Antihistamines and allergy

First-Generation OTC Antihistamine Use and Voice Function in Individuals with Allergic Rhinitis: A Preliminary Report of Clinically Impactful Findings

PURPOSE

The primary goal of this investigation was to characterize the effect of the first-generation, over-the-counter antihistamine Chlor-Trimeton on laryngeal structure and function in a previously unstudied population - individuals diagnosed with allergic rhinitis who routinely take over-the-counter antihistamines and deny the experience or diagnosis of voice disorder.

STUDY DESIGN

Prospective within-participant multimodality repeated measures design.

METHODS

Eight consented participants (seven females, one male) previously diagnosed with allergic rhinitis and without history of voice disorder who routinely took over-the-counter antihistamines completed the study. Volunteers completed the following measures before and 2hours after antihistamine administration: perceptual vocal function measures, phonation threshold pressure (PTP), acoustic measures, and laryngeal imaging. All pre- and post-administration data were descriptively analyzed for clinically significant change.

RESULTS

No clinically significant differences were identified for any acoustic or aerodynamic measures taken. Analyses of laryngeal imaging data indicated that all participants had evidence of mucosal changes in one or more of the following parameters: increased vascularity, mucus in the anterior commissure, and vocal fold color changes, all of which are consistent with prior descriptions of allergy larynx.

CONCLUSIONS

Empirical study of laryngeal appearance in individuals diagnosed with allergic rhinitis, affirmed clinical observations of laryngeal tissue changes consistent with allergy larynx. Stable PTP suggests potential vocal fold cover adaptations from routine use of over-the-counter antihistamines that may buffer the typical desiccating effect on voice function observed in prior studies of healthy individuals.

Treatment of Allergies to Fur Animals

Allergy to fur animals is becoming an increasingly common clinical problem in everyday medical practice. Depending on the route of exposure to the allergen, patients present with many, often non-specific symptoms. The most common illnesses among people with allergies to the above-mentioned allergens are as follows: allergic rhinitis, allergic conjunctivitis, atopic bronchial asthma, food allergy, allergic contact dermatitis, and sometimes anaphylactic shock. In recent years, there has been a change in the holistic approach to the treatment of allergy patients. The method of treatment should be tailored to a specific patient, taking into account his or her predispositions, economic possibilities, and therapeutic goals. The article describes the main methods of treating allergies, focusing primarily on allergies to fur animals. Allergy treatment always requires great care, and qualification for specific types of therapy should be preceded by a thorough and accurate diagnosis.

Nanosuspensions in ophthalmology: Overcoming challenges and enhancing drug delivery for eye diseases

This review article provides a comprehensive overview of the advancements in using nanosuspensions for controlled drug delivery in ophthalmology. It highlights the significance of ophthalmic drug delivery due to the prevalence of eye diseases and delves into various aspects of this field. The article explores molecular mechanisms, drugs used, and physiological factors affecting drug absorption. It also addresses challenges in treating both anterior and posterior eye segments and investigates the role of mucus in obstructing micro- and nanosuspensions. Nanosuspensions are presented as a promising approach to enhance drug solubility and absorption, covering formulation, stability, properties, and functionalization. The review discusses the pros and cons of using nanosuspensions for ocular drug delivery and covers their structure, preparation, characterization, and applications. Several graphical representations illustrate their role in treating various eye conditions. Specific drug categories like anti-inflammatory drugs, antihistamines, glucocorticoids, and more are discussed in detail, with relevant studies. The article also addresses current challenges and future directions, emphasizing the need for improved nanosuspension stability and exploring potential technologies. Nanosuspensions have shown substantial potential in advancing ophthalmic drug delivery by enhancing solubility and absorption. This article is a valuable resource for researchers, clinicians, and pharmaceutical professionals in this field, offering insights into recent developments, challenges, and future prospects in nanosuspension use for ocular drug delivery.

