka, Japan.
| | | | | | | | | |
Collapse
|
42
|
de Blic J, Wahn U, Billard E, Alt R, Pujazon MC. Levocetirizine in children: evidenced efficacy and safety in a 6-week randomized seasonal allergic rhinitis trial. Pediatr Allergy Immunol 2005; 16:267-75. [PMID: 15853959 DOI: 10.1111/j.1399-3038.2005.00216.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Studies evaluating newer antihistamines in children are few. Levocetirizine is a potent and highly selective H1-antihistamine with a proven efficacy in adults. Primary objective was to assess the efficacy of levocetirizine 5 mg once-daily in reducing seasonal allergic rhinitis (SAR) symptoms, as measured by Total Four Symptom Score (T4SS = sum of sneezing, rhinorrhea, nasal and ocular pruritus), over the first 2 wk of treatment. Efficacy over 4 and 6 wk of treatment, effect on nasal congestion and on health-related quality of life as measured by PRQLQ (Paediatric Rhinoconjunctivitis Quality of Life Questionnaire) were among the major secondary objectives. A double-blind, randomized, placebo-controlled study including 177 children with a documented SAR (to grass and/or weed) for at least a year and having a mean baseline T4SS > or = 6 (out of 12). Children evaluated daily the severity of T4SS and nasal congestion on a scale from 0 (absent) to 3 (severe). PRQLQ responses were assessed on a scale from 0 (not bothered) to 6 (extremely bothered) and analysed descriptively. Global evaluation of disease evolution judged by investigators, parents and children was made on a scale from 1 (marked worsening) to 7 (marked improvement). For the primary objective, levocetirizine was statistically highly superior to placebo with a difference in adjusted means of 1.29 (95% CI: 0.66-1.92) in favour of levocetirizine (p < 0.001). The effect of levocetirizine was almost twice that of placebo (94.1% relative improvement over placebo). Nasal congestion was improved with levocetirizine reaching maximum difference to placebo of 0.31 (p < 0.05), a relative improvement over placebo of 77.5%. PRQLQ scores at week 2 improved with levocetirizine more than with placebo (0.85 vs. 0.51, respectively) remaining larger after 4 and 6 wk of treatment. In the study, 84.3%, 80.9%, 80.9% of children had their disease evolution rated as slightly-to-markedly improved by, respectively, the investigators, the parents and children themselves. Incidence of treatment-emergent adverse events was similar in both groups (33.7% with levocetirizine; 30.7% with placebo). No child in the levocetirizine group discontinued treatment because of adverse events. The 6-wk duration of this study was longer than the usual 2-4-wk duration for similar studies and shows that levocetirizine controls SAR symptoms in children over the entire pollen season.
Collapse
|
43
|
Abstract
Antihistamines are the cornerstone of treatment for many allergic diseases, such as allergic rhinitis and chronic urticaria. Since the discovery of their beneficial effects in the 1940s, scientists have found molecules with greater selectivity to block specific histamine receptors without some of the detrimental side effects that are seen if antihistamines cross the blood-brain barrier. Levocetirizine is the active enantiomer of cetirizine and a selective H(1)-histamine blocker. It exhibits many favourable characteristics of an ideal antihistamine, both pharmacodynamically and pharmacokinetically, including high bioavailability, rapid onset of action, limited distribution and low degree of metabolism. Furthermore, clinical trials indicate that it is safe and effective for the treatment of allergic rhinitis and chronic urticaria with a minimal amount of untoward effects.
