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)

Forty-two ragweed hay fever patients participated in a study which examined the profile of symptom relief provided by terfenadine, and the relative adequacy of symptom control with the drug given from the beginning of the season compared with treatment started after symptoms were well established. Compared with placebo, terfenadine effectively relieved sneeze, itch and eye symptoms. It had no effect on running, blowing and drainage. Subjectively perceived congestion benefited marginally. When the drug was begun after symptoms were well established, sneezing responded quickly and maximally. Eye discomfort lessened but not to the level experienced by those dosed from the beginning of the season. The pattern in other symptom categories was less clear. Overall, terfenadine improved all rhinitis symptoms except those related to hypersecretion. Some symptoms appeared to respond better when drug dosing commenced at the beginning of the season.
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PMID:Profile of ragweed hay fever symptom control with terfenadine started before or after symptoms are established. 210 13

Allergic rhinitis is a classic example of a type I immunological reaction. After allergic provocation tests a biphasic reaction is seen in the respiratory tract that is more pronounced in the lower than in the upper respiratory tract due to the physiological changes during the nasal cycle. The early phase of the immediate reaction starts some minutes after allergen provocation. After 5-10 h the nasal symptoms (discharge, blockage, sneezing and itching of the nose) reappear, a phenomenon which is called the "late-phase response" (LPR). The LPR is of great clinical importance in the pathophysiology of perennial allergic rhinitis and phenomena such as nasal priming and nasal hyper-reactivity. The most important effector cell of the early phase of the immediate reaction is the mast cell, whereas basophils, eosinophils and neutrophil granulocytes seem to be more important for the LPR. There is also evidence for morphological and functional heterogeneity of mast cells in man. The role of the chemotactically immigrated eosinophils in allergic reactions has not been clear until now: the eosinophil-derived mediators may enhance or inhibit the allergic reaction. Also the eosinophils show different morphological and functional states (so-called hypo- and hyperdense eosinophils). The symptoms of allergic rhinitis (sneezing, discharge, blockage, itching of the nose) are caused by different mediators, of which the most important is histamine. Other mediators or modulators of the allergic reactions are leucotrienes, prostaglandins, PAF, serotonin, and the kallikrein-kinine and complement systems. In recent years many regulatory peptides have been detected in the human nasal mucosa.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Current pathophysiologic aspects of allergic rhinitis. I]. 226 46

Therapeutic approaches to seasonal allergic rhinitis are reviewed in this paper. Pharmacotherapeutic approaches include nonsedative antihistamines, anti-allergic drugs, vasoconstrictors, anticholinergic agents and topical corticosteroids. The choice of treatment depends upon its relative efficacy and safety. Although effective, immunotherapy has been seriously questioned in recent years owing to the occurrence of possibly serious side-effects. Antihistamines are safe and effective for treatment of histamine-mediated symptoms of itching, sneezing and rhinorrhoea. The newer compounds do not cause sedation. For nasal symptoms, topical anti-allergic drugs are not as effective as other treatments. Topical vasoconstrictors are often used, though they cause side-effects when the treatment is prolonged. Anticholinergic drugs are safe and effective for rhinorrhea. Corticosteroids are highly effective for most symptoms, but their administration by oral or parenteral routes cannot be recommended because of side-effects. Topical corticosteroids inactivated by hepatic first pass metabolism are favoured as they are highly effective and safe. Their mechanism of action is not completely understood, but they act through both an anti-inflammatory effect and an anti-allergic activity decreasing mediator release. These drugs are the most effective in the treatment of nasal obstruction because of their anti-inflammatory effect. They are usually administered in response to symptoms, but in the future, it is likely that they will be used prophylactically before the pollen season in order to decrease the priming effect.
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PMID:Pathophysiology and treatment of seasonal allergic rhinitis. 228 90