Evaluation of subchronic toxicity of the compound of diphenhydramine hydrochloride and caffeine after 28 days of repeated oral administration in Sprague-Dawley rats and beagle dogs

This study was designed to evaluate the subchronic toxicity of the compound of diphenhydramine hydrochloride (DH) and caffeine in Sprague-Dawley (SD) rats and beagle dogs. A total of 180 SD rats (15/sex/group) were randomly divided into the compound low-, medium- and high-dose groups (51, 102, 204 mg/kg), DH group (60 mg/kg), caffeine group (144 mg/kg) and the vehicle control group. Sixty beagle dogs (5/sex/group) were randomly divided into the compound low-, medium- and high-dose groups (male: 14.20, 28.30, 56.60 mg/kg, female: 5.66, 14.20, 28.30 mg/kg), DH group (male: 16.60 mg/kg, female: 8.30 mg/kg), caffeine group (male: 40.00 mg/kg, female: 20.00 mg/kg) and the vehicle control group. Rats and dogs were given continuous oral administration for 28 days following a 28-day recovery period. The adverse effects of the compound on rats and beagle dogs mainly included anorexia and liver function impairment. Most adverse effects induced by administration were reversible. Under the experimental conditions, the no-observed-adverse-effect level (NOAEL) of the compound of DH and caffeine was 51 mg/kg/day for SD rats and 28.30 mg/kg/day (male) and 5.66 mg/kg/day (female) for beagle dogs.

Factors associated with patellofemoral pain in recreational road cyclists: A cross-sectional study in 59953 cyclists - SAFER XXXIII

OBJECTIVE

Patellofemoral pain (PFP) is a common cycling-related injury, and independent factors need to be identified to enable effective injury prevention strategies. We aim to determine factors associated with PFP in cyclists entering mass community-based events.

DESIGN

Cross-sectional study.

SETTING

2016-2020 Cape Town Cycle Tour.

PARTICIPANTS

Consenting race entrants.

MAIN OUTCOME MEASURES

62758 consenting race entrants completed a pre-race medical questionnaire, and 323 reported PFP. Selected factors associated with PFP (demographics, cycling experience and training, chronic disease history) were explored using multivariate analyses.

RESULTS

Prevalence ratio (PR) of PFP was similar for sex and age groups. Independent factors associated with PFP (adjusted for sex and age) were history of chronic disease [Composite Chronic Disease Score (0-10)(PR = 2.0, p < 0.0001) and any allergies (PR = 2.0, p < 0.0001)].

CONCLUSION

A history of chronic diseases and allergies is associated with PFP in cyclists. Practical clinical recommendations are: 1) that prevention programs for PFP be considered when cycling is prescribed as a physical activity intervention for patients with chronic disease, and 2) that older cyclists presenting with PFP be assessed for the presence of risk factors or existing chronic disease.

Drug repositioning of anti-microbial agent nifuratel to treat mast cell-mediated allergic responses

Objectives: Our objective was to assess the effects and mechanisms of nifuratel on IgE-mediated mast cell (MC) degranulation and anaphylaxis in both in vitro and in vivo settings.Methods: The anti-allergic activity of nifuratel was evaluated in mast cell cultures and the passive cutaneous anaphylaxis (PCA) model. The effects of nifuratel on signaling pathways stimulated by antigen in mast cells were measured by immunoblotting, immunoprecipitation, in vitro protein tyrosine kinase assay, and other molecular biological methods.Results: Nifuratel reversibly inhibited antigen-induced degranulation of MCs (IC50, approximately 0.34 μM for RBL-2H3 cells; approximately 0.94 μM for BMMCs) and suppressed the secretion of inflammatory cytokines IL-4 (IC50, approximately 0.74 μM) and TNF-α (IC50, approximately 0.48 μM). Mechanism studies showed that nifuratel inhibited the phosphorylation of Syk by antigen via the inhibition of recruitment of cytosolic Syk to the ɣ subunit of FcεRI, and decreased the activation of Syk downstream signaling proteins LAT, Akt, and MAPKs. Finally, nifuratel dose-dependently suppressed the IgE-mediated passive cutaneous anaphylaxis in mice (ED50, approximately 22 mg/kg).Conclusion: Our findings suggest that nifuratel inhibits pathways essential for the activation of mast cells to suppress anaphylaxis, thereby indicating that the anti-microbial drug, nifuratel, could be a potential drug candidate for IgE-mediated allergic disorders.

