COVID-19 is an immune-mediated inflammatory disease caused by SARS-CoV-2 infection,the combination of anti-inflammatory and antiviral therapy is predicted to provide clinical benefits.We recently demonstrated that mas...COVID-19 is an immune-mediated inflammatory disease caused by SARS-CoV-2 infection,the combination of anti-inflammatory and antiviral therapy is predicted to provide clinical benefits.We recently demonstrated that mast cells(MCs)are an essential mediator of SARS-CoV-2-initiated hyperinflammation.We also showed that spike protein-induced MC degranulation initiates alveolar epithelial inflammation for barrier disruption and suggested an off-label use of antihistamines as MC stabilizers to block degranulation and consequently suppress inflammation and prevent lung injury.In this study,we emphasized the essential role of MCs in SARS-CoV-2-induced lung lesions in vivo,and demonstrated the benefits of co-administration of antihistamines and antiviral drug remdesivir in SARS-CoV-2-infected mice.Specifically,SARSCoV-2 spike protein-induced MC degranulation resulted in alveolar-capillary injury,while pretreatment of pulmonary microvascular endothelial cells with antihistamines prevented adhesion junction disruption;predictably,the combination of antiviral drug remdesivir with the antihistamine loratadine,a histamine receptor 1(HR1)antagonist,dampened viral replication and inflammation,thereby greatly reducing lung injury.Our findings emphasize the crucial role of MCs in SARS-CoV-2-induced inflammation and lung injury and provide a feasible combination antiviral and anti-inflammatory therapy for COVID-19 treatment.展开更多
BACKGROUND: Currently there is very limited data in the literature assessing the prevalence of antihistamine prescription, and there is no local prevalence data about the prescription of antihistamine agents among pri...BACKGROUND: Currently there is very limited data in the literature assessing the prevalence of antihistamine prescription, and there is no local prevalence data about the prescription of antihistamine agents among primary practitioner and emergency physicians. The objectives are 1) to report the prevalence of antihistamine prescription for children less than 6 years old with acute upper respiratory infection and 2) to explore the associated factors for the prescription practice.METHODS: This is a cross-sectional study. All consecutive cases of paediatric patients aged 6 or below who presented to the emergency department during a study period of one week from April 1 to July 4, 2009 with diagnosis of acute upper respiratory infection were included. Totally 162 patients were included.RESULTS: Among the 162 cases, 141(87%) patients were prescribed one antihistamine of any group. Sixty(37%) patients were prescribed two or more antihistamines. In multivariate logistic regression model, age was found to be signi? cantly(P<0.001) associated with multiple antihistamine prescription(OR=1.042, 95%CI=1.02 to 1.06). Years of graduation of attending physician for more than 5 years was also a strong predictor of multiple antihistamine prescription(OR=4.654, 95%CI=2.20 to 9.84, P<0.001).CONCLUSION: In the local emergency department, patients' age and the years of graduation from medical school of the attending physician were predictors of multiple antihistamine prescription for acute upper respiratory infections for children aged less than 6.展开更多
BACKGROUND Immunochemotherapy involving the combination of programmed cell death 1/programmed cell death ligand 1 inhibitors with chemotherapy has advanced the treatment of locally advanced esophageal squamous cell ca...BACKGROUND Immunochemotherapy involving the combination of programmed cell death 1/programmed cell death ligand 1 inhibitors with chemotherapy has advanced the treatment of locally advanced esophageal squamous cell carcinoma(ESCC).The use of corticosteroids as pretreatment might reduce immunotherapy efficacy.AIM To investigate the impact of baseline corticosteroid use on neoadjuvant immunochemotherapy(nIC)outcomes in locally advanced ESCC patients.METHODS Patients with locally advanced ESCC who received nIC at Sun Yat-sen University Cancer Center and the Third Affiliated Hospital of Sun Yat-sen University were included.Patients were divided into dexamethasone and antihistamine groups on the basis of the administered pretreatment.Antiallergic efficacy and safety were evaluated,as well as its impact on short-term efficacy[complete pathological response(pCR),major pathological response(MPR)]and long-term efficacy[overall survival(OS),progression-free survival(PFS)]of nIC.RESULTS From September 2019 to September 2023,142 patients were analyzed.No severe treatment-related adverse events or deaths were observed.Allergy occurrence was greater in the antihistamine group(P=0.014).Short-term efficacy was not significantly different:The pCR rates were 29.9%and 40.0%,and the MPR rates were 57.9%and 65.7%in the dexamethasone and antihistamine groups,respectively.The long-term efficacy was not significantly different:The 2 years OS rates were 95.2%and 93.5%,and the 2 years PFS rates were 90.3%and 87.8%.Subgroup analysis revealed no difference in OS between the 20 mg dexamethasone group and the<20 mg dexamethasone group,but PFS was significantly greater in the 20 mg dexamethasone group(93.9%vs 56.4%,P=0.001).CONCLUSION Dexamethasone or antihistamines can be used before nIC in locally advanced ESCC without affecting short-or long-term efficacy.Administering 20 mg dexamethasone before nIC may improve PFS in ESCC.展开更多
