Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

108 pollen-sensitive persons (positive skin test, positive history) and 40 latent pollen-allergic persons (positive skin test, but no conjunctival or nasal manifestations during the flowering season) were given intranasally increasing concentrations of pollen extract until a reaction occurred (itching, sneezing, running and blocked nose). 7.4% of the patients reacted to 0.001% w/v of the pollen extract, 56.5% reacted to 0.01, and 36% to a dose of 0.1% w/v. The corresponding figures for persons with latent allergy were 0.7, 5 and 30%; 62.5% reacted to 1.0 or 2.5% w/v of the extract. There was a relatively sharp division between doses of 0.1 and 1.0% w/v: persons who responded only to 1% concentrations invariably belonged to the group of latent allergy. 35 persons with positive skin tests to dust mites were divided into 3 groups: those with either a positive or a negative history of dust allergy and those concentrations of dust mite extracts (0.012, 0.12 and 1.2% w/v). Patients were considered to have latent allergy if they were sensitive to dust mite but were free from symptoms; or if they were sensitive to dust mite and pollen, but were symptom-free outside the flowering season. Although the group reacted slightly more often only to concentrations of 1.2%, the nasal response occurred on the whole with the same frequency with all three concentrations. In contrast to pollen allergy a positive intranasal dust mite test is not necessarily clinically relevant. Provocation tests are, therefore, not an infallible means to ascertain the presence of clinically relevant allergy.
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PMID:[The clinical significance of challenge tests (author's transl)]. 46 9

Sixteen patients with allergic rhinitis were recruited into a double-blind crossover protocol studying the immediate effect of nedocromil sodium (NS) on the pattern of nasal symptoms and secretions after allergen challenge. After pretreatment with placebo or NS, allergen challenge resulted in pruritus, rhinorrhea, nasal congestion, and/or sneezing within 10 minutes in 12 of 16 subjects. Prostaglandin D2 (PGD2), a marker of mast cell degranulation, increased proportionately with symptom scores, remaining above the 95% confidence interval for 120 minutes after both pretreatments. No difference in PGD2 between the NS-treatment and placebo-treatment days was observed. Protein markers extravasated through the vasculature (albumin and IgG) or secreted by mucosal glands (lactoferrin) were assayed. Total protein, albumin, IgG, and lactoferrin all remained greater than 95% confidence interval for 100 minutes after allergen challenge in the placebo-pretreated group and 120 minutes in the NS-pretreated group. Although there appeared to be a trend for lower secretion of PGD2, albumin, and IgG in the NS-treated group, the overall differences did not achieve statistical significance. This protocol revealed that two topical 130 microliter doses of a 1% solution of NS failed to significantly reduce allergen-induced symptoms, PGD2 generation, or secretion of albumin, IgG, or lactoferrin when NS was compared with placebo. The anti-inflammatory and mast cell-stabilizing effects of NS may require more prolonged pretreatment before provocation to be effective.
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PMID:Effects of nedocromil sodium on allergen-induced rhinitis in humans. 131 Oct 8

A double-blind, placebo-controlled trial was undertaken to assess the safety and efficacy of once daily cetirizine in alleviating the symptoms of perennial allergic rhinitis. Subjects were adults with perennial allergic rhinitis, characterized by nasal congestion, postnasal discharge, sneezing, rhinorrhea, nasal itching, lacrimation, ocular itching, and itching of the roof of the mouth, and a total pretreatment symptom severity score of greater than or equal to 8. Patients were randomized to treatment with 10 mg cetirizine, 20 mg cetirizine, or placebo for 4 weeks. Efficacy was assessed in 215 patients and safety in 216. Cetirizine in once daily dosages of 10 or 20 mg proved to be effective in relieving the overall symptoms of perennial allergic rhinitis and particularly postnasal discharge and sneezing. The 10-mg dose afforded optimal symptomatic relief, and the 20-mg dose provided little or no additional benefit. Cetirizine was well tolerated, and the frequency of somnolence was not significantly greater in patients receiving this drug than in those given placebo.
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PMID:Efficacy and safety of cetirizine therapy in perennial allergic rhinitis. 134 5