Collapse
MESH Headings
- Allergy and Immunology/trends
- Cetirizine/chemistry
- Cetirizine/pharmacology
- Cetirizine/therapeutic use
- Chronic Disease
- Clinical Trials, Phase III as Topic
- Double-Blind Method
- Histamine H1 Antagonists, Non-Sedating/chemistry
- Histamine H1 Antagonists, Non-Sedating/pharmacology
- Histamine H1 Antagonists, Non-Sedating/therapeutic use
- Humans
- Multicenter Studies as Topic
- Piperazines/chemistry
- Piperazines/pharmacology
- Piperazines/therapeutic use
- Randomized Controlled Trials as Topic
- Rhinitis, Allergic, Perennial/drug therapy
- Rhinitis, Allergic, Perennial/etiology
- Rhinitis, Allergic, Perennial/physiopathology
- Rhinitis, Allergic, Seasonal/drug therapy
- Rhinitis, Allergic, Seasonal/etiology
- Rhinitis, Allergic, Seasonal/physiopathology
- Stereoisomerism
- Urticaria/drug therapy
- Urticaria/etiology
- Urticaria/physiopathology
Collapse
Affiliation(s)
- R Matthew Bloebaum
- The University of Texas Medical Branch, Department of Internal Medicine, Allergy and Immunology Division, Medical Research Bldg. 8.104, 301 University Boulevard, Galveston, Texas 77555-1083, USA
| | | |
Collapse
|
44
|
Abstract
Antihistamines are useful medications for the treatment of a variety of allergic disorders. Second-generation antihistamines avidly and selectively bind to peripheral histamine H1 receptors and, consequently, provide gratifying relief of histamine-mediated symptoms in a majority of atopic patients. This tight receptor specificity additionally leads to few effects on other neuronal or hormonal systems, with the result that adverse effects associated with these medications, with the exception of noticeable sedation in about 10% of cetirizine-treated patients, resemble those of placebo overall. Similarly, serious adverse drug reactions and interactions are uncommon with these medicines. Therapeutic interchange to one of the available second-generation antihistamines is a reasonable approach to limiting an institutional formulary, and adoption of such a policy has proven capable of creating substantial cost savings. Differences in overall efficacy and safety between available second-generation antihistamines, when administered in equivalent dosages, are not large. However, among the antihistamines presently available, fexofenadine may offer the best overall balance of effectiveness and safety, and this agent is an appropriate selection for initial or switch therapy for most patients with mild or moderate allergic symptoms. Cetirizine is the most potent antihistamine available and has been subjected to more clinical study than any other. This agent is appropriate for patients proven unresponsive to other antihistamines and for those with the most severe symptoms who might benefit from antihistamine treatment of the highest potency that can be dose-titrated up to maximal intensity.
Collapse
Affiliation(s)
- Larry K Golightly
- Pharmacy Care Team, University of Colorado Hospital, Denver, Colorado 80262, USA.
| | | |
Collapse
|
45
|
Abstract
UNLABELLED Cetirizine is a selective, second-generation histamine H1 receptor antagonist, with a rapid onset, a long duration of activity and low potential for interaction with drugs metabolised by the hepatic cytochrome P450 system. Cetirizine was generally more effective than other H1 receptor antagonists at inhibiting histamine-induced wheal and flare responses. Cetirizine is an effective and well tolerated agent for the treatment of symptoms of seasonal allergic rhinitis (SAR), perennial allergic rhinitis (PAR) and chronic idiopathic urticaria (CIU) in adult, adolescent and paediatric patients. In adults with these allergic disorders, cetirizine was as effective as conventional dosages of ebastine (SAR, PAR, CIU), fexofenadine (SAR), loratadine (SAR, CIU) or mizolastine (SAR). This agent was significantly more effective, and with a more rapid onset of action, than loratadine in 2-day studies in environmental exposure units (SAR). In paediatric patients, cetirizine was as at least as effective as chlorphenamine (chlorpheniramine) [SAR], loratadine (SAR, PAR) and oxatomide (CIU) in the short term, and more effective than oxatomide and ketotifen (PAR) in the long term. Cetirizine was effective in reducing symptoms of allergic asthma in adults and reduced the relative risk of developing asthma in infants with atopic dermatitis sensitised to grass pollen or house dust mite allergens. It had a corticosteroid-sparing effect in infants with severe atopic dermatitis and was effective in ameliorating reactions to mosquito bites in adults. Cetirizine was well tolerated in adults, adolescents and paediatric patients with allergic disorders. In adult, adolescent and paediatric patients aged 2-11 years, the incidence of somnolence with cetirizine was dose related and was generally similar to that with other second-generation H1 receptor antagonists. Although, its sedative effect was greater than that of fexofenadine in some clinical trials and that of loratadine or fexofenadine in a postmarketing surveillance study. In infants aged 6-24 months, the tolerability profile of cetirizine was similar to that of placebo. Cetirizine did not have any adverse effects on cognitive function in adults, or cognitive function, behaviour or achievement of psychomotor milestones in paediatric patients. Cetirizine was not associated with cardiotoxicity. CONCLUSION Cetirizine is well established in the treatment of symptoms of SAR, PAR or CIU. It demonstrated a corticosteroid-sparing effect and reduced the relative risk of developing asthma in sensitised infants with atopic dermatitis. Cetirizine was effective in the treatment of allergic cough and mosquito bites; however, its precise role in these indications has yet to be clearly established. On the basis of its favourable efficacy and tolerability profile and rapid onset of action, cetirizine provides an important option for the treatment of a wide range of allergic disorders.