Topical Formulation of Nano Spray-Dried Levocetirizine Dihydrochloride against Allergic Edema

Levocetirizine dihydrochloride active ingredient was microencapsulated using nano spray-drying technology for preparing microparticles containing topical gel against edema. Hydroxyl propyl methyl cellulose (HPMC) was used as a carrier polymer during spray drying. The active ingredient content of the nano spray-dried products was 52.81% (w/w) and 51.33% (w/w) for ex vivo and in vivo experiments, respectively, and the average particle size was 2.6 µm. X-ray diffraction analysis indicated an amorphous state of the active ingredient embedded in the amorphous matrix of the polymer. Dermal oil gels composed of Miglyol 812 gelated by Dermofeel viscolid included 5% (w/w) (for ex vivo) and 10% (w/w) (for in vivo) active ingredient without or with 0.05% (w/w) menthol penetration enhancer. Qualitative ex vivo penetration studies using a confocal Raman microscopic correlation mapping were executed on human abdominal skin. The results showed that the active ingredient was enriched in the epidermis and upper dermis layer of the skin using oleogel loaded with the nano spray-dried drug-HPMC composite. Menthol addition to the oleogel resulted in the concentration of levocetirizine in the dermis. In vivo tests were performed on a mouse model of croton oil-induced ear edema. Negative control and Fenistil-treated groups were compared using the prepared oil gels with and without menthol. Without penetration enhancer, 20 µL of our oil gel loaded with nano spray-dried levocetirizine dihydrochloride composite showed similar effectiveness to the same volume of Fenistil gel, while 5 µL menthol containing sample was sufficient to eliminate the skin irritation similarly to 20 µL Fenistil.

Integrative transcriptome-wide analysis of atopic dermatitis for drug repositioning

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases, which significantly impact the quality of life. Transcriptome-wide association study (TWAS) was conducted to estimate both transcriptomic and genomic features of AD and detected significant associations between 31 expression quantitative loci and 25 genes. Our results replicated well-known genetic markers for AD, as well as 4 novel associated genes. Next, transcriptome meta-analysis was conducted with 5 studies retrieved from public databases and identified 5 additional novel susceptibility genes for AD. Applying the connectivity map to the results from TWAS and meta-analysis, robustly enriched perturbations were identified and their chemical or functional properties were analyzed. Here, we report the first research on integrative approaches for an AD, combining TWAS and transcriptome meta-analysis. Together, our findings could provide a comprehensive understanding of the pathophysiologic mechanisms of AD and suggest potential drug candidates as alternative treatment options.

Integrative genomic and transcriptomic analyses on publicly available data-sets together with in silico drug repositioning identifies alternative therapeutic options to treat atopic dermatitis.

Predictors of multiple injuries in individual distance runners: A retrospective study of 75,401 entrants in 4 annual races-SAFER XX

BACKGROUND

There are limited data on factors that predict an increased risk of multiple injuries among distance runners. The objective of this study was to determine risk factors that are predictive of individual runners with a high annual multiple injury risk (MIR).

METHODS

A retrospective, cross-sectional study at 4 annual (2012-2015) Two Oceans 21.1 km and 56.0 km races in South Africa with 75,401 consenting race entrants. Running-related injury data were collected retrospectively through an online pre-race medical screening questionnaire. The average number of injuries for each runner every year was calculated by taking a runner's race entry history and injury history into account and categorizing entrants into 4 MIR categories (high, intermediate, low, and very low (reference)). Multiple logistic regression modeling (odds ratios) was used to determine whether the following factors were predictive of a high MIR (average > 1 injury/year): demographics, training and racing, chronic-disease history (composite chronic disease score (CCDS)), and history of allergies.

RESULTS

Of all entrants, 9.2% reported at least 1 injury, and 0.4% of entrants were in the high MIR category; the incidence rate was 2.5 injuries per 10 runner-years (95% confidence interval (95%CI): 2.4-2.7). Significant factors predictive of runners in the high MIR category were: running for > 20 years: OR = 2.0 (95%CI: 1.3-3.1; p = 0.0010); a higher CCDS: OR = 2.2 (95%CI: 2.0-2.4; p < 0.0001); and a history of allergies: OR = 2.8 (95%CI: 2.0-3.8; p < 0.0001).

