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)

To examine mast cell involvement in allergic rhinitis, levels of tryptase, a specific marker for mast cell activation, and histamine, a marker of mast cell and basophil activation, were measured in nasal-lavage fluid after nasal-allergen challenge. Twelve atopic subjects with allergic rhinitis and five nonatopic subjects were challenged with timothy grass or ragweed pollen at increasing doses of allergen. Tryptase and histamine levels were determined by an ELISA and radioenzyme assay, respectively; clinical responses were measured by assessment of sneezing, rhinorrhea, nasal congestion, and ocular tearing or itching. A positive clinical response was observed in seven of the atopic subjects and in none of the nonatopic subjects. Tryptase levels increased at least sevenfold higher than baseline levels in 100% of the atopic clinical responders and reached a maximum at the same dose of allergen where clinical symptoms were maximal. In contrast, histamine levels were only threefold or greater elevated in five of seven atopic clinical responders at this dose of allergen. (Histamine levels were lower in one subject and were only 50% higher in another subject than the corresponding baseline value.) Histamine levels and symptom scores were maximal at the same dose of allergen in only four of seven clinical responders. Overlap of peak mediator levels in subjects without a clinical response with those of the clinical responders occurred only in the case of histamine. Tryptase levels in nasal-lavage fluid appear promising as a useful indicator of allergic reactions and indicate that mast cell activation is the major factor in the immediate nasal-allergic response.
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PMID:Tryptase levels in nasal-lavage fluid as an indicator of the immediate allergic response. 304 43

The term hyper-reactivity defines an inadequate reaction of the nose to normal airborne stimuli that are harmless to most of the population. In such cases the nose always shows exactly the same symptoms, irrespective of whether the rhinitis is allergic (IgE- or cell-mediated) or nonspecific (vasomotor). These symptoms include sneezing, nasal obstruction, hypersecretion, and itching of the nose. The vascular supply of the nose consists of capacitance vessels (veins, venules, sinusoids), resistance vessels (arteries, arterioles), and exchange vessels (capillaries of fenestrated types). Drug and mediator effects may be directed to different nasal vessel systems. The autonomic innervation of the nose is complex. Some neuropeptides have been demonstrated, in addition to the classical neurotransmitters of the sympathetic and parasympathetic system. Neuropeptide Y (NPY) is found in adrenergic fibers, vasoactive intestinal peptide (VIP) in cholinergic neurones; substance P (SP), calcitonin-gene-related peptide (CGRP) and neurokinine (NKA) are found in sensory nerves. The possible significance of the different neurotransmitters and mediators in nasal hyperreactivity is discussed.
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PMID:[Current aspects of nasal hyperreactivity]. 306 18

This study was a double-blind, parallel group comparison of terfenadine (TRF) 60 mg b.i.d. and mequitazine (MQZ) 5 mg b.i.d. for 7 days in the symptomatic treatment of acute pollinosis. The trial took place in the same geographic area and during the same pollen season (May-July 85), to ensure homogeneity of the study population. The fourteen investigators participating in this multicentre trial recruited 141 patients (69 TRF; 72 MQZ) suffering from well-documented pollinosis, mainly hay fever and sometimes allergy to tree pollens. Symptoms (nasal itching, sneezing, rhinorrhoea, obstruction, conjunctivitis) and possible somnolence were rated daily using a 4-point rating-scale of 0 to 3 by the patient on a diary card. Assessment of over-all efficacy and tolerability - focusing on atropinic side-effects - was made at the end of the seven-days treatment period by the physician, after reviewing the diary card and questioning the patient. The means score profile of each symptom for the study period was similar with the two treatments. Both had a fast onset of action with the regression of the total symptoms' score being already significant at day 1. Over-all assessment of efficacy at day 7 showed no significant difference between the two treatments. The daily somnolence scores however showed a clear and significant difference between the two drugs: the frequency of moderate to marked somnolence from day 2 to 7 was around 15% with MQZ and around 5% on days 2 to 5 and 0% on days 6 and 7 with TRF, the difference being significant on days 2, 5, 6 and 7.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A double-blind comparison of terfenadine and mequitazine in the symptomatic treatment of acute pollinosis. 308 1

