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)

During her 26th week of pregnancy a 20-year-old woman developed generalized pruritus, urticaria, flushing, tinnitus, and tachycardia during plasmapheresis with 5% human serum albumin (HSA) as adjunctive treatment for anti-Kell isoimmunization. The reaction was controlled with intravenous diphenhydramine. Despite pretreatment with diphenhydramine and betamethasone a subsequent attempt to perform plasmapheresis with infusion of 5% HSA resulted in a more severe reaction which progressed to respiratory distress. Intradermal skin testing with 5% HSA produced a 9 x 11-mm wheal and 17 x 21-mm erythema at 15 minutes. An enzyme-linked immunoassay was positive for IgE antibody to 5% HSA before and after dialysis for removal of Na caprylate. These results are consistent with an IgE-mediated basis for this patient's reaction to HSA.
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PMID:Anaphylaxis to human serum albumin. 230 85

The effects of local capsaicin pretreatment on the cutaneous triple response reaction induced by allergen exposure or anti-IgE were studied in man. Acute exposure of the human skin to capsaicin caused a burning sensation and a clearcut flare reaction but no wheal response. Upon repeated administration these local reactions to capsaicin disappeared. The flare component and the subjective itching sensation of the cutaneous allergy reaction to rat antigen in sensitized persons or anti-IgE in non-allergic persons were then markedly reduced. Two weeks after capsaicin pretreatment the flare response to allergen was not significantly changed compared to the control reaction, suggesting a reversible effect of capsaicin treatment. The wheal component of the allergy or anti-IgE reaction was, however, not influenced by capsaicin pretreatment, indicating that the wheal and flare components are caused by different mechanisms. It is concluded that capsaicin sensitive sensory nerves are of importance for the human cutaneous triple response reaction induced by allergen exposure. Thus, secondary release of mediators, such as CGRP or tachykinins from sensory nerve branches, may contribute to the flare component of this reaction. Furthermore the itching sensation seems to be dependent to a large extent on capsaicin-sensitive nerves. However, sensory nerves seem to have less importance for the wheal reaction, i.e. the protein extravasation response.
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PMID:Capsaicin-sensitive nerves and the cutaneous allergy reaction in man. Possible involvement of sensory neuropeptides in the flare reaction. 349 9

The effect of topical dermal anaesthesia on the immediate allergic skin reaction was evaluated in a double-blind, randomized, placebo-controlled study. Twenty-one patients with strictly seasonal allergic rhinitis, confirmed by a positive skin test for the respective pollen allergen, were studied in the pollen-free winter months. Skin-prick tests for one pollen allergen and histamine were performed after pre-treatment of the skin for 1 hr with an emulsion of lidocaine and prilocaine (EMLA) and the equivalent vehicle on different test sites. The skin-prick tests were made with a preloaded standardized test needle (Phazet). The area of the induced weal-and-flare reaction was measured and subsequently calculated with the help of a digitizer served by a microcomputer. The topical dermal anaesthesia induced a reduction of the flare response to histamine by 49% (P less than 0.01) and allergen by 21% (P less than 0.05). No reduction of the histamine- and allergen-induced weal response were noted. Our findings indicate that the treatment did not affect the allergen-induced release of inflammatory mediators and the vascular leakage induced by these mediators. However, this study seems to confirm earlier suggestions that the flare response is partly mediated through neural reflex activity as it was ameliorated by topical anaesthesia. Furthermore, from a clinical point of view, this study shows that it is possible to perform a valid skin test, without any associated itching and pain, if only the weal response is taken into account in the evaluation of the skin-prick test.
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PMID:Topical dermal anaesthesia inhibits the flare but not the weal response to allergen and histamine in the skin-prick test. 362 49

A woman complained of severe itching and flushing after sexual intercourse or other physical contact with her husband. She developed a weal and flare on intradermal testing with her husband's semen and sweat, pooled donor semen and the sweat from her 2 sons. This is a report of allergy to human semen and the 1st reported case of allergy to human sweat.
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PMID:Woman allergic to husband's sweat and semen. 370 44

The effects of topical treatment with capsaicin or mustard oil on histamine-induced pruritus, wheal formation and flare response were studied in the human skin. Capsaicin pretreatment resulted in a reversible marked reduction or abolition of the axon reflex flare, but did not influence whealing. Itching was also strongly diminished or even abolished, provided that the flare response was completely blocked. The onset of itching was significantly promoted by pretreatment of the skin with mustard oil, inducing axon reflex vasodilatation. It is concluded that, in addition to the axon reflex flare, capsaicin-sensitive peptide-containing primary afferent neurones are also intimately involved in the mediation of the sensation of itching.
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PMID:Capsaicin prevents histamine-induced itching. 372 47

The anticoagulant activity of heparin is dependent on its affinity for antithrombin III (AT III) and on its molecular weight. In contrast, heparin fractions differing in these respects are equally effective inhibitors of the human complement system in vitro. In this study we designed and evaluated a model to investigate the effects of different heparin fractions on a complement dependent inflammation. Locally administered heparin, in a dose-dependent manner, inhibited the flare, itch and wheal responses induced by intradermal injection of heat-aggregated human IgG (HAGG). These reactions were also inhibited by the antihistamine mepyramine, favouring the view that HAGG activates complement and that the observed inflammatory response is mediated by anaphylatoxin liberation of histamine. Similar cutaneous reactions induced by trypsin, which can generate C3a and C5a by proteolysis of C3 and C5, the histamine liberator compound 48/80 or histamine were inhibited by mepyramine but not by heparin. Thus it is strongly suggested that heparin inhibits the HAGG induced reactions by modulating the early pre-C3 steps of complement activation. On a weight basis heparin fractions differing in AT III-affinity or in average molecular weight (5,000 and 16,000 D) were equally potent modulators of the HAGG-induced inflammation. We conclude that heparin can inhibit an apparently complement-dependent inflammation irrespective of its AT III-affinity or of its size, and suggest that a heparin with low anticoagulant activity could be of value as a modulator of inflammation and should be useful in investigating the consequences of complement inhibition in inflammation.
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PMID:Inhibition of complement dependent experimental inflammation in human skin by different heparin fractions. 373