CONCLUSION

Runners who have been running recreationally for > 20 years and those with multiple chronic diseases or a history of allergies were at higher risk of multiple running-related injuries. This high-risk group can be targeted for further study and possible injury-prevention interventions.

Polysorbate 80-Induced Anaphylactoid Reaction and the Effects on Cardiovascular Function: Dose Threshold and Species Comparison

Polysorbate 80 (PS80) is commonly used in pre-clinical formulations. The dose threshold for cardiovascular (CV) changes and hypersensitivity reaction in the dog was assessed and compared to other species. PS80 was administered by intravenous (IV) bolus (.5, 1 mg/kg), IV infusion (.3, .5, 1, 3 mg/kg), subcutaneous (SC) injection (5, 10, 15 mg/kg) and oral gavage (10 mg/kg) to dogs with CV monitoring. Monkeys and minipigs received PS80 by IV infusion at 3 mg/kg. Plasma histamine concentration was measured following PS80 IV infusion and with diphenhydramine pre-treatment in dogs only. In dogs, PS80 was not associated with CV changes at doses up to 15 mg/kg SC and 10 mg/kg oral, but decreased blood pressure and increased heart rate with IV bolus at ≥ .5 mg/kg and IV infusion at ≥ 1.0 mg/kg and decreased body temperature with IV infusion at 3 mg/kg was observed. Transient edema and erythema were noted with all administration routes, in all three species including doses that were devoid of CV effects. In monkeys and minipigs, PS80 did not induce CV, cutaneous or histamine concentration changes. These results suggest that mild, transient skin changes occur following PS80 administration at doses that are not associated with CV effects in the dogs. In dogs, the cardiovascular effect threshold was <.5 mg/kg for IV bolus, .3 mg/kg for IV infusion, 15 mg/kg for SC injection, and 10 mg/kg for oral administration. Monkey and minipig were refractory to PS80-induced histamine release at 3 mg/kg by IV infusion over 15 minutes.

The effect of treatment with fexofenadine and fluticasone propionate on the gene expression levels of Th9 transcription factors in patients with allergic rhinitis

T helper-9 (Th9) is a new T cell subset involved in allergic rhinitis (AR) pathogenesis. Fexofenadine and fluticasone propionate are the first effective line of AR treatment. This study aimed to evaluate the effect of fexofenadine and fluticasone propionate on the gene expression levels of Interferon regulatory factor 4 (IRF4), B cell-activating transcription factor-like (BATF), and SPI1 gene-encoded protein (PU.1), essential transcription factors for Th9 cell differentiation, in AR patients. Twenty-six AR patients (aged 32.8 ± 9.1 years, 13 men and 13 women) were treated with fexofenadine and fluticasone propionate for one month. Expression levels of PU.1, IRF4, and BATF genes were measured using Real-Time PCR. Our results showed that after one month of treatment, the expression level of IRF4 and BATF genes decreased significantly (P < 0.001, P < 0.01, respectively), while PU.1 gene expression was not remarkably different. Overall, our results showed that after one month of treatment with fexofenadine and fluticasone propionate, the expression levels of IRF4 and BATF genes in AR patients decreased, which may be due to this treatment regimen. However, the exact mechanism of action of fexofenadine and fluticasone propionate needs further study.

Independent Risk Factors Predicting Gradual Onset Injury in 2824 Trail Running Race Entrants: SAFER XVIII Study

INTRODUCTION

Trail running is characterized by elevation changes, with uneven and varying running surfaces. Risk factors that may predict gradual-onset running-related injuries (GORRIs) in short-distance trail running have not been explored. The objective was to determine risk factors that predict GORRIs in trail running race entrants who entered mass community-based trail running events.

METHODS

In this descriptive cross-sectional study, data were collected prospectively from a prerace medical screening questionnaire over 4 trail run events held annually. Using a Poisson regression model, runner demographics, race distance, running training/racing variables, history of chronic diseases (number of chronic diseases reported as a cumulative "chronic disease composite score"), and allergies were investigated to determine factors predicting self-reported GORRI history in the previous 12 mo.