Purpose: Interstitial cystitis/Bladder pain syndrome is an inflammatory disorder of the bladder, for which histamine has been implicated in the pathogenesis of the disease. The condition is often refractory to standar...Purpose: Interstitial cystitis/Bladder pain syndrome is an inflammatory disorder of the bladder, for which histamine has been implicated in the pathogenesis of the disease. The condition is often refractory to standard-of-care medical treatments, including the antihistamines hydroxyzine or cimetidine, and procedures. Herein we report a physician-sponsored proof-of-principle case series of four adult female patients with chronic painful bladder and frequent urination, who were treated once daily with a low dose H1 + H2 histamine receptor antagonist combination. Materials and Methods: Four adult females with Interstitial cystitis/Bladder pain syndrome were treated once daily with a compounded oral dosage form containing the H1 receptor antagonist-cetirizine 8 mg in combination with the H2 receptor antagonist-famotidine 22 mg. The case series consists of a retrospective review of the symptom severity prior to versus following H1 + H2 treatment. Results and Conclusions: The once daily dual histamine receptor antagonist therapy substantially reduced the pain and urination frequency, and prophylactically maintained all four patients long-term with substantially reduced disease severity. The reduction in symptom severity was achieved at amounts that do not exceed the US FDA approved and exceptionally safe daily doses for the two over-the-counter monotherapies. This case series provides proof-of-principle evidence that a dual antihistamine combination of cetirizine plus famotidine effectively treated and maintained female patients, who were previously refractory to standard-of-care medications and/or procedures.展开更多
Objective: To test the efficacy of a new topical vehicle formulation containing cetirizine in emu oil in treating inflammatory skin conditions. Methods: A single blind half body comparative study of patients with psor...Objective: To test the efficacy of a new topical vehicle formulation containing cetirizine in emu oil in treating inflammatory skin conditions. Methods: A single blind half body comparative study of patients with psoriasis, atopic and stasis dermatitis were all treated with midpotency topical steroid (desoximethasone) in propylene glycol base, desoximethasone and cetirizine in propylene glycol base, desoximethasone in emu oil base and desoximethasone with cetirizine dissolved in emu oil. Results: Based on patients’ ranking of creams’ efficacy, and supported by photographic data and investigators’ clinical assessment, results clearly indicated that desoximethasone and cetirizine in emu base was statistically more efficacious than either desoximethasone alone or with cetirizine in neutral propylene glycol base or desoximethasone in emu oil base (without cetirizine). Conclusions: Cetirizine and emu oil, having inherent anti-inflammatory and other beneficial properties synergistically, and by different biochemical pathways, enhance and magnify each other’s pharmaceutical effects that are useful in treatment of skin inflammatory diseases.展开更多
Objective: To investigate the antihistamine-releasing effect of a peptide isolated from wasp venom of Vespa orientalis.Methods: This peptide was separated from crude venom by chromatography methods and mass spectromet...Objective: To investigate the antihistamine-releasing effect of a peptide isolated from wasp venom of Vespa orientalis.Methods: This peptide was separated from crude venom by chromatography methods and mass spectrometry. Then various concentrations(2, 4, 8, 16, 32, 64, 128 and256 mmol/L) of the peptide were incubated with mast cells and lactate dehydrogenase assay was performed.Results: No significant effect was observed in lactate dehydrogenase absorbance under128 mmol/L concentration. This implied that the peptide did not cause cell death in mast cells and consequently, histamine release did not happen. Moreover, the results showed the IC50 of mast cells degranulation at 126 mmol/L, which was approximately high implying that this peptide had high selectivity for normal cells and did not cause histamine release from these cells.Conclusions: This would be a great aim in new drug development, in which an agent acts potentially on its target tissue without activating the immune system.展开更多
Nasal obstruction, a primary symptom of allergic rhinitis, results in breathing difficulties and decreases quality of life in patients. Quantitative methods are required for diagnosis of nasal obstruction to accuratel...Nasal obstruction, a primary symptom of allergic rhinitis, results in breathing difficulties and decreases quality of life in patients. Quantitative methods are required for diagnosis of nasal obstruction to accurately assess drug efficacy, not only in patients but also in animal models. Acoustic rhinometry is a non-invasive technique to measure nasal airway patency using acoustic reflections. To date, little information on its application in non-human primates (NHP) has been accumulated. Macaque monkeys are a practical NHP model because of their high similarity with humans in their biomedical nature, including genomic and immunologic events and morphology. We established an allergic rhinitis model of cynomolgusmacaque (Macaca fascicularis) sensitized with Japanese cedar pollen and applied acoustic rhinometry to measure nasal congestion. The extent of nasal congestion followed by allergen challenge was successfully quantified as the minimal cross-sectional area (MCA) of the nasal passage for the first time in an NHP allergic model. We also applied this acoustic technique to evaluate the efficacy of an antihistamine drug, fexofenadine. The acoustic assessment achieved quantitative evaluation of the efficacy of fexofenadine on nasal congestion in a macaque allergic model.展开更多
Objective:To evaluate the efficacy and safety of Peitu Shengjin prescription versus H1 antihistamine in the treatment of allergic rhinitis.Methods:Electronic searching"China Knowledge Network","Wanfang ...Objective:To evaluate the efficacy and safety of Peitu Shengjin prescription versus H1 antihistamine in the treatment of allergic rhinitis.Methods:Electronic searching"China Knowledge Network","Wanfang Database","Vip Database","Chinese Biomedical Literature Database",PubMed,Embase,The Cochrane Library,all published on the prescription of Peitu Shengjin prescription comparison H1 antihistamine In randomized controlled trials(RCTs)of drug treatment of allergic rhinitis,two researchers screened the literature according to the inclusion and exclusion criteria,and conducted Meta-analysis using RevMan5.3 software.Results:A total of 22 studies were involved,involving a total of 1463 subjects,including 822 in the treatment group and 641 in the control group.Meta-analysis results show that compared with oral H1 antihistamines,Peitu Shengjin prescription can improve the total effective rate of allergic rhinitis(RR=1.19,95%CI[1.14,1.24],P<0.00001);reduce recurrence Rate(RR=0.46,95%CI[0.23,0.90],P=0.02);reduce serum IL-6(MD=-17.33,95%CI[-21.96,-12.70],P<0.00001)and serum IL-8(MD=-100.35,95%CI[-175.18,-25.52],P=0.009);reduce the patient’s total score of symptoms and signs(SMD=-1.21,95%CI[-1.82,-0.61],P<0.0001)And TCM symptom scores(SMD=-0.98,95%CI[-1.28,-0.68],P<0.00001);superior to the control group in improving patients'nasal congestion,nasal itching,and turbinate/nasal mucosa enlargement,in improving runny nose There is no obvious advantage compared with the control group in terms of sneezing symptoms;in terms of safety,there are fewer mild adverse reactions in the treatment group(RD=-0.05,95%CI[-0.09,-0.00],P=0.04).Conclusion:Compared with H1 antihistamine,Peitu Shengjin prescription can improve clinical efficacy,improve patients'symptoms and signs and TCM symptoms,regulate immune function,and is not easy to relapse and has good safety.展开更多
Background:Chronic urticaria(CU)is a common skin disease,which has a negative effect on quality of life.Current treatments do not fully control the symptoms of urticaria for many CU patients,thus effective and safe tr...Background:Chronic urticaria(CU)is a common skin disease,which has a negative effect on quality of life.Current treatments do not fully control the symptoms of urticaria for many CU patients,thus effective and safe treatments for CU are still needed.Objective:This review aims to evaluate the effectiveness and safety of cupping therapy in patients with CU.Search strategy:The search strategy looked for the presence of related keywords,such as‘‘chronic urticaria"and‘‘cupping therapy,"in the title and abstract of research articles indexed in major databases.Randomized controlled trials(RCTs)were selected after querying nine electronic databases from their inception to May 2019 with the above search terms.Inclusion criteria:RCTs were included if they recruited patients with CU who were intervened with dry or wet cupping.Publications could be written in Chinese or English.Data extraction and analysis:Data were extracted,and the studies were assessed for the quality of their methodological design and risk of bias.Meta-analyses of the RCT data were conducted to assess the total effective rate of the treatment as the primary outcome.Skin disease quality of life index score,recurrence rate,and adverse events were assessed as secondary outcomes.Subgroup analyses were conducted based on different interventions.Results:Thirteen comparisons from 12 RCTs involving 842 participants were included.There were no significant differences between wet cupping and medications in total effective rate(n=372;risk ratio[RR]=1.10,95%confidence interval[CI]0.97 to 1.25;P=0.14)or recurrence rate(n=240;RR=0.56,95%CI 0.23 to 1.36;P=0.20).Cupping therapy,in combination with antihistamine treatment was more efficacious than antihistamines alone,with a greater total effective rate(n=342;RR=1.18,95%CI 1.01 to1.39;P=0.03)and lower recurrence rate(n=342;RR=0.52,95%CI 0.32 to 0.84;P=0.007).Cupping therapy combined with acupuncture was more effective than acupuncture alone(n=156;RR=1.25,95%CI 1.07 to 1.46;P=0.006).No serious adverse events were reported.Conclusion:Wet cupping may be as effective as treatment with antihistamines.When cupping therapy is used as an adjuvant therapy to antihistamines or acupuncture,it may enhance the efficacy.Results drawn from these studies should be interpreted with caution and applied with care to clinical practice,because of the poor quality among the studies that were reviewed.Systematic review registration:PROSPERO,CRD42019137451.展开更多
