Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P15088 (mast cell)
 14,925 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In recent years, there has been renewed interest in the topical treatment of allergic conjunctivitis, a disorder that is involved in the common red-eye syndrome. Topical treatment for rapid relief of symptoms is most often preferred by the patient, although physicians are more cautious with the choice of an agent that might worsen symptoms due to contact irritation induced by the substance or its preservative. Theoretical advantages of topical over oral administration include a more rapid onset of action, since the active agent is applied directly to the affected tissue, and a reduced potential for systemic adverse effects. The range of topical agents currently available for the treatment of allergic conjunctivitis varies widely. The 4 primary aims when considering local drug application are: rapid symptomatic relief (particularly applicable to local vasoconstrictors and histamine antagonists);prophylactic therapy (mast cell stabilisers);avoidance of systemic adverse reactions (eye drops containing corticosteroids); anddirect route of administration (specific ocular immunotherapy). In this article we review the underlying pathological mechanisms, present a clinical and diagnostic overview and discuss the available therapeutic options. Finally, we present our treatment strategy, which is based on the nature of the disorder and the patient's expectations. In seasonal or perennial conjunctivitis the combination of decongestants and antihistamines should be first choice for palliative treatment. Mast cell stabilisers should be used as prophylaxis, while immunotherapy can provide a cure. In vernal and atopic keratoconjunctivitis, the decongestant/antihistamine combination can be used for long-term treatment, while courses of topical corticosteroids may prevent flares. Mast cell stabilisers, with lodoxamide in the first place, are used for prophylactic therapy. Surgery may be useful in handling complications. In giant papillary conjunctivitis, hygienic measures regarding contact lenses are mandatory, and sodium cromoglycate (cromolyn sodium) may provide rapid relief. In contact conjunctivitis, removal or avoidance of the sensitiser is most important. Topical use of corticosteroids should be limited to severe cases.
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PMID:Optimal use of topical agents for allergic conjunctivitis. 1802 May 17

In a Japanese cedar pollen-induced allergic conjunctivitis model in guinea pigs, symptoms were aggravated by repeated pollen challenges. In addition, the number of mast cells in the conjunctiva was increased by multiple challenges. The amount of a mast cell mediator, histamine in ophthalmic lavage fluid was also increased by multiple challenges. In the present study, we evaluated the effects of multiple dexamethasone treatments to assess the relationship between the aggravation of symptoms and mast cell hyperplasia. Sensitized guinea pigs were challenged by dropping a pollen suspension onto their eye surface once a week until the 15th challenge. Dexamethasone (10 mg/kg, p.o.) was administered once 3 h before the 15th challenge or 3 h before every 1st--15th challenge. Mast cells in the conjunctival tissue were detected by toluidine blue staining. Histamine was fluorometrically assayed by high-performance liquid chromatography. Serum Cry j 1-specific IgE titer was measured by an enzyme-linked immunosorbent assay. The results indicated that a single treatment with dexamethasone did not affect the 15th challenge-induced symptoms; however, multiple treatments with the corticosteroid suppressed not only conjunctivitis symptoms after every challenge but also the mast cell hyperplasia and the increase in histamine in the lavage fluid. Conversely, the increase in the IgE titer in the serum was not affected by multiple treatments with dexamethasone. In conclusion, increased numbers of mast cells in the conjunctival tissue may be associated with the aggravation of allergic conjunctivitis symptoms.
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PMID:Effects of multiple dexamethasone treatments on aggravation of allergic conjunctivitis associated with mast cell hyperplasia. 1831 Sep 11

Allergic diseases, such as allergic asthma, allergic rhinitis, atopic dermatitis, conjunctivitis, urticaria, food allergy, and/or anaphylaxis, are associated with the skewing of immune responses towards a T helper 2 (TH2) phenotype, resulting in eosinophilic inflammation. TH2 cytokines, such as interleukin (IL)-4, IL-5 and IL-13, promote IgE production, mast cell differentiation, and eosinophil growth, migration and activation which then lead to the pathologic abnormalities in allergic diseases. Moreover, the impaired function of regulatory T cells has been noted in allergic diseases. To date, treatments for allergic diseases, such as antihistamines, corticosteroids, bronchodilators and some allergen-specific immunotherapy, are effective but costly and require long-term and recurrent drug administration. Gene therapy has been shown to be an easy, effective, and convenient treatment by delivering the allergen or the therapeutic protein in the form of plasmid DNA in vivo to modulate allergic immune responses. We summarize here the recent advances of gene therapy in allergic diseases and discuss the challenges in clinical application.
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PMID:Gene therapy for allergic diseases. 1951 63

Allergy is an over-reaction of the body's immune system to innocuous foreign substances or allergens that the body perceives as a potential threat or undesirable. It is estimated to affect approximately 20% of the population. Of this subset at least 20% suffer from ocular allergy. It has a significant impact on the quality of life of the individual. Allergic diseases are those conditions in which an antibody- and/or T-cell mediated mechanisms are involved. Allergic eye diseases are characterized by IgE-mast cell mediated, as seen in allergic conjunctivitis; chronic mast cell activation and eosinophil/T-lymphocyte-mediated response, as seen in giant papillary conjunctivitis, vernal keratoconjunctivitis and atopic keratoconjunctivitis; or a T-lymphocyte-mediated response in contact ocular allergy. The management of allergic eye disease is aimed at preventing the release of mediators of allergy, controlling the allergic inflammatory cascade and preventing ocular surface damage secondary to the allergic response. In the management of ocular allergic disease, the clinician is advised to recommend non-pharmacologic and pharmacologic therapeutic regimens that address the acute presentation of ocular allergy and provide prophylaxis aimed at providing long-term maintenance therapy. This approach to the management of allergic eye diseases aims to minimize the impact of the allergic reaction on the individual's quality of life. To achieve success in the management of allergic eye diseases, the clinician requires a considerable understanding of the pathophysiology, clinical features and differential diagnosis of the different types of ocular allergy, as well as an adequate knowledge of their pharmacotherapy.
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PMID:The management of allergic eye diseases in primary eye care. 1987 97

Allergic conjunctival diseases caused by immediate hypersensitivity are classified into several subtypes, including seasonal or perennial allergic conjunctivitis, vernal keratoconjunctivitis (VKC), atopic karatoconjunctivitis, giant papillary conjunctivitis. The gold standard in treatment of seasonal allergic conjunctivitis, especially Japanese cedar pollinosis, is anti allergic ophthalmic solution, mast cell stabilizer and histamine H1 blocker. During the peak pollen count period, we use an ophthalmic steroid solution. Preseasonal treatment with anti allergic ophthalmic solution is effective to decrease symptoms during the peak pollen count period. Topical steroids are most effective treatment for VKC, but are also frequently associated with increasing intraocular pressure. A recent treatment combining anti allergic ophthalmic solution, steroid ophthalmic solution and topical immunomodulator (cyclosporine 0.1% or tacrolimus 0.1%) proves very effective and safe for severe VKC.
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PMID:[Ophthalmology]. 1989 34

Non-allergic eosinophilic conjunctivitis (NAEC) is a fairly common but poorly known ailment, often associated with dry eye syndrome. The majority of patients are middle-aged or elderly women. The symptoms are similar to those in allergic conjunctivitis, whereas atopic allergy cannot be found. Eosinophilic inflammation is first eased by instillation of glucocorticoid antibiotic eye drops, and the treatment is usually continued with mast cell stabilizer and moistening drops for a long time. Short courses of glucocorticoid drops and, sometimes, immunosuppressive medication of longer duration are required as additional therapies.
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PMID:[Non-allergic eosinophilic conjunctivitis]. 2059 44

Ocular allergy is an inflammatory response of the conjunctival mucosa that also affects the cornea and eyelids. Allergic conjunctivitis includes seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis (AKC) and giant papillary conjunctivitis (GPC). In general, allergic conditions involve mast cell degranulation that leads to release of inflammatory mediators and activation of enzymatic cascades generating pro-inflammatory mediators. In chronic ocular inflammatory disorders associated with mast cell activation such as VKC and AKC constant inflammatory response is observed due to predominance of inflammatory mediators such as eosinophils and Th2-generated cytokines. Antihistamines, mast-cell stabilizers, nonsteroidal anti-inflammatory agents, corticosteroids and immunomodulatory agents are commonly indicated for the treatment of acute and chronic allergic conjunctivitis. In recent years newer drug molecules have been introduced in the treatment of allergic conjunctivitis. This article reviews recent patents and emerging therapeutics in the treatment of allergic conjunctivitis.
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PMID:Recent patents and emerging therapeutics in the treatment of allergic conjunctivitis. 2117 52

Current treatment options for allergic rhinoconjunctivitis include topical antihistamines, vasoconstrictors, mast cell stabilizers, intranasal corticosteroids (INCS), and nonsteroidal anti-inflammatory drugs that are generally used as a supplement to oral or intranasal therapies, necessitating the use of multiple treatments for the different symptoms of allergic rhinitis (AR). To assess the efficacy of INCS for ocular symptoms (OS) of AR. A search was performed of clinical trials (n = 32) from 1973 to 2009 of English articles (Medline, Embase, and PubMed) using "intranasal corticosteroid," "allergic rhinitis," "ocular symptoms," "allergic conjunctivitis," and "rhinoconjunctivitis" as key words. Quality assessment for the 32 eligible studies was performed using the Jadad score. Statistical analysis for continuous data was done by weighted mean difference or standardized mean difference. Thirty-two trials were included and separated into three different groups. The overall weighted mean was obtained from the Jadad score and came out to 9.29 (95% CI, 8.7-9.88). For meta-analysis for total OS scores and individual symptoms (10 parallel studies) the weighted mean was 10.17 (95% CI, 9.34-11). In the parallel studies, meta-analysis of individual symptoms (nine studies) gave a weighted mean of 10.09 (95% CI, 9.55-10.63). For eye symptoms but no individual symptoms (13 studies), the weighted mean was 8.56 (95% CI, 7.66-9.46). To date, clinical studies conducted statistically showed the efficacy of INCS on the OS of AR as evidenced by the meta-analysis results for the studies reporting total OSs.
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PMID:Efficacy of intranasal corticosteroids for the ocular symptoms of allergic rhinitis: A systematic review. 2126 95

Allergic diseases have greatly increased in industrialized countries. About 30% of people suffer from allergic symptoms and 40%-80% of them have symptoms in the eyes. Atopic conjunctivitis can be divided into seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC). The treatment of SAC is simple; antihistamines, anti-inflammatory agents, or chromoglycate. In severe cases of SAC, subcutaneous or sublingual immunotherapy is helpful. PAC needs longer therapy, often year round, with mast cell stabilizers, antihistamines, and sometimes local steroids. Atopic keratoconjunctivitis is a more severe disease showing chronic blepharitis often connected with severe keratitis. It needs, in many cases, continuous treatment of the lid eczema and keratoconjunctivitis. Blepharitis is treated with tacrolimus or pimecrolimus ointment. Conjunctivitis additionally needs corticosteroids and, if needed, cyclosporine A (CsA) drops are administered for longer periods. Basic conjunctival treatment is with mast cell-stabilizing agents and in addition, antihistamines are administered. Vernal keratoconjunctivitis is another chronic and serious allergic disease that mainly affects children and young people. It is a long-lasting disease which commonly subsides in puberty. It demands intensive therapy often for many years to avoid serious complicating corneal ulcers. Treatment is mast cell-stabilizing drops and additionally antihistamines. In relapses, corticosteroids are needed. When the use of corticosteroids is continuous, CsA drops should be used, and in relapses, corticosteroids should be used additionally. Nonallergic eosinophilic conjunctivitis (NAEC) is a less known, but rather common, ocular disease. It affects mostly middle-aged and older women. The eye symptoms of NAEC are largely similar to those seen in chronic allergic conjunctivitis. Basic therapy is mast cell-stabilizing drops. Eosinophilic inflammation needs additional corticosteroids. In severe cases, CsA drops are recommended. Antihistamines should be avoided. It is important to recognize the different forms of allergic ocular diseases and to start the treatment early and intensively enough to avoid chronicity of the disease and accompanying tissue destruction.
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PMID:Updates in the treatment of ocular allergies. 2143 49

About 30% of people suffer from allergic symptoms, and 40% to 80% of them have eye symptoms. Atopic conjunctivitis is divided into seasonal allergic conjunctivitis and perennial allergic conjunctivitis. The treatment of seasonal allergic conjunctivitis is simple: antihistamines, anti-inflammatory agents, or cromoglycate. Perennial allergic conjunctivitis needs longer therapy with mast cell stabilizers and sometimes local steroids. Atopic keratoconjunctivitis requires long-term treatment of the lid eczema and keratoconjunctivitis. Vernal keratoconjunctivitis mainly affects children and young people. It commonly calms down after puberty. It demands intensive therapy, often for many years, to avoid serious complicating corneal ulcers. Giant papillary conjunctivitis is a foreign body reaction in contact lens users or patients with sutures following ocular surgery. Nonallergic eosinophilic conjunctivitis affects mostly middle-aged and older women with eosinophilic conjunctivitis and dry eye. Contact allergic blepharoconjunctivitis is often caused by cosmetics and eye medication. Work-related ocular allergies should be considered as a cause of resistant ocular symptoms in workplaces.
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PMID:Diagnostics and new developments in the treatment of ocular allergies. 2238 7


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