RESULTS

This study included 2824 race entrants (80% of entrants). The retrospective annual incidence for GORRIs was 13%. Independent risk factors predicting GORRIs were longer race distance (P<0.0001), increasing chronic disease composite score (P=0.0012), and a history of allergies (P=0.0056). The lower limb (94%) was the main anatomic region of GORRIs, and soft tissue injuries accounted for most (83%) GORRIs. Common specific GORRIs were iliotibial band syndrome (22%), Achilles tendon injury (10%), and hamstring injury (9%).

CONCLUSIONS

Independent risk factors predicting GORRIs among trail running entrants included longer race distance, a higher chronic disease composite score, and a history of allergies. This study has highlighted trail running race entrants at risk for sustaining GORRIs who could be targeted for future injury prevention interventions.

Chitosan-centered nanosystems as sustained therapeutics for allergic rhinitis intervention: Inhibition of histamine-induced cascades

Allergic rhinitis (AR), histamine-mediated upper airway inflammatory disorder, is characterized by sneezing, itching, airway hyperreactivity, etc. Though it is clinically well-managed by non-invasive inhaled antihistamines, for example, ketotifen (KT, histamine release inhibitor) and cetirizine (CTZ, histamine receptor antagonist), inherent defects of short mucosal in situ retention, frequent administration resulting in irritation to mucosa, and lack of target-specific sequential release of dual drug systems which have been proven to be more effective are inevitable, urging for alternative therapeutic strategies. Recent advances in nanotechnology may be pivotal to generating muco-adhesive nanosystems, which is desirable to prolong local retention, reduce dosing frequency and relieve mucosal irritation. In this regard, KT incorporated and CTZ decorated hydroxybutyl chitosan nanoparticles (K ⊂ CH NPs) were fabricated as nasal adaptive sequential release dual drug system for long-term AR therapy. Nasal adaptive morphology transformation and two-step payload release up to 72 h were achieved in vitro, with ~ 3-fold higher bio-adhesivity over free drugs appeared. K ⊂ CH NPs accomplished longer histamine release inhibition (~ 24 h) and histamine H₁ receptor antagonism (~ 6 h), compared with free KT&CTZ of ~ 12 h and ~ 2 h, respectively. The nanosystems provided comparable anti-allergic effect to free antihistamines via successive intranasal dropping in AR rat, while encouragingly, significantly (P < 0.05) better therapeutic efficacy at reduced treatment frequency (every 4 days) and dose (half-dose). Therefore, the outcomes establish K ⊂ CH NPs as effective low-dose and long-interval administered nanosystems to ameliorate histamine-mediated AR inflammation, which could in principal find extensive utilizations in respiratory allergy intervention.

Management of adult asthma and chronic rhinitis as one airway disease

Introduction: Chronic rhinitis is defined as nasal inflammation with the presence of minimum two symptoms such as nasal obstruction, rhinorrhea, sneezing and/or itching one hour daily for a minimum of 12 weeks/year. According their etiology, four groups of rhinitis are described: allergic, infectious, non-allergic non-infectious and mixed.Chronic rhinitis is frequently associated with asthma, shares similar mechanisms of the pathogenesis and has a negative impact of its outcomes sustaining the concept of unified airways disease.Areas covered: The present review summarizes the complex relationship between chronic rhinitis and asthma on the basis of recent epidemiological data, clinical characteristics, diagnosis and therapeutic management. All four groups are discussed with the impact of their specific treatment on asthma outcomes. Some medications are common for chronic rhinitis and asthma while others are more specific but able to treat the associated comorbidity.Expert opinion: The systematic assessment of chronic rhinitis in patients with asthma and its specific treatment improves both disease outcomes. Conversely, several therapies of asthma demonstrated beneficial effects on chronic rhinitis. Treating both diseases at the same time by only one medication is an interesting option to explore in the future in order to limit drugs administration, related costs and side effects.