Collapse
|
46
|
Affiliation(s)
- F Estelle R Simons
- Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, and the Canadian Institutes of Health Research National Allergy, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
| |
Collapse
|
47
|
Passalacqua G, Guerra L, Compalati E, Massacane P, Rogkakou A, Zanella C, Baena-Cagnani R, Canonica GW. Comparison of the Effects in the Nose and Skin of a Single Dose of Desloratadine and Levocetirizine over 24 Hours. Int Arch Allergy Immunol 2004; 135:143-7. [PMID: 15345913 DOI: 10.1159/000080657] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2004] [Accepted: 07/20/2004] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Desloratadine (DL) and levocetirizine (LCZ) are the newest commercialized antihistamines. Pharmacokinetics, pharmacodynamics and clinical data are available for both drugs, but there is to date no direct comparison involving the nose and skin at the same time. We compared the effects of a single dose of the two drugs in the nose and skin over 24 h. METHODS Twenty-three patients with symptomatic allergic rhinitis were enrolled in a randomized double-blind crossover administration of DL and LCZ. The histamine-induced wheal and flare was measured at baseline and 2 and 24 h after dosing. A reflective total symptom score (rTSS) for the previous 24 h was assessed before and after each dose. An instant symptom score was also measured at various time points after each drug. RESULTS LCZ provided greater inhibition of the flare at 2 h (p = 0.05) and at 24 h (p = 0.007) and greater inhibition of the wheal only at 2 h (p = 0.02). The decrease in wheal and flare was significant versus baseline (p = 0.007) with both drugs. The rTSS of the previous 24 h decreased significantly with both LCZ (11.53 vs. 8.0; p < 0.05) and DL (11.3 vs. 7.9; p < 0.05). The instant TSS progressively decreased in parallel with both drugs, but a difference in favor of LCZ was seen 2 h after dosing. CONCLUSIONS Single doses of DL and LCZ had a comparable effect on nasal symptoms, but LCZ was faster and displayed a greater effect on histamine wheal.
Collapse
Affiliation(s)
- Giovanni Passalacqua
- Allergy and Respiratory Diseases, Department of Internal Medicine, University of Genoa, Genoa, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Ciprandi G, Cirillo I, Vizzaccaro A, Tosca MA. Levocetirizine improves nasal obstruction and modulates cytokine pattern in patients with seasonal allergic rhinitis: a pilot study. Clin Exp Allergy 2004; 34:958-64. [PMID: 15196286 DOI: 10.1111/j.1365-2222.2004.01960.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Allergic rhinitis is characterized by an IgE-dependent inflammation. Nasal obstruction is related to allergic inflammation. Some antihistamines have been demonstrated to be capable of improving this nasal symptom. OBJECTIVE The aim of this pilot study was to evaluate nasal symptoms, nasal airflow, inflammatory cells, and cytokine pattern in patients with seasonal allergic rhinitis (SAR), before and after treatment with levocetirizine, desloratadine, or placebo. METHODS Thirty patients with SAR were evaluated, 27 males and three females (mean age 26.9+/-5.4 years). All of them received levocetirizine (5 mg/day), desloratadine (5 mg/day), or placebo for 2 weeks. The study was double-blind, parallel-group, placebo-controlled, and randomized. Total symptom score (TSS) (including: rhinorrhea, nasal itching, sneezing, and nasal obstruction) was assessed before and after treatment. Rhinomanometry, nasal lavage, and nasal scraping were performed in all subjects before and after treatment. Inflammatory cells were counted by conventional staining; IL-4 and IL-8 were measured by immunoassay on fluids recovered from nasal lavage. RESULTS Levocetirizine treatment induced significant symptom relief (P=0.0009) and improved nasal airflow (P=0.038). Desloratadine also relieved TSS (P=0.01), but did not affect nasal airflow. Levocetirizine significantly reduced eosinophils (P=0.029), neutrophils (P=0.005), IL-4 (P=0.041), and IL-8 (P=0.02), whereas desloratadine diminished IL-4 only (P=0.044). Placebo treatment did not significantly affect any evaluated parameters. CONCLUSIONS This pilot study demonstrates the effectiveness of levocetirizine in: (i) relieving nasal symptoms, (ii) improving nasal airflow, (iii) reducing leucocyte infiltration, and (iv) diminishing cytokine levels. These findings are the first evidence of the effectiveness of levocetirizine in SAR.
Collapse
Affiliation(s)
- G Ciprandi
- Allergologia, Ospedale San Martino, Genoa, Italy.
| | | | | | | |
Collapse
|
49
|
Lee DKC, Gardiner M, Haggart K, Fujihara S, Lipworth BJ. Comparative effects of desloratadine, fexofenadine, and levocetirizine on nasal adenosine monophosphate challenge in patients with perennial allergic rhinitis. Clin Exp Allergy 2004; 34:650-3. [PMID: 15080821 DOI: 10.1111/j.1365-2222.2004.1904.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Summary Background There are no data directly comparing the relative efficacy of modern H(1)-antihistamines in allergic rhinitis using nasal provocation challenge. Objective We elected to study the comparative effectiveness of usual clinically recommended doses of desloratadine (DES), fexofenadine (FEX), and levocetirizine (LEV), on nasal adenosine monophosphate (AMP) challenge in patients with perennial allergic rhinitis (PAR). Methods 16 patients with PAR were randomized in double-blind cross-over fashion to receive single doses of DES 5 mg, FEX 180 mg, LEV 5 mg, or placebo (PL), with nasal AMP challenge performed 12 h after dosing. Measurements of peak nasal inspiratory flow (PNIF) were made over 60 min after nasal AMP challenge. Results Pre-challenge values (mean+/-SEM) for PNIF (L/min) were not significantly different comparing all groups; DES (129+/-9), FEX (128+/-11), LEV (128+/-13), and PL (128+/-12). The maximum % PNIF fall from baseline over 60 min after nasal AMP challenge was significantly attenuated (P<0.05) compared to PL (50+/-4), with DES (32+/-5), FEX (36+/-4), and LEV (36+/-4). The area under the 60-min time-response curve (%.min) was also significantly attenuated (P<0.05) compared to PL (2110+/-268), with DES (1126+/-285), FEX (1225+/-255), and LEV (1261+/-194). There were no significant differences between the three H(1)-antihistamines for any outcomes. Conclusion DES, FEX, and LEV were equally effective in attenuating the response to nasal AMP challenge. However, further long-term studies will be required to study their comparative effects on nasal symptoms, quality of life, as well as on nasal inflammatory cells.
Collapse
Affiliation(s)
- D K C Lee
- Asthma & Allergy Research Group, Ninewells Hospital & Medical School, University of Dundee, Dundee, Scotland, UK
| | | | | | | | | |
Collapse
|
50
|
Shimizu T, Nishihira J, Watanabe H, Abe R, Ishibashi T, Shimizu H. Cetirizine, an H1-receptor antagonist, suppresses the expression of macrophage migration inhibitory factor: its potential anti-inflammatory action. Clin Exp Allergy 2004; 34:103-9. [PMID: 14720269 DOI: 10.1111/j.1365-2222.2004.01836.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND H1-receptor antagonists are often effective in the treatment of allergic disorders such as atopic dermatitis. Cetirizine, a putative H1-receptor antagonist, has recently been shown to have anti-inflammatory properties through the inhibition of leucocyte recruitment and activation, and by the reduction of ICAM-1 expression on keratinocytes. OBJECTIVE To further elucidate the anti-inflammatory properties of cetirizine, we first examined its effects on antigen-induced eosinophilia and neutrophila in vivo. We then examined the anti-inflammatory effects of cetirizine on a human keratinocyte A431cell line. METHODS Mice were sensitized subcutaneously with ragweed pollen and were challenged intraperitoneally with the allergen. Cetirizine diluted in sterile water (0-20 mg/kg) or only sterile water was administered orally. Peritoneal cells were obtained at 8 and 24 h after challenge. The eosinophilia and neutrophilia induced by ragweed pollen extract were quantitated. Macrophage migration inhibitory factor (MIF), macrophage inflammatory protein 2 (MIP-2) and eotaxin contents of peritoneal fluid were also measured by mouse ELISA. The effects of cetirizine on MIF-induced IL-8 production in A431 cells were examined by ELISA. The effects of cetirizine on MIF expression and production in A431 cells were examined by human MIF ELISA and Northern blot analysis. RESULTS Eosinophilia and neutrophilia induced by ragweed pollen extract were found to be significantly reduced in cetirizine-treated mice (20 mg/kg). MIF, a pleuripotent cytokine, was significantly decreased at 8 and 24 h in the peritoneal fluid by cetirizine treatment. MIP-2 and eotaxin were also decreased 8 and 24 h, respectively, after challenge in the peritoneal fluid with cetirizine treatment. MIF stimulates IL-8 production in A431 cells. We found that MIF production in A431 cells was inhibited by 10 microm cetirizine. Consistent with this, cetirizine significantly inhibited MIF-induced IL-8 production. CONCLUSION These results suggest that cetirizine exerts its anti-inflammatory effects by inhibiting MIF as well as IL-8 production, such as those involved in inflammatory allergic skin disease, suggesting a broad spectrum of action beyond its mere H1-receptor-antagonistic function.
Collapse
Affiliation(s)
- T Shimizu
- Departments of Dermatology Molecular Biochemistry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | | | | | | | | |
Collapse
|