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)

The physiologic functions of histamine have been recognized for more than 100 years, yet new roles are still being uncovered. Most importantly, a newly discovered receptor of the amine has helped refine our understanding of histamine. This new receptor, the histamine H4 receptor (H4R), has a higher affinity for histamine compared with the histamine H1 receptor and appears to be more selectively expressed, found mainly on hematopoietic cells. H4R is involved in chemotaxis and inflammatory mediator release by eosinophils, mast cells, monocytes, dendritic cells, and T cells. Studies in animal models using selective antagonists or H4R-deficient mice have shown a role for the receptor in inflammation in vivo. In particular, H4R antagonists have shown promise in experimental models of asthma and pruritus, two conditions where currently marketed antihistamines targeting the histamine H1 receptor are not optimally effective in humans. Thus, a new class of H4R-specific antihistamines may be distinctively effective in treating allergic diseases associated with chronic pruritus and asthma.
Curr Allergy Asthma Rep 2008 Mar
PMID:The new biology of histamine receptors. 1837 70

Although the reported incidence of hypersensitivity reactions (HSR) to antineoplastic agents is considered to be uncommon, it is difficult to evaluate their exact prevalence, mainly because their definition is vast and pathogenic mechanisms are vague. HSR include facial flushing, erythema, pruritus, fever, tachycardia, dyspnea, tongue swelling, rash/hives, headache, chills, weakness, vomiting, burning sensations, dizziness, and edema. Treatment and prevention consists of slowing the infusion rate, steroids, and type 1 and 2 histamine receptor antagonists. Desensitization could allow the small number of patients who experience severe HSR to receive effective therapy for their cancer. Reintroductions have only been reported as single case studies or small cohorts. Large-scale validation on desensitization strategies is still missing. With regard to oxaliplatin, knowledge of its rare but eminent toxicity is paramount, because this drug is widely used in treating colorectal cancer, the second-highest cause of cancer mortality in the United States.
Curr Allergy Asthma Rep 2008 Mar
PMID:Hypersensitivity reactions to oxaliplatin and other antineoplastic agents. 1837 76

Like other inflammatory dermatoses, the pathogenesis of atopic dermatitis (AD) has been largely attributed to abnormalities in adaptive immunity. T helper (Th) cell types 1 and 2 cell dysregulation, IgE production, mast cell hyperactivity, and dendritic cell signaling are thought to account for the chronic, pruritic, and inflammatory dermatosis that characterizes AD. Not surprisingly, therapy has been directed toward ameliorating Th2-mediated inflammation and pruritus. Here, we review emerging evidence that inflammation in AD occurs downstream to inherited and acquired insults to the barrier. Therapy based upon this new view of pathogenesis should emphasize approaches that correct the primary abnormality in barrier function, which drives downstream inflammation and allows unrestricted antigen access.
Curr Allergy Asthma Rep 2008 Jul
PMID:Skin barrier function. 1860 81

Itch, the hallmark of atopic dermatitis, has a significant impact on quality of life for patients with this disease. Various central and peripheral mediators have been suggested to play a role in the pathophysiology of atopic eczema itch. Significant cross-talk occurs among stratum corneum, keratinocytes, immune cells, and nerve fibers, which are in close proximity to one another and induce itch. The impaired barrier function associated with the itch-scratch cycle further augments this vicious cycle. Recent advances in our understanding of itch pathophysiology shed light on peripheral and central neural sensitization of nerve fibers that contribute significantly to itch in atopic dermatitis. Recently, several new mediators have been described as associated with itch in atopic dermatitis, including serine proteases, interleukin 31, and nerve growth factor. This review covers the peripheral and central mechanisms and mediators involved in pathogenesis of itch in atopic dermatitis.
Curr Allergy Asthma Rep 2008 Jul
PMID:What causes itch in atopic dermatitis? 1860 82

Allergic rhinitis (AR) is a chronic inflammatory respiratory disease affecting 5%-50% of the worldwide population and its prevalence is increasing (Herman 2007). In addition, AR is associated with asthma and other co-morbidities such as conjunctivitis and sinusitis. The main symptoms are nasal congestion, rhinorrea, sneezing, itching, and post-nasal drainage induced after allergen exposure by an IgE-mediated inflammation of the membranes lining the nose. AR is not a life-threatening disease, but it has been shown to have a significant impact on quality of life. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines propose a classification of AR in intermittent and persistent, each graded as mild or moderate-severe, and provide a stepwise approach to the treatment. Inhaled steroids and antihistamine are the main tools in AR therapy but more safe and effective drugs are, however, needed. Inhaled steroid ciclesonide appears to be safe and effective.
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PMID:New treatment options in allergic rhinitis: patient considerations and the role of ciclesonide. 1872 55

Fluticasone furoate nasal spray (FFNS) is a novel, enhanced-affinity glucocorticoid administered in a unique side-actuated device for the treatment of allergic rhinitis. No previous clinical studies have compared the efficacy of FFNS with another intranasal steroid. The purpose of this study was to compare the efficacy and safety of FFNS, 110 microg/day, once daily with fluticasone propionate nasal spray (FPNS), 200 microg/day, twice daily in patients with Japanese cedar pollinosis to support the regulatory filing in Japan. In this multicenter, randomized, placebo-controlled, double-blind, parallel-group study, patients (>or=16 years old) were randomized to receive 2 weeks of treatment with FFNS (n = 151), FFNS placebo (n = 72), FPNS (n = 148), or FPNS placebo (n = 75). FFNS once daily was noninferior to FPNS twice daily in mean change from baseline in three total nasal symptom scores (3TNSS; sneezing, rhinorrhea, and nasal congestion; -1.23 +/- 0.140 and -1.06 +/- 0.142, respectively). Compared with placebo, FFNS was superior in reducing 3TNSS (p < 0.001). Both FFNS and FPNS showed similar mean changes from baseline in 4TNSS (3TNSS and nasal itching) and individual nasal symptom scores. The onset of action for FFNS was observed from the 1st day of treatment, whereas in the FPNS group it was observed on the 2nd day. There were similar improvements in rhinoscopy findings, activity of daily life interference, and patient-rated overall evaluation to therapy in the FFNS and FPNS groups. FFNS was well tolerated. Treatment with once-daily FFNS was effective and noninferior to twice-daily FPNS in reducing nasal symptoms. Faster onset of action for FFNS was observed.
Allergy Asthma Proc
PMID:Comparison of fluticasone furoate and fluticasone propionate for the treatment of Japanese cedar pollinosis. 1906 37

Allergic conjunctivitis is an inflammatory condition of the ocular surface characterized by ocular itching, redness, tearing, chemosis, and eyelid swelling. The purpose of this study was to assess the comparative efficacy of an ophthalmic antihistamine/mast cell stabilizer solution and an intranasal steroid at reducing the signs and symptoms of allergic conjunctivitis induced by the conjunctival allergen challenge (CAC) model. Sixty subjects were enrolled in a single center, randomized, placebo-controlled, parallel-treatment, four-visit CAC study. After titration and confirmation of the allergic reaction at visits 1 and 2, subjects were randomized at visit 3 into one of 4 treatment groups (olopatadine 0.2% ophthalmic solution, fluticasone furoate nasal spray, a tear substitute, or saline nasal spray), dosed with study medication, and challenged 15 minutes later, after which ocular allergic signs and symptoms were assessed. Subjects continued treatment of the assigned medication for 6 days. At visit 4, subjects underwent similar procedures to those performed at visit 3. Fifty-nine subjects completed the study. Olopatadine 0.2% ophthalmic solution showed statistical and clinical superiority over fluticasone furoate nasal spray at all post-CAC time points after a single dose (p < 0.001) and after a 1-week loading period (p < 0.01) for ocular itching, the primary end point. Similarly, olopatadine 0.2% showed statistical and clinical superiority over fluticasone furoate for the majority of time points for ocular redness, tearing, chemosis, and eyelid swelling. Olopatadine 0.2% ophthalmic solution was statistically and clinically superior to fluticasone furoate nasal spray for the relief of signs and symptoms of allergic conjunctivitis.
Allergy Asthma Proc
PMID:A comparison of olopatadine 0.2% ophthalmic solution versus fluticasone furoate nasal spray for the treatment of allergic conjunctivitis. 1946 11

Patients with chronic diseases, including chronic respiratory diseases, usually have considerably impaired sleep quality that may increase the frequency of exacerbations and severity of symptoms, lead to difficulty in patient management, and reduce quality of life (QOL). During the last few decades, several studies have shown that, in addition to the classic signs of sneezing, nasal itching, rhinorrhea, and nasal obstruction, allergic rhinitis has an important impact on the QOL of adults and children. In 2001, the ARIA (Allergic Rhinitis and its Impact on Asthma) report based its new severity classification on the impact of rhinitis on QOL, with the inclusion of sleep disturbances. Thus, allergic rhinitis patients may also suffer from sleep disorders, emotional problems, as well as impairment in daily activities and social functioning. Given that sleep is fundamental for physical and mental health, the present document reviews the methods and questionnaires used to assess the quality of sleep, the importance of sleep in allergic rhinitis, impairment and improvement of sleep in allergic rhinitis by using medications (antihistamines, topical nasal corticosteroids, nasal decongestants, antileukotrienes) and, finally, the relationship between the sleep apnea syndrome with allergic rhinitis and its treatment.
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PMID:Sleep and allergic rhinitis. 1912 31

Seasonal allergic rhinitis (SAR) is common in adolescents. However, few studies have investigated the effectiveness of intranasal corticosteroids (INSs) for nasal and ocular symptoms of SAR solely in adolescents. The purpose of this study was to determine the safety and efficacy of the INS mometasone furoate nasal spray (MFNS) in adolescents; a post hoc analysis was conducted of adolescents who had participated in a study with adults. Data were analyzed retrospectively for subjects aged 12-17 years with moderate or severe SAR randomized to mometasone furoate, 200 mcg once daily (n = 86), or placebo (n = 82) for 15 days in a multicenter, double-blind, placebo-controlled study. Symptom scores (0 = none to 3 = severe) were recorded in diaries twice daily. End points included changes from baseline in total nasal symptom score (TNSS), individual nasal symptom score (rhinorrhea, congestion, itching, and sneezing), and total ocular symptom score (TOSS). Over 15 days, a significantly greater decrease from baseline in mean TNSS was observed in subjects receiving mometasone furoate (-2.47; -28.8%) compared with those receiving placebo (-0.9; -9.6%; p < 0.001). Significant improvement versus placebo was seen for each full day of treatment. Mometasone furoate significantly improved individual nasal symptoms (p < or = 0.03) and TOSS (p = 0.011) versus placebo. The incidence of adverse events was similar for both treatment groups. MFNS, 200 mcg once daily, is an effective and well-tolerated treatment for symptoms of SAR in adolescents.
Allergy Asthma Proc
PMID:Mometasone furoate improves nasal and ocular symptoms of seasonal allergic rhinitis in adolescents. 1946 75

The diagnostic challenge of rhinitis is to determine the etiology, specifically whether it is allergic or nonallergic. We therefore evaluated the general features of patients with allergic (AR) and nonallergic rhinitis (NAR), as well as health-related quality of life (HRQoL). The study group consisted of 323 patients (201 F/122 M) with a mean age of 31.79 +/- 12.64 years. Almost two thirds of the population had AR (63.5%). Neither the demographic characteristics nor the duration of rhinitis was different between the two groups. Total immunoglobulin E was significantly higher in AR. Although both groups displayed a mild-intermittent rhinitis profile, patients with AR had more seasonal and NAR had more perennial symptoms (p = 0.01). Frequency of nasal obstruction was comparable in both groups, whereas patients with AR significantly complained of rhinorrhea (86.8%), followed by nasal obstruction, sneezing, and nasal itching compared with the NAR group. Conjunctivitis and sinusitis were more prominent in the AR than NAR group (p = 0.01). However, the prevalences of asthma and bronchial hyperreactivity were not different, as well as the other allergic or systemic comorbidities. Furthermore, the impairment in HRQoL was similar in both groups, using a generic questionnaire- Short form-36 (SF-36). In conclusion, although the allergy test results still remain the only relevant difference, the diagnosis of NAR is important as it has many differences/similarities with AR and is seen almost half as often as AR in patients with chronic rhinitis.
J Asthma 2009 Jun
PMID:Allergic and nonallergic rhinitis: can we find the differences/similarities between the two pictures? 1954 69


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