Manifesto on united airways diseases (UAD): an Interasma (global asthma association - GAA) document

OBJECTIVE

The large amount of evidence and the renewed interest in upper and lower airways involvement in infectious and inflammatory diseases has led Interasma (Global Asthma Association) to take a position on United Airways Diseases (UAD).

METHODS

Starting from an extensive literature review, Interasma executive committee discussed and approved this Manifesto developed by Interasma scientific network (INES) members.

RESULTS

The manifesto describes the evidence gathered to date and defines, states, advocates, and proposes issues on UAD (rhinitis, rhinosinusitis and nasal polyposis), and concomitant/comorbid lower airways disorders (asthma, chronic obstructive pulmonary disease, bronchiectasis, cystic fibrosis, obstructive sleep apnoea) with the aim of challenging assumptions, fostering commitment, and bringing about change. UAD refers to clinical pictures characterized by the coexistence of upper and lower airways involvement, driven by a common pathophysiological mechanism, leading to a greater burden on patient's health status and requiring an integrated diagnostic and therapeutic plan. The high prevalence of UAD must be taken into account. Upper and lower airways diseases influence disease control and patient's quality of life.

CONCLUSIONS

Patients with UAD need to have a timely and adequate diagnosis, treatment, and, when recommended, referral for management in a specialized center. Diagnostic testing including skin prick or serum specific IgE, lung function, fractional exhaled nitric oxide (FeNO), polysomnography, allergen-specific immunotherapies, biological therapies and home based continuous positive airway pressure (CPAP) whenever these are recommended, should be part of the management plan for UAD. Education of medical students, physicians, health professionals, patients and caregivers on the UAD is needed.

No Time for Lullabies Tracing down Pharmacological Effects & Uses of H1-Antihistamines in Children Younger than 6 Years

Objectives. To provide a qualitative and a quantitative analysis of H1-antihistamines pharmacological uses pattern among children (<6 years old) and to evaluate the parental-related awareness. Methods. A cross-sectional study was carried out at 5 retail pharmacies in Jordan over 5 months (October/2019-February/2020). Parents who requested any of H1-antihistmine agent for a child (<6 years) were invited to participate. Results. A total of 516 children, most of them were toddlers (1-3) years, received at least 1 H1-antihistamine. More than half of the cases received H1-antihistamine as self-medication (56.3%). Sedating antihistamine agents were the most frequently used among children (<6 years old) (77.9%) among which Chlorpheniramine maleate was the most commonly used agent (62.9%). About half of the children (47.0%) received H1-antihistamine to induce sleep. Whereas, 21.7% and 12.9% received them to manage flu, and allergic rhinitis (AR), respectively. Around 66.6% of the cases were classified as off-label use. Most of the parents (80.5%) were aware of the sedative adverse effects of H1-antihistamines, whereas a fewer number (31.9%) were aware of their cognitive effects. Finally, more than two thirds of parents (79.7%) were unfamiliar with off-label drug use in children. Conclusion. Despite the availability of less-sedating H1-antihistamines with a wide safety and efficacy record, the use of sedating H1-antihistamines remains popular in children.

Asthma and stroke: a narrative review

Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation, bronchial reversible obstruction and hyperresponsiveness to direct or indirect stimuli. It is a severe disease causing approximately half a million deaths every year and thus possessing a significant public health burden. Stroke is the second leading cause of death and a major cause of disability worldwide. Asthma and asthma medications may be a risk factors for developing stroke. Nevertheless, since asthma is associated with a variety of comorbidities, such as cardiovascular, metabolic and respiratory, the increased incidence of stroke in asthma patients may be due to a confounding effect. The purpose of this review is to analyze the complex relationship between asthma and stroke.