A double-blind, parallel, multicenter study was undertaken in 215 ragweed skin test positive-patients with fall hay fever. The patients were randomized and treated for seven days with either 60 mg terfenadine twice daily, morning and evening, and a placebo at noon, or with 4 mg chlorpheniramine or placebo three times daily. The severity of nasopharyngeal itching, sneezing, rhinorrhea, nasal congestion, and itchy, watery, red eyes was ranked daily by patients and evaluated before and after treatment by the physician investigators. The patients reported a significant reduction in symptoms within one day. The physician investigators detected moderate to complete relief of symptoms in a greater proportion of the patients treated with terfenadine (70%) and chlorpheniramine (73%) than in the placebo-treated patients (48%). The incidence of sedation with terfenadine treatment (2.5%) was not different from that with placebo (2.4%) and both were lower than with chlorpheniramine (7.6%). We conclude that terfenadine is as effective as chlorpheniramine for the treatment of fall hay fever and that, unlike chlorpheniramine, the incidence of sedation with terfenadine was not different from placebo.
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PMID:Terfenadine treatment of fall hay fever. 312 74

The role of mediators in allergic inflammation of respiratory airways has recently been elucidated through the development of experimental systems for in vivo evaluation of hypersensitivity reactions in humans. Antigen challenge in hay-fever patients has been shown to be associated with the release of histamine, kinins, peptidoleukotrienes, leukotriene B4 and prostaglandin D2 in nasal secretions. Endobronchial antigen stimulation in asthmatic patients has been shown to induce local release of histamine, prostaglandin D2 and leukotriene C4. The effects of inflammatory mediators seem to be different: nasal challenge with histamine causes rhinorrhea, itching, sneezing and nasal obstruction, whereas local stimulation with leukotriene C4 and prostaglandin D2 induces only a marked obstruction. Bronchial provocation with histamine is associated with smooth muscle contraction, hypersecretion, vasodilation and increase in vascular permeability. Leukotriene C4 or prostaglandin D2 inhalation induces a marked bronchoconstriction. On molar basis, the potencies of these arachidonic acid derivatives are respectively about 1000 fold and 30 fold higher than that of histamine. Mast cells seem to play a pivotal role in the pathogenesis of immediate allergic responses, whereas eosinophils, neutrophils and basophils seem to be mainly involved in late phase reactions. Since paf-acether is a potent chemotactic factor for eosinophils and neutrophils, it is reasonable to suppose that this lipid mediator is generated during the immediate allergic reaction and is involved in the appearance of late phase responses.
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PMID:[Mediators of immunologic inflammation of the respiratory tract]. 315 33

A double-blind, double-dummy comparative study was made of 30 adult birch pollen-allergic outpatients with seasonal rhinoconjunctivitis. They were treated with either topically applied beclomethasone dipropionate 100 micrograms in each nostril twice daily for 4 weeks, placebo, or an injection of 2 ml of a suspension containing 5 mg betamethasone dipropionate and 2 mg betamethasone disodium phosphate per ml (Diprospan) immediately prior to the birch pollen season. Placebo- and topical steroid-treated patients experienced an increase in rhinoconjunctivitis symptoms, i.e. nasal blockage, nasal itching, rhinorrhea, sneezing and eye symptoms, and placebo-treated patients used significantly more antihistamine tablets during the pollen season. Diprospan-treated patients experienced fewer symptoms on all measured parameters. We concluded that one injection of Diprospan immediately prior to the birch pollen season produces significantly fewer rhinoconjunctivitis symptoms than does placebo and topical steroid treatment.
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PMID:Intramuscular betamethasone dipropionate vs. topical beclomethasone dipropionate and placebo in hay fever. 318 22

Thirty patients with seasonal allergic rhinitis entered a double blind study comparing budesonide (nasal spray, 400 micrograms/d) and i.m. injection of 80 mg methylprednisolone acetate. Symptoms were assessed over a "run in" period of 3-7 days followed by a treatment period of 3 weeks. Pollen counts were evaluated daily. Both the systemic and topical corticosteroid treatment resulted in a significant improvement of nasal and ocular symptoms and were accompanied by reduced antihistamine intake. A comparison of the two treatments in relation to the pollen count yielded statistically significantly fewer nasal symptoms, such as itching, secretion, and sneezing in the budesonide-treated group. Nasal blockage and ocular symptoms remained unchanged, but the use of eyedrops was significantly reduced in the methylprednisolone-treated group. Side effects of both treatments were mild and the incidence negligible. Methylprednisolone-treated patients had a significantly lower cortisol value after 7 days but still had a normal response to ACTH-stimulation. We conclude that the acute symptoms of allergic rhinitis are at least as well ameliorated by regular topical application of budesonide as by a single injection of methylprednisolone acetate. The accompanying allergic conjunctivitis may require additional treatment.
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PMID:Clinical comparison of systemic methylprednisolone acetate versus topical budesonide in patients with seasonal allergic rhinitis. 336 27