Fifty-two cases of perennial rhinitis were studied, leading to the diagnosis of seven cases of nonallergic rhinitis with eosinophilia syndrome (NARES) a frequency of 13.5%. Symptoms of nasal hyperreactivity involving sneezing, rhinorrhea, nasal obstruction and pruritus were more severe than in other types of rhinitis. The frequency of hyposmia was very specific to NARES. Nasal endoscopy and sinus CT revealed an evolution towards nasal polyposis in four patients. The nasal challenge to house dust mites showed the absence of any increase in local eosinophilia. Bronchial hyperreactivity to carbachol occurred in one case. There was no case of intolerance to aspirin. There was particular adrenergic hyperreactivity among the seven patients, evidenced by study of the reactivity of the cardiovascular alpha and beta receptors. The authors emphasize the features that are shared by NARES and by the triad, which suggest that NARES is the early phase of the triad. They advance the pathogenic hypothesis of an autonomic nervous system dysregulation with a predominating adrenergic hyperreactivity. Inflammatory effects of local release of neurotransmitters induce a switch from a neurogenic to a self-sustaining inflammation. Tissue eosinophilia is regulated by chemical attractants and activating substances of various origins and plays a major part in the chronic inflammatory state.
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PMID:Nonallergic rhinitis with eosinophilia syndrome a precursor of the triad: nasal polyposis, intrinsic asthma, and intolerance to aspirin. 234 37

The possible role of leukotriene D4 (LTD4) in nasal allergy was investigated in healthy volunteers. Nasal blood flow, nasal airway resistance, nasal discharge and nasal itching and sneezing were examined. LTD4 was found to induce a dose-response related increase in nasal mucosal blood flow as measured by laser-Doppler flowmetry. Histamine exhibited similar effects on blood flow in the same concentration range. Nasal airway resistance as recorded by rhinomanometry, increased in a dose-related manner after topical LTD4. Nasal secretion was obtained by nasal lavage and estimated from a dilution principle. Topical LTD4 did not increase the amount of nasal secretion, whereas a dose-related increase was found after topical histamine. LTD4 did not cause itching, sneezing or other irritative symptoms. In conclusion, LTD4 may play a role in nasal allergy by increasing blood flow and nasal airway resistance. Itching, sneezing and discharge, however, are apparently not caused by LTD4 but can be accounted for by the release of histamine or other mediators.
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PMID:Effect of leukotriene D4 on nasal mucosal blood flow, nasal airway resistance and nasal secretion in humans. 242 55

Allergic rhinitis is characterised by symptoms of sneezing, itching of the nose with watery secretions, and nasal obstruction. We have previously shown that patients can have the diagnosis of allergic rhinitis confirmed by nasal provocation tests and assessment of nasal inspiratory peak flow (NIPF) after specific allergen or hyperosmolar challenge. We now show that histamine is released into the nasal lavage fluid in response to such challenges. Saline lavage alone results in detectable histamine levels in the order of 5 ng/ml, but in the presence of allergen (HDM) there is a significant increase in histamine release in atopics but not in control subjects. With hyperosmolar challenge, atopics showed a biphasic response in that histamine release was increased with 1.8% and 3.6% saline but returned to baseline with 5.4% and 7.2% saline, then showing a further increase with 9.0% saline. This raises the possibility of two populations of responsive mast cells. Hyperosmolar challenge leads to symptoms of nasal itch and sneezing as well as histamine release in atopics but not in controls. This suggests that hyperosmolar challenge can be used as a simple diagnostic test for allergic rhinitis and may provide a model for nasal hyper-reactivity.
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PMID:Nasal histamine release following hyperosmolar and allergen challenge. 247 Feb 66

The efficacy and tolerability of Naaga (the magnesium salt of N-acetyl-aspartyl-glutamate) and of sodium cromoglycate after intranasal application were tested and compared in 100 patients suffering from chronic allergic rhinitis. The study was conducted according to a randomized, double-blind design in four centers. The intensity and frequency of typical allergic symptoms such as nasal obstruction, sneezing, runny and itching nose, conjunctivitis, ocular itching and tear flow were recorded on a 4-point scale (absent, light, moderate and severe). The intensity of nasal and ocular symptoms was found to be marked for patients in two centers. For the patients in the other two centers the drugs' efficacy was difficult to assess because symptoms were not marked (rated either as absent or light) at the beginning of the study. Thus the assessment of efficacy was based on 60 patients (centers 1 and 2), while the assessment of tolerability was based on the whole patient sample (n = 100). There was no statistically significant difference between the two compounds in terms of efficacy. A total of five patients in each of both groups complained of moderate untoward effects (all patients from the same center).
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PMID:[NAAGA versus disodium cromoglycate in perennial allergic rhinopathy: results of a multicenter study]. 250 Jun 92

A total of 317 patients received loratadine, 10 mg once daily, terfenadine 60 mg twice daily, or placebo in a 14-day, double-blind, randomized study in seasonal allergic rhinitis. Four nasal and four nonnasal symptoms were evaluated. At the end point evaluation, mean total scores of combined nasal and nonnasal symptoms decreased from baseline (improved) 46%, 44%, and 35%, respectively, for loratadine, terfenadine, and placebo. The difference between loratadine and placebo treatment was significant (p = 0.03). Loratadine was particularly effective compared with placebo in relieving nasal discharge, sneezing, and itching/burning eyes. Therapeutic response to treatment was good or excellent in 66 (64%) of 103 loratadine-treated patients, 58 (56%) of 104 terfenadine-treated patients, and 48 (47%) of 102 placebo-treated patients. Adverse experiences reported during the study were usually mild or moderate and were not significantly different among the three treatment groups. Sedation (somnolence) was reported by 10 loratadine-treated patients, seven terfenadine-treated patients, and eight placebo-treated patients. Loratadine, 10 mg once daily, was comparable to terfenadine, 60 mg twice daily, and significantly superior to placebo in the symptomatic relief of seasonal allergic rhinitis.
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PMID:Efficacy and safety of loratadine (10 mg once daily), terfenadine (60 mg twice daily), and placebo in the treatment of seasonal allergic rhinitis. 257 17

The efficacy of terfenadine in combination with phenylpropanolamine was assessed by comparison with terfenadine alone in a double-blind, parallel group study of 66 patients with nasal birch pollen allergy. The patients were allocated randomly into two groups; 34 patients received terfenadine (60 mg) twice daily and 32 patients a combination tablet containing terfenadine (60 mg) and phenylpropanolamine (50 mg) twice daily for 17 days during the birch pollen season. Nasal symptoms (sneezing, discharge, itching and blockage) were relieved significantly by both drugs, but control of symptoms was more rapid and better with the terfenadine-phenylpropanolamine combination. Rhinoscopic evaluation of nasal secretion and mucosal swelling showed no differences between the treatment groups. Compared with pre-season values, nasal peak expiratory flow (PEF)-values worsened significantly during the season in the terfenadine, but not in the terfenadine-phenylpropanolamine, group. The general condition of the patients was significantly better in the terfenadine-phenylpropanolamine group. There were no marked side-effects in either group. At the end of the trial some of the patients in both treatment groups still had symptoms; this is apparently due to the long-lasting and severe pollen season. It is concluded that terfenadine combined with phenylpropanolamine gives better control of seasonal allergic rhinitis than terfenadine alone.
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PMID:Terfenadine with or without phenylpropanolamine in the treatment of seasonal allergic rhinitis. 257 26

The object of the above study was to evaluate the tolerability and possible therapeutic use of MgNAAGA (Mg salt of N-acetyl-aspartyl-glutamic acid) in patients with allergic rhinitis. Out of 22 subjects with respiratory allergy, 12 were treated for 15 days with MgNAAGA and 10 with DSCG for the same length of time. During this period, patients kept a diary in which they recorded the following symptoms: rhinorrhea, itching, sneezing and nasal obstruction. The trial drug was found to be well tolerated and not to give rise to relevant side effects. The therapeutic efficacy was similar to that of DSCG.
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PMID:[Evaluation of the efficacy of the magnesium salt of N-acetyl-aspartyl-glutamic acid in the treatment of acute rhinitis]. 257 79


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