Dasatinib Inhibits Lyn and Fyn Src-Family Kinases in Mast Cells to Suppress Type I Hypersensitivity in Mice

Mast cells (MCs) are systemically distributed and secrete several allergic mediators such as histamine and leukotrienes to cause type I hypersensitivity. Dasatinib is a type of anti-cancer agent and it has also been reported to inhibit human basophils. However, dasatinib has not been reported for its inhibitory effects on MCs or type I hypersensitivity in mice. In this study, we examined the inhibitory effect of dasatinib on MCs and MC-mediated allergic response in vitro and in vivo. in vitro, dasatinib inhibited the degranulation of MCs by antigen stimulation in a dose-dependent manner (IC₅₀, ~34 nM for RBL-2H3 cells; ~52 nM for BMMCs) without any cytotoxicity. It also suppressed the secretion of inflammatory cytokines IL-4 and TNF-α by antigen stimulation. Furthermore, dasatinib inhibited MC-mediated passive cutaneous anaphylaxis (PCA) in mice (ED₅₀, ~29 mg/kg). Notably, dasatinib significantly suppressed the degranulation of MCs in the ear tissue. As the mechanism of its effect, dasatinib inhibited the activation of Syk and Syk-mediated downstream signaling proteins, LAT, PLCγ1, and three typical MAP kinases (Erk1/2, JNK, and p38), which are essential for the activation of MCs. Interestingly, in vitro tyrosine kinase assay, dasatinib directly inhibited the activities of Lyn and Fyn, the upstream tyrosine kinases of Syk in MCs. Taken together, dasatinib suppresses MCs and PCA in vitro and in vivo through the inhibition of Lyn and Fyn Src-family kinases. Therefore, we suggest the possibility of repositioning the anti-cancer drug dasatinib as a treatment for various MC-mediated type I hypersensitive diseases.

Characterization and identification of charcoal of inedible Kerandang fish (Channa pleurophthalmus Blkr) body parts and potential antiallergenic properties

Background and Aim

The study about the antiallergenic properties of inedible fish body parts is still limited. Therefore, this study aimed to characterize the charcoal from the body parts of Kerandang fish (Channa pleurophthalmus Blkr) and identify its antiallergenic properties.

Materials and Methods

This study used some non-edible body parts extracted from the Kerandang fish (i.e., the scalp, scales, and dorsal, pectoral, ventral, anal, and caudal fins) using a maceration method with different solvents (ethanol, ethyl acetate, and chloroform). The identification of active compounds in the extract was carried out using liquid chromatography-high-resolution mass spectrometry (LC-HRMS) analysis, while the antihyaluronidase activity was determined using the antihyaluronidase test. The highest charcoal antihyaluronidase activity-extract was applied to ovalbumin-induced mice for 7 days with various doses (10, 15, and 20 mg/kg). The specific immunoglobulin E (IgE) was measured using enzyme-linked immunosorbent assay on day 8.

Results

Our LC-HRMS analysis showed that the active compound of charcoal in the caudal fins of Kerandang fish was hexadecanamide. The highest inhibition (IC₅₀) of hyaluronidase was found in the ethyl acetate extract of fish caudal fins at a concentration of 4 mg/mL. We found that 15 mg/kg body weight of charcoal of fish caudal fins suppressed IgE expression in male mice.

Conclusion

Our findings indicate that the charcoal of non-edible body parts of Kerandang and one of its constituent, hexadecanamide, may have strong antiallergic effects.

Using Patient Profiles To Guide The Choice Of Antihistamines In The Primary Care Setting In Malaysia: Expert Consensus And Recommendations

H1-antihistamines are recognized to be effective for conditions such as allergic rhinitis and chronic spontaneous urticaria. However, management of such conditions in the real-world primary care setting may be challenging due to diverse patient-specific considerations, the wide range of antihistamines available, choice of other treatment modalities, and the complexity of interpreting specialist treatment algorithms. Despite regular updates to international guidelines, regional/national surveys of healthcare professionals show a clear gap between guidelines and real-world practice, particularly at the primary care level. This article thus presents the consensus opinion of experts from relevant specialties in Malaysia - allergology, pediatrics, otorhinolaryngology, and dermtology - on harmonizing the use and choice of antihistamines in primary care. Patient profiling is recommended as a tool to guide primary care practitioners in prescribing the appropriate antihistamine for each patient. Patient profiling is a three-step approach that involves 1) identifying the individual's needs; 2) reviewing patient-specific considerations; and 3) monitoring treatment response and referral to specialists in more severe or difficult-to-treat cases. Concurrently, guidelct 3ines should be reviewed and updated periodically to include recommendations that are easily actionable for primary care practitioners.