Thirty-eight workers from a factory producing nickel-cadmium and other types of batteries came to us for medical evaluation. They included 21 women and 17 men (seniority 2-20 years, age range 31-63 years), and represented a self-selected subset of 700-900 ever-employed and 200+ recently or currently employed workers in the factory. Thirty-four worked on the nickel-cadmium assembly line. Symptoms and signs included: headache in 34; weakness, fatigue and lassitude in 26; dizziness in 16; pruritus and skin eruptions in 37; gingivitis, teeth loss and caries in 34; nasal congestion, nosebleeds and anosmia in 30; cough, phlegm production, wheezing and shortness of breath in 26; "asthma" in 14; bone pain in 18; urinary frequency, beta 2 microglobulinuria and kidney stones in 17; and sterility or multiple abortions (33) in 8 of 21 women. One additional patient had died from an "amyotrophic lateral sclerosis-like syndrome", while CT scans in six workers revealed brain atrophy. One other worker had leukemia, and two had died from cancer (lung and pancreas). Those who had worked for more than 10 years had more symptoms and signs than shorter-term employees, especially neurological illness, bone pain and urinary tract problems, including beta 2 microglobulinuria. Past blood and urinary cadmium levels were in the range of 1.6-8.7 micrograms/dl and 8-306 micrograms/l, respectively. Our findings indicated that: a) health risks for workers were not confined to the nickel-cadmium assembly line or to older workers, b) hazardous exposures still existed and illness appeared in new workers after a clean-up and intervention program, and c) exposures involved increased risks for renal disease and cancers. Finally, there is a need to control exposures and determine health risks in the full cohort of those ever employed, in the workers' children, and in the surrounding environment (air, ground, water) due to the dumping of waste from the plant.
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PMID:Medical findings in nickel-cadmium battery workers. 142 13

This double-blind, double-dummy, parallel-group study was undertaken in 40 patients with seasonal allergic rhinoconjunctivitis during the 1990 hay fever season. The patients were randomized and treated for seven days with either 120 mg terfenadine or 10 mg loratadine, each drug taken once daily in the morning. The severity of nasal congestion, rhinorrhea, sneezing, nasopharyngeal itching, and itchy, watery, red eyes was evaluated before and at the end of treatment. The global severity of symptoms was ranked daily by the patient on a diary card. Both treatment groups experienced a significant improvement of symptoms after treatment (p < 0.01), without any significant difference between the two study drugs. Terfenadine and loratadine significantly improved symptom severity by 69 and 55% compared with the baseline values, respectively. Headache and fatigue were reported in three loratadine-treated patients, and sedation in one patient. No side effects were observed in patients receiving terfenadine. This study confirmed that terfenadine 120 mg once daily is a safe and effective treatment for hay fever.
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PMID:Comparative effects of terfenadine and loratadine in the treatment of hay fever. 166 95

Second-generation H1 receptor antagonists (cetirizine, terfenadine, astemizole, loratadine, azelastine, and acrivastine) offer several important advantages over the older first-generation antihistamines. They are substantially less sedating and have little or no anticholinergic activity. Many of them are effective for 12 to 24 hours, thereby increasing compliance. In addition to acting as competitive inhibitors of histamine, several seem to have other antiallergic mechanisms as well. They are all absorbed well when taken orally. Many studies demonstrate their effectiveness compared with placebo in the treatment of seasonal and perennial rhinitis and chronic urticaria, and several studies suggest that they have a role in the treatment of bronchial asthma. A number of multicenter, double-blind, placebo-controlled studies comparing the effectiveness of terfenadine, 60 mg bid, with chlorpheniramine, 8 mg bid, in seasonal allergic rhinitis demonstrate that both drugs are approximately equally potent in reducing the symptoms of sneezing, rhinorrhea, and nasal itching and are statistically significantly better than placebo. Ocular symptoms were reduced somewhat less but still significantly. No differences from placebo were recorded in their effect on nasal congestion. The effectiveness of cetirizine, 10 mg once daily, compared with astemizole, 10 mg once daily, was measured in double-blind, placebo-controlled studies of patients with seasonal allergic rhinitis. These studies also demonstrate statistically significant benefit from the study drugs compared with placebo in relieving all nasal symptoms except congestion. Both drugs also relieved ocular pruritus. Fewer studies have assessed azelastine, acrivastine, and loratadine, but all have been shown to provide significant relief of seasonal allergic rhinitis compared with placebo.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparative efficacy of H1 antihistamines. 168 23