BACKGROUND： Zingiber cassumunar Roxb., commonly known as Phlai in Thai, has been used as a traditional medicine in Thailand for the treatment of various diseases, including inflammation and chronic airway disease. OB...BACKGROUND： Zingiber cassumunar Roxb., commonly known as Phlai in Thai, has been used as a traditional medicine in Thailand for the treatment of various diseases, including inflammation and chronic airway disease. OBJECTIVE： The purpose of this study was to assess the antihistaminic effect of Phlai on skin testing DESIGN, SETTING, PARTICIPANTS AND INTERVENTION： This was a randomized, open-label, three- way crossover study. Twenty allergic rhinitis （AR） patients were enrolled. In randomized sequence, patients received a single dose of Ph/ai capsules （100 or 200 mg） or Ioratadine （10 mg） with a washout period of 1 week between each treatment. MAIN OUTCOME MEASURES： Skin prick testing for histamine and common aeroallergen （house dust mite） were performed before treatment and after 1,2, 3, 4, 6, 8, 12 and 24 hours of treatment. The main treatment outcomes were the mean wheal and flare responses to the skin prick test after treatment. RESULTS： Both 100 mg and 200 mg Phlai doses suppressed wheal and flare responses to house dust mite allergen, but only 200 mg of Phlai capsules significantly suppressed wheal and flare responses to histamine. Repeated measures analysis of variance showed that Ioratadine caused more wheal and flare suppression than Phial capsules in responses to the histamine skin prick test. However, there were no significant differences among the effects of 100 mg Phlai capsules, 200 mg Phlai capsules and Ioratadine in suppression of wheal and flare induced by the mite skin prick test. Both doses of Phlai were well-tolerated with no adverse events.CONCLUSION： Both 100 mg （compound D 4 mg） when taken as a single therapeutic dose, inhibited AR patients. and 200 mg （compound D 8 mg） Phlai capsules, skin reactivity to histamine and mite skin prick tests in TRIAL REGISTRATION： Thai clinical trial registry （TCTR20160510001）展开更多
A series of benzimidazole derivatives have been designed, synthesized and evaluated for H1 antihistamine activity. Six compounds have showed potent antihistamine H1 activity. The primary SAR analysis indicated that be...A series of benzimidazole derivatives have been designed, synthesized and evaluated for H1 antihistamine activity. Six compounds have showed potent antihistamine H1 activity. The primary SAR analysis indicated that benzyl or benzylidinyl substituted on the exo-nitrogen atom and C2 of the benzimidazole were significant. Further experiments indicated that compound 17d displayed excellent activity to reduce mast cell degranulation, moderate anti-PAF activity and decreased potency on hERG compared to astennizole. Hence compound 17d could serve as anti-allergic agent for further development.展开更多
Objective:To study the effect of Jumihaidokuto(Shi-Wei-Bai-Du-Tang,十味败毒汤)in the management of chronic spontaneous urticaria.Methods:A randomized two-arm,parallel group study was conducted to compare the effect of...Objective:To study the effect of Jumihaidokuto(Shi-Wei-Bai-Du-Tang,十味败毒汤)in the management of chronic spontaneous urticaria.Methods:A randomized two-arm,parallel group study was conducted to compare the effect of Jumihaidokuto(6 g daily)with a control for 8 weeks.Concomitant therapy(e.g.,antihistamines)was continued.Twenty?one subjects with severe chronic urticaria were enrolled in this study.The primary treatment outcome was the severity score proposed by the Japanese Dermatological Association.Secondary outcomes were quality of life(Skindex-16),itch intensity(Visual Analogue Scale),and patients'subjective disability due to wheal or itch.After the subjects were randomly assigned to groups by block randomization,10 received Jumihaidokuto,and 11 did not.All subjects had already taken antihistamines.Results:Improvement was significant when comparing the severity score of the Jumihaidokuto group with that of the control group(P<0.01).Skindex-16 values for both groups gradually decreased in the same fashion.Conclusion:Concomitant use of Jumihaidokuto with antihistamine was more effective than antihistamine alone in the management of chronic idiopathic urticaria.展开更多
Objective:Serum total IgE (tlgE) levels are elevated in patients with chronic urticaria (CU);however,the nature of the elevated serum tlgE level in CU patients remains unclear.The aim of this study was to investigate ...Objective:Serum total IgE (tlgE) levels are elevated in patients with chronic urticaria (CU);however,the nature of the elevated serum tlgE level in CU patients remains unclear.The aim of this study was to investigate the relationship between elevated serum levels of tlgE in patients with CU and the sensitivity of these patients to antihistamine treatments.Methods:Blood samples of 302 patients with CU were collected,and their levels of serum tlgE were measured.The patients were divided into two groups according to their serum tlgE level:High serum tlgE level group (>150 U/mL)and Low serum tlgE level group (< 150 U/mL).The correlations between the serum tlgE end disease severity as well as the sensitivity of patients to antihistamine treatments were assessed.Data were statistically analyzed using t-tasts and Chi-square tests.Results:Higher rates of positive autologous serum skin test results (X2=5.707,P=0.017) and skin scratch test results (x2 =5.878,P=0.015),higher CU scores (average:2.88±0.73 vs.2.18±0.59,t =6.377,P< 0.001),and longer disease course durations (median:8.5 vs.14.6,z=5.525,P<0.001) were observed in patients with high levels of serum tlgE compared with those with low levels of serum tlgE;moreover,patients with higher levels of serum tlgE were less sensitive to antihistamine therapies compared with those with lower levels of serum tlgE (x2=16.783,P < 0.001).Conclusion:Our study indicates that the high serum tlgE level is associated with the disease severity as well as with low sensitivity to antihistamine treatment of patients.展开更多
基金supported by the National Natural Science Foundation of China(82172242,81873965)State Key Laboratory of Respiratory Disease,Guangzhou,China(SKLRD-OP-202207)+2 种基金National Key R&D Program of China(2020YFC0842000)Natural Science Foundation of Guangdong(2022A1515012053)Key Project from the Chinese Academy of Sciences(QYZDB-SSWSMC059)。
文摘COVID-19 is an immune-mediated inflammatory disease caused by SARS-CoV-2 infection,the combination of anti-inflammatory and antiviral therapy is predicted to provide clinical benefits.We recently demonstrated that mast cells(MCs)are an essential mediator of SARS-CoV-2-initiated hyperinflammation.We also showed that spike protein-induced MC degranulation initiates alveolar epithelial inflammation for barrier disruption and suggested an off-label use of antihistamines as MC stabilizers to block degranulation and consequently suppress inflammation and prevent lung injury.In this study,we emphasized the essential role of MCs in SARS-CoV-2-induced lung lesions in vivo,and demonstrated the benefits of co-administration of antihistamines and antiviral drug remdesivir in SARS-CoV-2-infected mice.Specifically,SARSCoV-2 spike protein-induced MC degranulation resulted in alveolar-capillary injury,while pretreatment of pulmonary microvascular endothelial cells with antihistamines prevented adhesion junction disruption;predictably,the combination of antiviral drug remdesivir with the antihistamine loratadine,a histamine receptor 1(HR1)antagonist,dampened viral replication and inflammation,thereby greatly reducing lung injury.Our findings emphasize the crucial role of MCs in SARS-CoV-2-induced inflammation and lung injury and provide a feasible combination antiviral and anti-inflammatory therapy for COVID-19 treatment.
文摘BACKGROUND: Currently there is very limited data in the literature assessing the prevalence of antihistamine prescription, and there is no local prevalence data about the prescription of antihistamine agents among primary practitioner and emergency physicians. The objectives are 1) to report the prevalence of antihistamine prescription for children less than 6 years old with acute upper respiratory infection and 2) to explore the associated factors for the prescription practice.METHODS: This is a cross-sectional study. All consecutive cases of paediatric patients aged 6 or below who presented to the emergency department during a study period of one week from April 1 to July 4, 2009 with diagnosis of acute upper respiratory infection were included. Totally 162 patients were included.RESULTS: Among the 162 cases, 141(87%) patients were prescribed one antihistamine of any group. Sixty(37%) patients were prescribed two or more antihistamines. In multivariate logistic regression model, age was found to be signi? cantly(P<0.001) associated with multiple antihistamine prescription(OR=1.042, 95%CI=1.02 to 1.06). Years of graduation of attending physician for more than 5 years was also a strong predictor of multiple antihistamine prescription(OR=4.654, 95%CI=2.20 to 9.84, P<0.001).CONCLUSION: In the local emergency department, patients' age and the years of graduation from medical school of the attending physician were predictors of multiple antihistamine prescription for acute upper respiratory infections for children aged less than 6.
文摘BACKGROUND Immunochemotherapy involving the combination of programmed cell death 1/programmed cell death ligand 1 inhibitors with chemotherapy has advanced the treatment of locally advanced esophageal squamous cell carcinoma(ESCC).The use of corticosteroids as pretreatment might reduce immunotherapy efficacy.AIM To investigate the impact of baseline corticosteroid use on neoadjuvant immunochemotherapy(nIC)outcomes in locally advanced ESCC patients.METHODS Patients with locally advanced ESCC who received nIC at Sun Yat-sen University Cancer Center and the Third Affiliated Hospital of Sun Yat-sen University were included.Patients were divided into dexamethasone and antihistamine groups on the basis of the administered pretreatment.Antiallergic efficacy and safety were evaluated,as well as its impact on short-term efficacy[complete pathological response(pCR),major pathological response(MPR)]and long-term efficacy[overall survival(OS),progression-free survival(PFS)]of nIC.RESULTS From September 2019 to September 2023,142 patients were analyzed.No severe treatment-related adverse events or deaths were observed.Allergy occurrence was greater in the antihistamine group(P=0.014).Short-term efficacy was not significantly different:The pCR rates were 29.9%and 40.0%,and the MPR rates were 57.9%and 65.7%in the dexamethasone and antihistamine groups,respectively.The long-term efficacy was not significantly different:The 2 years OS rates were 95.2%and 93.5%,and the 2 years PFS rates were 90.3%and 87.8%.Subgroup analysis revealed no difference in OS between the 20 mg dexamethasone group and the<20 mg dexamethasone group,but PFS was significantly greater in the 20 mg dexamethasone group(93.9%vs 56.4%,P=0.001).CONCLUSION Dexamethasone or antihistamines can be used before nIC in locally advanced ESCC without affecting short-or long-term efficacy.Administering 20 mg dexamethasone before nIC may improve PFS in ESCC.
文摘Purpose: Interstitial cystitis/Bladder pain syndrome is an inflammatory disorder of the bladder, for which histamine has been implicated in the pathogenesis of the disease. The condition is often refractory to standard-of-care medical treatments, including the antihistamines hydroxyzine or cimetidine, and procedures. Herein we report a physician-sponsored proof-of-principle case series of four adult female patients with chronic painful bladder and frequent urination, who were treated once daily with a low dose H1 + H2 histamine receptor antagonist combination. Materials and Methods: Four adult females with Interstitial cystitis/Bladder pain syndrome were treated once daily with a compounded oral dosage form containing the H1 receptor antagonist-cetirizine 8 mg in combination with the H2 receptor antagonist-famotidine 22 mg. The case series consists of a retrospective review of the symptom severity prior to versus following H1 + H2 treatment. Results and Conclusions: The once daily dual histamine receptor antagonist therapy substantially reduced the pain and urination frequency, and prophylactically maintained all four patients long-term with substantially reduced disease severity. The reduction in symptom severity was achieved at amounts that do not exceed the US FDA approved and exceptionally safe daily doses for the two over-the-counter monotherapies. This case series provides proof-of-principle evidence that a dual antihistamine combination of cetirizine plus famotidine effectively treated and maintained female patients, who were previously refractory to standard-of-care medications and/or procedures.
文摘Objective: To test the efficacy of a new topical vehicle formulation containing cetirizine in emu oil in treating inflammatory skin conditions. Methods: A single blind half body comparative study of patients with psoriasis, atopic and stasis dermatitis were all treated with midpotency topical steroid (desoximethasone) in propylene glycol base, desoximethasone and cetirizine in propylene glycol base, desoximethasone in emu oil base and desoximethasone with cetirizine dissolved in emu oil. Results: Based on patients’ ranking of creams’ efficacy, and supported by photographic data and investigators’ clinical assessment, results clearly indicated that desoximethasone and cetirizine in emu base was statistically more efficacious than either desoximethasone alone or with cetirizine in neutral propylene glycol base or desoximethasone in emu oil base (without cetirizine). Conclusions: Cetirizine and emu oil, having inherent anti-inflammatory and other beneficial properties synergistically, and by different biochemical pathways, enhance and magnify each other’s pharmaceutical effects that are useful in treatment of skin inflammatory diseases.
基金financially supported by Natural Antimicrobial Centre of Excellence of Shiraz University
文摘Objective: To investigate the antihistamine-releasing effect of a peptide isolated from wasp venom of Vespa orientalis.Methods: This peptide was separated from crude venom by chromatography methods and mass spectrometry. Then various concentrations(2, 4, 8, 16, 32, 64, 128 and256 mmol/L) of the peptide were incubated with mast cells and lactate dehydrogenase assay was performed.Results: No significant effect was observed in lactate dehydrogenase absorbance under128 mmol/L concentration. This implied that the peptide did not cause cell death in mast cells and consequently, histamine release did not happen. Moreover, the results showed the IC50 of mast cells degranulation at 126 mmol/L, which was approximately high implying that this peptide had high selectivity for normal cells and did not cause histamine release from these cells.Conclusions: This would be a great aim in new drug development, in which an agent acts potentially on its target tissue without activating the immune system.
文摘Nasal obstruction, a primary symptom of allergic rhinitis, results in breathing difficulties and decreases quality of life in patients. Quantitative methods are required for diagnosis of nasal obstruction to accurately assess drug efficacy, not only in patients but also in animal models. Acoustic rhinometry is a non-invasive technique to measure nasal airway patency using acoustic reflections. To date, little information on its application in non-human primates (NHP) has been accumulated. Macaque monkeys are a practical NHP model because of their high similarity with humans in their biomedical nature, including genomic and immunologic events and morphology. We established an allergic rhinitis model of cynomolgusmacaque (Macaca fascicularis) sensitized with Japanese cedar pollen and applied acoustic rhinometry to measure nasal congestion. The extent of nasal congestion followed by allergen challenge was successfully quantified as the minimal cross-sectional area (MCA) of the nasal passage for the first time in an NHP allergic model. We also applied this acoustic technique to evaluate the efficacy of an antihistamine drug, fexofenadine. The acoustic assessment achieved quantitative evaluation of the efficacy of fexofenadine on nasal congestion in a macaque allergic model.