A group of Angus X Holstein cattle were determined to have allergic rhinitis. Clinical signs included nasal discharge, tearing, sneezing, and nasal pruritus. The diagnosis was made on the basis of intradermal skin testing of affected and clinically normal cattle. The affected cattle had positive test results to various tree, grass, weed, and mold allergens. The clinical signs and seasonal occurrence were similar to those features for allergic rhinitis in man. Breeding data indicated an inherited mode of transmission, although only females were affected.
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PMID:Familial allergic rhinitis in cattle. 341 Jul 80

Nasal histamine (H), leukotriene C4 (I-LTC4) and SRS-A activity were studied in seven aspirin-(ASA)-intolerant patients (AIR) with rhinitis and in five ASA-tolerant control patients with chronic rhinitis after nasal provocation (NP) with a lysine acetylsalicylate solution. The same parameters were also studied after metabisulfite (MBS) NP in four sulfite-intolerant patients with rhinitis and in six control patients with chronic rhinitis. In six ASA-intolerant subjects and in four controls, we studied the PGD2 levels in nasal washes after ASA NP 0.2 mL of lysine acetylsalicylate solution (10 mg/mL) was sprayed intranasally in ASA-intolerant patients and controls and a 25-mg/mL MBS solution in sulfite intolerant patients and controls. Nasal wash fluids were obtained using 5 mL of 0.15 M saline before and 7 1/2, 15, 30, and 60 minutes after nasal provocation. The nasal provocation with ASA induced itching and sneezing in four out of seven intolerant subjects. In this subgroup histamine values in nasal wash fluids were significantly higher versus the remaining ASA-intolerant patients at 30 and 60 minutes (P less than .05 and P less than .01, respectively) and versus controls at 60 minutes (P less than .01). We found significantly higher I-LTC4 (P less than .01) and SRS-A levels in nasal washes collected from ASA-intolerant subjects versus controls at 60 minutes after nasal provocation. There was no significant increase in the mean PGD2 values in either the ASA-intolerant or control groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Study of mediators of anaphylaxis in nasal wash fluids after aspirin and sodium metabisulfite nasal provocation in intolerant rhinitic patients. 368 66

The currently available beclomethasone dipropionate (BDP) metered-dose nasal aerosol spray is considered uncomfortable by some patients because of the force of delivery. It was compared for efficacy and acceptability in a double-blind study with a new aqueous suspension BDP spray for the treatment of seasonal allergic rhinitis in 44 symptomatic patients aged 12 to 43 years. After 7 days of baseline evaluation, every patient was given both an aerosol canister and an aqueous spray bottle each containing either BDP, 42 mcg per spray, or placebo (P). For 15 days the patient sprayed each nostril twice a day with one spray of suspension (BDP or P) followed 5 minutes later by one spray of aerosol (P or BDP). Patients were evaluated before the study medications were started (day 1) and on days 4, 8, and 15 for nasal and eye symptoms. Nasal cytologic specimens were examined on days 1 and 15, and rhinomanometry was performed on days 1, 8, and 15 of the study. Topical BDP by both methods of delivery was rapidly effective in decreasing mean nasal obstruction, rhinorrhea, sneezing, and itching symptoms as well as mean eye symptoms with no statistically significant differences between them. Nasal airflow increased with both treatments; rhinomanometry significantly correlated with subjective nasal obstruction scores. Of 34 patients with nasal eosinophils, 74% had fewer eosinophils after treatment. Most patients (84%) preferred the aqueous spray over the pressurized aerosol.
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PMID:Clinical, rhinomanometric, and cytologic evaluation of seasonal allergic rhinitis treated with beclomethasone dipropionate as aqueous nasal spray or pressurized aerosol. 371 53


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