Allergic rhinitis is characterized by a profuse rhinorrhea in addition to paroxysms of sneezing, nasal congestion, and pruritus. To define better the sources of nasal secretion produced during rhinitis, nasal allergen challenges were performed on nine atopic subjects with seasonal rhinitis. A single dose of allergen was sprayed into one side of the nose, and nasal lavages were collected bilaterally for 7 hours. Nasal lavages were assayed for protein (total protein, albumin, lactoferrin, and lysozyme) and mediator (histamine and prostaglandin D2) content. Protein concentrations increased and remained elevated above baseline levels in both ipsilateral and contralateral secretions for up to 3 hours after allergen challenge. The proportion of albumin relative to total protein (the albumin percent) increased on the ipsilateral side, whereas the relative proportions of lactoferrin and lysozyme (the lactoferrin percent and lysozyme percent) increased on the contralateral side. Prostaglandin D2, but not histamine, increased selectively on the ipsilateral side. These data suggest that the ipsilateral protein secretory response is due to allergen-induced mast cell mediator release causing increased vascular permeability, whereas the contralateral protein secretory response is primarily a reflex-induced glandular secretion.
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PMID:The pathophysiology of rhinitis. V. Sources of protein in allergen-induced nasal secretions. 171 3

This double-blind, multicentre study was designed to compare the efficacy and tolerability of terfenadine 120 mg with cetirizine 10 mg, each taken once daily, in the treatment of seasonal allergic rhinitis. Two hundred and eighty-five patients were recruited to the study by nine general practice centres in the south of England during the 1989 hay-fever season. Symptom severity was assessed daily by the patient and before and after the one-week treatment period by the investigator. At the second clinic visit both patient and investigator assessed the overall response to treatment. The two treatment groups were well matched for all demographic variables and baseline symptom scores. Improvement in all seven symptoms (nasal congestion, sneezing, rhinorrhoea, itching nose, itching eyes, watery eyes and red eyes) and overall response to treatment were similar in both treatment groups. Adverse events were mainly of mild to moderate severity and were reported by 14 patients on terfenadine and 21 patients treated with cetirizine (p = 0.317). This study confirmed terfenadine's role as the treatment of choice in hayfever. A single 120 mg dose in the morning effectively reduced symptoms by 43 to 70 per cent of baseline values, with an acceptably low incidence of side effects. Cetirizine at a single dose of 10 mg displayed equal efficacy in controlling hayfever symptoms but, in common with other studies, had a significantly greater incidence of drowsiness (p = 0.046).
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PMID:Multicentre, double-blind comparison of terfenadine and cetirizine in patients with seasonal allergic rhinitis. 197 16

Studies using nasal provocation followed by nasal lavage have demonstrated that histamine plays an important role in the mediation of allergic rhinitis but not of rhinovirus infection. The response to antigen challenge is often biphasic. During the early response, increases in histamine levels appear to be associated with activation of mast cells. In a subset of persons who exhibit an additional late response, however, the rise in histamine is concomitant with an increase in the number of basophils. Further evidence of the role of histamine in allergic rhinitis has emerged from nasal provocation experiments involving pretreatment with a variety of drugs known to antagonize or affect release of histamine. Nasal provocation with histamine causes sneezing, itching, rhinorrhea, and nasal congestion. Most H1 antihistamines have been found to inhibit sneezing and to lessen the increase in vascular permeability, but they do not affect histamine release. The H1 antihistamine terfenadine, however, inhibits histamine release during the early response; effects on late response remain unknown. Prednisone decreases histamine levels during the late, but not the early, response. One-week pretreatment with topical steroids, on the other hand, affects both the early and the late response.
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PMID:The role of histamine in allergic rhinitis. 197 83

Retrospective experience with drug therapy in 747 patients with essential hypertension registered from 1972-1983 is reported. Five hundred patients were seen between 1972 to 1978 and 247 between 1979-1983; the latter group was characterised by the use of beta blockers as first line drugs. Hypertension was graded according to level of diastolic blood pressure as mild, moderate and moderately severe or severe in 423, 211, and 113 patients, respectively. The overall response to treatment at 6 months was satisfactory in 66.2% of mild, 50.2% of moderate and 58.4% of severe grades of hypertension. A large number of patients in both the groups having varying grades of severity needed at least 2 to 3 drugs for the control of hypertension. The side effects of drugs were generally mild which included general weakness with diuretics; skin rash, nasal congestion and pruritus with methyldopa; cold extremities with beta blockers and palpitations with prazosin.
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PMID:Experience with anti-hypertensive drug therapy in a hypertension clinic--1972-1983. A retrospective analysis. 198 Oct 83


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