Doxepin hydrochloride, a tricyclic antidepressant, was evaluated in a double-blind, placebo-controlled crossover trial for the treatment of chronic idiopathic urticaria in 16 adults. Efficacy was evaluated by symptom scores, concomitant antihistamine use, and suppression of histamine- and codeine-induced wheal response. Doxepin-treated subjects experienced fewer lesions (p less than 0.001), less waking hours with lesions (p less than 0.01), lesser degree of itch and/or discomfort (p less than 0.001), and less swelling or angioedema (p less than 0.001) as compared to placebo-treated subjects. Doxepin-treated subjects required less daily concomitant antihistamine use (mean 0.13 tablets versus 1.48 tablets, p less than 0.05). Doxepin also significantly suppressed histamine- and codeine-induced cutaneous wheal response as compared to placebo. Lethargy was commonly observed but diminished with continued use. Dry mouth and constipation were also commonly observed. We conclude that doxepin is an effective agent for the treatment of chronic idiopathic urticaria.
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PMID:Efficacy of doxepin in the treatment of chronic idiopathic urticaria. 378 54

Leukotriene D4 (LTD4) increased the blood flow rate in human skin, equipotent to histamine in the dose range of 3.1-200 pmol. The vasodilatation lasted for up to 60 min, and no late reactions occurred. Indomethacin did not affect the LTD4-induced blood flow rate. H1 and H2 antagonists reduced the increase in blood flow rate, but did not abolish the response to LTD4. Local nerve block inhibited the axon reflex-mediated flare component of the LTD4-induced blood flow rate, leaving a local red reaction. This local red reaction was not affected by H1 and H2 antagonists. These results indicate histamine as a mediator of the axon reflex, and show that LTD4 causes a direct vasodilatory effect that is not mediated via histamine or cyclooxygenase products. The laser-Doppler flowmeter was applied for dynamic studies of the vasopressor response in the skin during a Valsalva maneuver, and the relative changes in blood flow were confirmed by control estimates of the blood flow rate by a 133xenon washout method. The pressor response to a Valsalva maneuver was reversed by local nerve block, but not affected by LTD4. Therefore LTD4 did not interfere with the sympathetic activity on the cutaneous vessels. Leukotriene D4 caused a dose-dependent wheal reaction, equipotent to histamine in the dose range of 0.2-200 pmol. Only minor whealing occurred when the vasculature to the test arm was occluded before injection of LTD4 and the circulation restored 30 min later. Most of the LTD4 was apparently metabolized within this period. Subsequent injections of LTD4 into the same sites demonstrated the development of tachyphylaxis with respect to whealing. This evidence suggests that LTD4 cannot mediate sustained inflammation. The injections of LTD4 caused neither pain nor itching. In conclusion, the elucidated properties point to LTD4 as a possible mediator of microvascular changes during acute inflammation.
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PMID:Vascular effects of leukotriene D4 in human skin. 380 52

Penicillin allergy presents a major obstacle to the successful management of some antepartum infections. We studied 15 pregnant women with histories of penicillin allergy confirmed by positive immediate wheal-and-flare skin tests. Thirteen had syphilis, one listeria sepsis, and one Streptococcus viridans endocarditis. Each patient was desensitized over four to six hours by oral administration of increasing doses of penicillin V. At the completion of the procedure, full-dose parenteral therapy with penicillin G or ampicillin was instituted. No extracutaneous reactions were detected. Five of the subjects (33 per cent) experienced pruritus (three) or urticaria (two), but no interruption of desensitization or therapy was necessary. All clinically apparent maternal infections were cured. The pregnancy complicated by listeriosis aborted in the first trimester. The 11 neonates delivered to date are normal. These results indicate that oral desensitization is an acceptably safe approach to therapy in pregnant women who are allergic to penicillin and have infections that require beta-lactam drugs.
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PMID:Penicillin allergy and desensitization in serious infections during pregnancy. 392 35

The effects of the H I receptor antagonists astemizole and chlorpheniramine on dermographism were compared in a double-blind study in sixteen patients. Both drugs resulted in a parallel and significant depression of the dermographic force-response curve and an elevation of the weal-force threshold, but the changes were greater in the patients receiving astemizole (a maximal potency shift of 74% for astemizole and 37% for chlorpheniramine). Subjective itch (10 cm line) and frequency of dermographic episodes were also reduced more by astemizole than by chlorpheniramine. The effect of astemizole was greater at 4 weeks than at 2 weeks, whereas the effect of chlorpheniramine had decreased at 4 weeks. The effect of astemizole but not chlorpheniramine was still apparent 4 weeks after treatment had been stopped. Since the degree of residual dermographism was comparable despite great differences in histamine weal inhibition a vasoactive mechanism in addition to that mediated by histamine must be involved in dermographic urticaria.
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PMID:A comparison of astemizole and chlorpheniramine in dermographic urticaria. 392 95


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