摘要:

The prevalence of atopy was evaluated in two groups of subjects with hypersensitivity to nonsteroidal anti‐inflammatory drugs (NSAID):1). 78 patients with aspirin‐induced asthma (AIA) confirmed by oral or bronchial provocation challenges2). 42 subjects with hypersensitivity to pyrazolone drugs (case history and positive skin tests to noramidopyrine/aminophenazone) who tolerated aspirin well.Fifty sex‐ and age‐matched persons from an unselected general population, with no hypersensitivity to NSAID, formed the control group. Atopy was estimated from the results of the following clinical and biologic parameters:1). 1) personal and family history of atopic diseases2). 2) skin prick tests with 16 aeroallergens3). 3) serum levels of specific IgE to five aeroallergens4). 4) total serum IgE level.Different definitions of atopy were used, consisting of constellations of two or three of the above‐mentioned features. The results of the study revealed that the prevalence of atopy varied according to the criteria used for its definition. Irrespective of the definition used, a similar distribution of atopy was observed in both groups of patients with hypersensitivity to NSAID. Atopy was more frequent in either group of patients with intolerance of NSAID than in the control group. Thus, atopy is related to adverse dr

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04544.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04782.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Bukstein D. A., Biondi R. M., Blumenthal M. M., Dockhorn R. J., Filley W I!, Fink J., Goldstein S., Graft D. E, Hirsch S. R., Joos T. H., Melamed J., Rowe M. S., Townley R. G. Tilarin in combination with astemizole.This multicentre double‐blind, placebo controlled study had a practical objective, based on the expectation that many patients with seasonal allergic rhinitis will be prescribed oral antihistamine monotherapy by their primary care physician, whereas allergy specialists are more likely to prescribe combination therapy including antiinflammatories. The specific question was, ‘Will the addition of nedocromil sodium 1% nasal spray to astemizole tablets improve control of symptoms of seasonal allergic rhinitis induced by ragweed pollen, as compared to astemizole therapy alone?’. Following a one‐week baseline, planned to coincide with the start of the local ragweed pollen season, patients (aged 12–64) were randomly assigned to four weeks' double‐blind test treatment with either nedocromil sodium 1% nasal spray four times daily (QID)+astemizole (n=146) or placebo nasal spray+astemizole (n=148) or double‐dummy (nasal spray+capsules) placebo (n=71). Patient diary cards were kept throughout the five weeks, and clinic visits were made before and after baseline and after one and four weeks' treatment. During the 10‐day peak pollen period, the diary card rhinitis symptom summary score (0–1 severity scale) was significantly reduced in patients receiving either astemizole alone (p<0.001) or the combination therapy (p<0.001) as compared with placebo. Direct comparison of the active treatments further showed that symptoms were signficantly less severe (p<0.01) with the combined therapy than with astemizole alone, and this despite significantly greater reliance on permitted rescue medications (p<0.05 for pseudoephedrine usage) in the astemizole group. Clinical assessments of rhinitis made during the peak pollen visit, after the first week of test treatment, were also significantly (p<0.05‐p<0.01) in favour of combined therapy with nedocromil sodium 1% nasal spray+astemizole rather than astemizole alone, and at the same time this preference was confirmed by physician (p=0.011) and patient (p=0.003) opinions of symptom control. In conclusion, this antiinflammatory+ antihistamine treatment proved superior to antihistamine alone for effective management of allergic rhinitis. The combined therapy worked quickly and was well‐tolerated, with no serious adverse events or untoward effects on blo

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04775.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04783.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1999.tb04734.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In order to clarify the pathogenetic role of basophils and mast cells in chronic urticaria, histamine and leukotriene (LT)C4release was examined in washed mixed leukocytes (n= 8) and skin mast cells (n= 5) from patients with chronic urticaria and compared with the same cells from normal controls (n= 9). Anti‐IgE‐stimulated basophil histamine release was significantly reduced in urticaria patients (median 2.9%vs15.1% in normal controls), whereas histamine release to A23187. FMLP, and PAF, as well as anti‐IgE‐induced LTC4release, showed no differences in both groups. In contrast, anti‐IgE‐stimulated skin mast cells from urticaria patients reacted similarly to those of controls (median histamine release 11.4%vs14.2% in normal controls). Pretreatment of the cells with interleukin (IL)‐3 upregulated responsiveness of basophil histamine release to anti‐IgE in urticaria patients (median histamine release 14.3%), but pretreatment with the H2‐antagonist cimetidine showed no effect. These data show that reduced basophil histamine releasability in chronic urticaria is not H2mediated. It is a stimulus, mediator‐, and cell type‐restricted phenomenon that can, at least partially, be reversed in the presence