基金Research and Development project of"Ten Diseases and ten Drugs"of Beijing Municipal Commission of Science and Technology(No.Z141100002214018)。
文摘Objective:To evaluate the efficacy and safety of Peitu Shengjin prescription versus H1 antihistamine in the treatment of allergic rhinitis.Methods:Electronic searching"China Knowledge Network","Wanfang Database","Vip Database","Chinese Biomedical Literature Database",PubMed,Embase,The Cochrane Library,all published on the prescription of Peitu Shengjin prescription comparison H1 antihistamine In randomized controlled trials(RCTs)of drug treatment of allergic rhinitis,two researchers screened the literature according to the inclusion and exclusion criteria,and conducted Meta-analysis using RevMan5.3 software.Results:A total of 22 studies were involved,involving a total of 1463 subjects,including 822 in the treatment group and 641 in the control group.Meta-analysis results show that compared with oral H1 antihistamines,Peitu Shengjin prescription can improve the total effective rate of allergic rhinitis(RR=1.19,95%CI[1.14,1.24],P<0.00001);reduce recurrence Rate(RR=0.46,95%CI[0.23,0.90],P=0.02);reduce serum IL-6(MD=-17.33,95%CI[-21.96,-12.70],P<0.00001)and serum IL-8(MD=-100.35,95%CI[-175.18,-25.52],P=0.009);reduce the patient’s total score of symptoms and signs(SMD=-1.21,95%CI[-1.82,-0.61],P<0.0001)And TCM symptom scores(SMD=-0.98,95%CI[-1.28,-0.68],P<0.00001);superior to the control group in improving patients'nasal congestion,nasal itching,and turbinate/nasal mucosa enlargement,in improving runny nose There is no obvious advantage compared with the control group in terms of sneezing symptoms;in terms of safety,there are fewer mild adverse reactions in the treatment group(RD=-0.05,95%CI[-0.09,-0.00],P=0.04).Conclusion:Compared with H1 antihistamine,Peitu Shengjin prescription can improve clinical efficacy,improve patients'symptoms and signs and TCM symptoms,regulate immune function,and is not easy to relapse and has good safety.
基金supported by the National Key Research and Development Program of the China-Key Project“Research on Modernization of Traditional Chinese Medicine”——“International Cooperation Research on Evaluation of Acupuncture Advantage Diseases”(No.2017YFC1703600 and 2017YFC1703605)。
文摘Background:Chronic urticaria(CU)is a common skin disease,which has a negative effect on quality of life.Current treatments do not fully control the symptoms of urticaria for many CU patients,thus effective and safe treatments for CU are still needed.Objective:This review aims to evaluate the effectiveness and safety of cupping therapy in patients with CU.Search strategy:The search strategy looked for the presence of related keywords,such as‘‘chronic urticaria"and‘‘cupping therapy,"in the title and abstract of research articles indexed in major databases.Randomized controlled trials(RCTs)were selected after querying nine electronic databases from their inception to May 2019 with the above search terms.Inclusion criteria:RCTs were included if they recruited patients with CU who were intervened with dry or wet cupping.Publications could be written in Chinese or English.Data extraction and analysis:Data were extracted,and the studies were assessed for the quality of their methodological design and risk of bias.Meta-analyses of the RCT data were conducted to assess the total effective rate of the treatment as the primary outcome.Skin disease quality of life index score,recurrence rate,and adverse events were assessed as secondary outcomes.Subgroup analyses were conducted based on different interventions.Results:Thirteen comparisons from 12 RCTs involving 842 participants were included.There were no significant differences between wet cupping and medications in total effective rate(n=372;risk ratio[RR]=1.10,95%confidence interval[CI]0.97 to 1.25;P=0.14)or recurrence rate(n=240;RR=0.56,95%CI 0.23 to 1.36;P=0.20).Cupping therapy,in combination with antihistamine treatment was more efficacious than antihistamines alone,with a greater total effective rate(n=342;RR=1.18,95%CI 1.01 to1.39;P=0.03)and lower recurrence rate(n=342;RR=0.52,95%CI 0.32 to 0.84;P=0.007).Cupping therapy combined with acupuncture was more effective than acupuncture alone(n=156;RR=1.25,95%CI 1.07 to 1.46;P=0.006).No serious adverse events were reported.Conclusion:Wet cupping may be as effective as treatment with antihistamines.When cupping therapy is used as an adjuvant therapy to antihistamines or acupuncture,it may enhance the efficacy.Results drawn from these studies should be interpreted with caution and applied with care to clinical practice,because of the poor quality among the studies that were reviewed.Systematic review registration:PROSPERO,CRD42019137451.
基金supported in part, by research grants from Thai Traditional Medical Knowledge Fund, Ministry of Public HealthThammasat University research fund, Thailand (Fund number 3/2556)
文摘BACKGROUND： Zingiber cassumunar Roxb., commonly known as Phlai in Thai, has been used as a traditional medicine in Thailand for the treatment of various diseases, including inflammation and chronic airway disease. OBJECTIVE： The purpose of this study was to assess the antihistaminic effect of Phlai on skin testing DESIGN, SETTING, PARTICIPANTS AND INTERVENTION： This was a randomized, open-label, three- way crossover study. Twenty allergic rhinitis （AR） patients were enrolled. In randomized sequence, patients received a single dose of Ph/ai capsules （100 or 200 mg） or Ioratadine （10 mg） with a washout period of 1 week between each treatment. MAIN OUTCOME MEASURES： Skin prick testing for histamine and common aeroallergen （house dust mite） were performed before treatment and after 1,2, 3, 4, 6, 8, 12 and 24 hours of treatment. The main treatment outcomes were the mean wheal and flare responses to the skin prick test after treatment. RESULTS： Both 100 mg and 200 mg Phlai doses suppressed wheal and flare responses to house dust mite allergen, but only 200 mg of Phlai capsules significantly suppressed wheal and flare responses to histamine. Repeated measures analysis of variance showed that Ioratadine caused more wheal and flare suppression than Phial capsules in responses to the histamine skin prick test. However, there were no significant differences among the effects of 100 mg Phlai capsules, 200 mg Phlai capsules and Ioratadine in suppression of wheal and flare induced by the mite skin prick test. Both doses of Phlai were well-tolerated with no adverse events.CONCLUSION： Both 100 mg （compound D 4 mg） when taken as a single therapeutic dose, inhibited AR patients. and 200 mg （compound D 8 mg） Phlai capsules, skin reactivity to histamine and mite skin prick tests in TRIAL REGISTRATION： Thai clinical trial registry （TCTR20160510001）
基金supported by National Major Scientific and Technological Special Project(No.2009ZX09301 -003)
文摘A series of benzimidazole derivatives have been designed, synthesized and evaluated for H1 antihistamine activity. Six compounds have showed potent antihistamine H1 activity. The primary SAR analysis indicated that benzyl or benzylidinyl substituted on the exo-nitrogen atom and C2 of the benzimidazole were significant. Further experiments indicated that compound 17d displayed excellent activity to reduce mast cell degranulation, moderate anti-PAF activity and decreased potency on hERG compared to astennizole. Hence compound 17d could serve as anti-allergic agent for further development.
文摘Objective:To study the effect of Jumihaidokuto(Shi-Wei-Bai-Du-Tang,十味败毒汤)in the management of chronic spontaneous urticaria.Methods:A randomized two-arm,parallel group study was conducted to compare the effect of Jumihaidokuto(6 g daily)with a control for 8 weeks.Concomitant therapy(e.g.,antihistamines)was continued.Twenty?one subjects with severe chronic urticaria were enrolled in this study.The primary treatment outcome was the severity score proposed by the Japanese Dermatological Association.Secondary outcomes were quality of life(Skindex-16),itch intensity(Visual Analogue Scale),and patients'subjective disability due to wheal or itch.After the subjects were randomly assigned to groups by block randomization,10 received Jumihaidokuto,and 11 did not.All subjects had already taken antihistamines.Results:Improvement was significant when comparing the severity score of the Jumihaidokuto group with that of the control group(P<0.01).Skindex-16 values for both groups gradually decreased in the same fashion.Conclusion:Concomitant use of Jumihaidokuto with antihistamine was more effective than antihistamine alone in the management of chronic idiopathic urticaria.
文摘Objective:Serum total IgE (tlgE) levels are elevated in patients with chronic urticaria (CU);however,the nature of the elevated serum tlgE level in CU patients remains unclear.The aim of this study was to investigate the relationship between elevated serum levels of tlgE in patients with CU and the sensitivity of these patients to antihistamine treatments.Methods:Blood samples of 302 patients with CU were collected,and their levels of serum tlgE were measured.The patients were divided into two groups according to their serum tlgE level:High serum tlgE level group (>150 U/mL)and Low serum tlgE level group (< 150 U/mL).The correlations between the serum tlgE end disease severity as well as the sensitivity of patients to antihistamine treatments were assessed.Data were statistically analyzed using t-tasts and Chi-square tests.Results:Higher rates of positive autologous serum skin test results (X2=5.707,P=0.017) and skin scratch test results (x2 =5.878,P=0.015),higher CU scores (average:2.88±0.73 vs.2.18±0.59,t =6.377,P< 0.001),and longer disease course durations (median:8.5 vs.14.6,z=5.525,P<0.001) were observed in patients with high levels of serum tlgE compared with those with low levels of serum tlgE;moreover,patients with higher levels of serum tlgE were less sensitive to antihistamine therapies compared with those with lower levels of serum tlgE (x2=16.783,P < 0.001).Conclusion:Our study indicates that the high serum tlgE level is associated with the disease severity as well as with low sensitivity to antihistamine treatment of patients.