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04545.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04784.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Knottnerus I. G., Riley P A. A clinical overview of Tilarin.Tilarina® is a nasal spray containing 1% nedocromil sodium, a non‐toxic pyranoquinoline dicarboxylate compound with potent antiallergic antiinflammatory properties. As a first‐line topical treatment for seasonal allergic rhinitis (SAR) the pharmacokinetics of nedocromil sodium nasal formulation are such that it rivals sodium cromoglycate for safety. Less than 8% of the total dose of nedocromil sodium is systemically absorbed from the nasal mucosa, and this is reversibly bound to plasma proteins and is cleared rapidly from the circulation. Nedocromil sodium is eliminated unmetabolised in the urine and faeces, with an elimination half‐life of 5.3±20.9 minutes. No sigdcant adverse effects have been reported following intranasal administration of 1% nedocromil sodium four times daily, to a total of 964 patients with allergic rhinitis during clinical trials. Laboratory studies have shown that nedocromil sodium has a more wide‐ranging pharmacological antiinflammatory profile than sodium cromoglycate and this is manifest in its clinical efficacy in allergic asthma and rhinoconjunctivitis. Analysis of pooled data from a series of double‐blind, placebo‐controlled group comparative studies in SAR patients demonstrated that, despite a significantly lower use of rescue antihistamines than with placebo treatment (31% reduction; p=0.005), four times daily dosage with nedocromil sodium 1% nasal spray sigmficantly reduced daily symptoms of rhinitis (p<0.001) and was considered effective by the majority of patients (p<0.001). Specific examples of the therapeutic efficacy of nedocromil sodium compared with placebo in patients with grass or ragweed pollen SAR can be found in the literature. One ragweed study (1) included four times daily sodium cromoglycate 4% nasal spray as an active comparator and showed a consistent, if non‐significant, trend in favour of nedocromil sodium 1%, which was the more effective drug in comparison to placebo. An Italian paediatric study (2) compared nedocromil sodium 1% nasal spray with placebo in 149 children of whom 72% were under twelve years of age. After one week, the clinicians observed a significant reduction (p=0.03) in sneezing with nedocromil sodium and after four weeks, patient (p<0.01) and clinican (p<0.001) opinions favoured the active treatment. Overall, the clinical profile of topical nedocromil sodium in SAR demonstrates fast relief of existing symptoms, sustained efficacy with four times daily use during peak pollen challenge, and a reduced need for concomitant symptomatic therapies. Nedocromil sodium 1% nasal spray is well tolerated, with minimal side‐effects, and is acceptable to a wide age

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04776.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Okano M, Nagano T, Nakada M, Masuda Y, Kino K. Yasueda H, Nose Y, Nishimura Y, Ohta N. Epitope analysis of HLA‐DR‐restricted helper T‐cell responses toDer pII, a major allergen molecule ofDermatophagoides pteronyssinus.T‐cell epitopes ofDer pII, a major allergen ofDermatophagoidees pteronpssinus, were analyzed by using human T‐cell clones. We tested 38 cloned T cells from two Japanese patients with allergic rhinitis, and identified at least two peptides (K33–T47 and 158–C73) as helper T‐cell epitopes. The former epitope was shown to be restricted by HLA‐DRBI* 1502, and the latter by HLA‐DRB1 *0405, both of which are typical Japanese HLA‐DR alleles, suggesting that those T‐cell epitopes might be important for the onset of house‐dust mite allergy in the Japanese population. We prepared 15 analog peptides of the HLA‐DRB1*1502‐restricted 15‐mer peptide. Of those 15 residues, five (F35, L37, A39, F41. and E42) were critical for the epitope activity, and three residues (F35, A39, and E42) seemed to be included in anchor motifs for HLA‐DRB1*1502. The epitope peptide was also recognized by HLA‐DRB1*1502‐positive healthy donors; however. only allergic T cells showed Th2 functions. Antigen‐presenting cells of nonallergic donors were able to activate allergic T cells to express Th2 function. This seemed to suggest that antigen recognition of T cells, as well as additional unknown factors which promote Th2, rather than Th1, responses, might be important f

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04546.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1996.tb04785.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY