Clinical reports: Antiinflammatory properties of cetirizine in a human contact dermatitis model: Clinical evaluation of patch tests is not hampered by antihistamines (original) (raw)
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Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy, 1992
The eflect of a single dose of prednisolone (20 mg) or cetiri/inc (10 mg) on the immunohistology of the cutaneous late-phase reaction was detertiiined in a doubleblind, placebo-controlled, cross-over study in 12 atopic allergic individuals. The subjects were challenged with intradermal allergen (30 BLJ) 2 hr after ingestion ofthe drugs or placebo. The magnitude of the cutaneous reactions were determined at 15 min. 6 and 24 hr., and skin biopsies performed at 24 hr. Cetirizine produced a 50% average inhibition ofthe immediate weal and fiare response (F = 0 001) and a 27" i. average inhibition of the 6 hr late-phase induration (NS). Prednisolone reduced the immediate (27"n. /' = 0()3) and significantly inhibited the late-phase reaction (53%, ^ = 002). Prednisolone significantly inhibited infiltration of CD45' (total leucocytes), neutrophil elastase + , EG2' (activated eosinophiis) and CD25 * (1L-2R) cells (/^ = 0-017. ()(}05, 0 005 and 0-032 respectively). CD3, CD4, CDS and HLA-DR expression was also Inhibited but this was not significant. Cetiri/ine also reduced the numbers of EG2 ^ cells, particularly those with high counts before treatment but the overall results were not significant. No other changes in the cellular infiltrate were demonstrated when cetirizine was compared with placebo. These findings indicate a single dose of prednist)Ione significantly reduces leucocyte infiltration and activation as well as the magnitude of the cutaneous late-phase reaction.
2017
vicious cycle which exacerbates the disease activity (Leung 2000; Amylynne et al 2011). The management of AD includes avoidance of irritants and trigger factors, tackle itching and skin dryness, as well as cope with the inflammatory reaction and secondary infections. Current mode of treatment is to provide anti-inflammatory therapy with or without antibiotics, in oral or topical administration.. Topical preparations to improve the barrier function of the skin in some chronic cases that have lasted not quite effective in reducing of itching in patients, oral antihistamines later become the treatment of choice for reducing of itching in AD (Adinoff et al 1996). Cetirizine is a potent second generation and selective antihistamine. ETAC (early treatment of the atopic child) study in 2002 showed its long-term use for 18 months in infants who suffer AD, which can reduce the probability of asthma by 50% in the group of children that were sensitized by pollen and house dust mites (Diepgen 2...
Role of Patch Test in Allergic Contact Dermatitis
Background: Patch Testing is a simple non invasive diagnostic procedure of Contact were subjected for patch test to detect Dermatitis. It is performed by applying the standard series of antigens along with suspected substances in appropriate concentrations to the normal skin in a standardised vehicle and the results are read after 48-72 hours as per the criteria laid down by International Contact Dermatitis Research Group. At present Patch Testing is the only practical and scientific method of demonstrating contact hypersensitivity. This Test elicits an immune response by challenging an already sensitized person to defined amounts of allergen and assessing the degree of response. The test relies on the allergen being absorbed in sufficient quantity to induce a reproducible inflammation of the skin at the site of application in sensitized person. Materials and Methods: A total of 50 patients of either sex, in the age group of 10-69 years, with clinically suspected contact dermatitis who attended the Out were studied. Based on history, occupational exposure, hobbies and examination findings patch test was conducted on them to detect causative agent. The test is based on the principle that in allergic individual, the whole skin is capable of reacting with the causative agent. For the test, patients presenting with eczematous lesions of more than one month in whom clinical suspicion of Allergic Contact Dermatitis is present and willing to undergo Patch Testing with informed consent were selected. Results: Patch test was found to be positive in 70.1% of the patients(I.e. 35 out of 50 cases studied).Occupation among these patients varied from housewives, mason,, farmers, factory workers, clerks, student and others. The predominant sites involved among those found to be positive to the test in the order of priority is hands, airborne, hands and feet, face, feet and other generalized parts Conclusion: The highest incidence of eczema was seen in the age group of 2 nd and 3 rd decade of life. Lichenification was the commonest morphological pattern followed by dry scaling, erythema papulovesiculation, oozing and depigmentation. Potassium dichromate was found to be the commonest allergen in hand dermatitis. It was followed by rubber ingredients, parthenium, nickel sulphate and others.
The effect of cetirizine on IFN-gamma and IL-10 production in children with allergic rhinitis
The Turkish journal of pediatrics
Cetirizine, one of the most commonly used antihistamines for the treatment of allergic diseases, possesses some anti-inflammatory properties. Despite its common use, the effect of cetirizine on the production of cytokines from peripheral blood mononuclear cells (PBMCs) needs further clarification. The aim of this study was to investigate whether cetirizine changes interleukin (IL)-10, (IF)-gamma and IL-4 production from PBMCs in children with allergic rhinitis. Thirteen children with allergic rhinitis sensitized to house dust mite (HDM) were treated with cetirizine for four weeks. Blood samples were drawn just prior to the treatment, on the last day of the treatment and two weeks following the cessation of treatment The cytokine production from PBMCs was tested in the presence or absence of HDM allergen and measured by ELISA assay. An augmentation in IL-10 production was observed in PBMCs at the 4th week of cetirizine treatment (p<0.05). Furthermore, a significant increase in IFN...
Onset and duration of action of topical antihistamine: a study of histamine skin test response
International Journal of Dermatology, 2008
Background Most patients who require skin prick testing cannot deal with their pruritus without taking antihistamines (AH). Orally administered AH has a quick onset of action, but it will suppress skin test responses (STR) from several days to weeks. In this study, we aimed to determine the onset and duration of action of single topical AH application by observing histamine-STR suppression over time.Methods A two-step, randomized, intraindividual parallel-comparative, double-blind, placebo-controlled trial was conducted on the volar side of the forearm. Step 1 was aimed to determine the onset, while step 2 determined the duration of action. The topical AH tested was a single application of 5% doxepin hydrochloride cream, while 10 mg/ml histamine dihydrochloride was used to test the skin responses.Results Our 10 subjects’ mean age was 35.8 ± 3.179 years. Histamine wheal response was suppressed starting on minute 90 and the wheal width were back to ≥ 7 mm2 on minute 270. Significant histamine reactivity difference between genders (P = 0.201) and atopic status (P = 1.000), which could be a source of bias in histamine STR, was not found among our subjects.Conclusion Single application of topical AH has an onset of action in 90 min and duration of action < 180 min. Because of its short duration of action, topical AH can be used in a patient who needs AH but is scheduled to undergo skin prick testing after a few hours, without influencing the patient's STR.
Journal of Allergy and Clinical Immunology, 2001
Background: Because asthma is not a curable condition, the development of strategies for prevention of the disease has a high priority. Atopic dermatitis is a common precursor to the development of asthma, and 2 studies have suggested that the use of an H 1 receptor antagonist might reduce the development of asthma while the treatment is being administered, at least in subgroups with evidence of high IgE levels. However, no trial to date has conducted follow-up after the initial treatment has been stopped to establish whether the intervention has merely suppressed symptoms or truly prevented disease. Objective: We sought to establish whether the use of cetirizine compared with placebo for 18 months in infants with atopic dermatitis suppressed or truly delayed the onset of asthma, even after cessation of therapy. Methods: The Early Treatment of the Atopic Child study was a double-blinded, parallel-group, randomized trial of 0.25 mg/kg body weight cetirizine administered twice daily compared with placebo given to infants between 1 and 2 years of age with atopic dermatitis. After 18 months of treatment, follow-up continued for a further 18 months. This article reports the outcome over the full 3 years of follow-up and relates the outcomes to the allergic status on the basis of IgE antibody measurements at recruitment. Results: Although there was no difference in cumulative prevalence of asthma between active and placebo treatment in the intention-to-treat population (P = .7), those infants with evidence of sensitivity to house dust mite, grass pollen, or both who were treated with cetirizine were significantly less likely to have asthma compared with those treated with placebo over the 18 months of treatment (P = .005 and .002, respectively), and this effect was sustained for the grass pollen-sensitized infants over the full 36 months (P = .008). In the house dust mite-sensitized group there was a gradual narrowing of the difference between active and placebo treatment in terms of cumulative prevalence of asthma at the end of 36 months but no evidence of a rebound immediately after the treatment stopped (P = .04). In the placebo population there was a significantly higher risk of development of asthma in those sensitized at baseline to egg ), house dust mite (relative risk, 1.6 [95% CI, 1.3-1.9]), grass pollen (relative risk, 1.7 [95% CI, 1.4-2.1]), or cat (relative risk, 1.5 [95% CI, 1.2-1.9]). Early and persistent sensitization conferred a higher risk than transient or later sensitization. Conclusions: Cetirizine compared with placebo truly delays or, in some cases, prevents the development of asthma in a subgroup of infants with atopic dermatitis sensitized to grass pollen and, to a lesser extent, house dust mite. Further studies are required focusing specifically on sensitized groups to substantiate this finding. The study also highlights risk factors for asthma in infants with atopic dermatitis and indicates that early and persistent aeroallergen sensitization confers a higher risk than later development of sensitivity. (J Allergy Clin Immunol 2001;108:929-37.)
367 Evaluation of Allergen Sensitivity in Patients with Contact Dermatitis in Antalya
World Allergy Organization Journal, 2012
eligible patients were challenged with antigen 27 minutes after dosing. To assess duration of action, patients were challenged with allergen 16 hours after dosing. The percentage of eyes with zero itching in both studies was assessed at 3 minutes post allergen challenge. Results: The percentage of eyes with zero itch at the 3 minutes timepoint after the onset of action allergen challenge was 60.0% for OLO-treated eyes compared with 5.9% for vehicle-treated eyes (P , .0001, OLO vs vehicle). The percentage of eyes with zero itch at 3 minutes post allergen challenge following the 16-hour dosing was 59.8% for OLO-treated eyes compared with 22.0% for vehicle-treated eyes (P , .0001, OLO vs vehicle). Conclusions: In bilateral CAC studies, ocular itching was prevented in a higher percentage (P , .0001) of eyes treated with 0.2% olopatadine hydrochloride ophthalmic solution when compared with vehicle as early as 30 minutes and for at least 16 hours post dosing.
Our Dermatology Online, 2017
Introduction: The patterns of positive patch test in Nepal have not been defined so far. The aim of this study was to describe the patterns of patch test reactivity in suspected Allergic Contact Dermatitis (ACD) patients. Methods: This was a hospital based retrospective study performed to investigate patch test reactivity in patients with ACD from April, 2016 through October, 2016. The data of patients who underwent patch test during this period were extracted and analyzed. Results: A total of 35 patients were included in the study. Nineteen (54.3%) tested positive to either one or more allergens. Among them, 17 (89.4%) reacted positively to a single allergen. The following patterns of positives were seen: nickel sulfate, 5 (26.3%), fragrance mix 3 (15.7%), and parthenium 3 (15.7%). Cobalt sulfate, formaldehyde, potassium dichromate, benzocaine nitrofurazone, chlorocresol each was positive in single patient. Majority of the patients were housewives (22.6%) followed by students and officers (13% each), farmers (10%), health care workers (9.7%), wet work (6.5%) and others (20). Less than half (45%) of the hand eczema showed positive patch test. Similarly,40% of the patient of scattered generalized dermatitis showed reactivity to parthenium, nickel sulfate and multiple antigens. Conclusions: The most common allergens identified were nickel sulfate, fragrance mix and parthenium. Since, there is no well defined contact allergen in the Nepalese community, so patch test kits developed elsewhere might not have been beneficial and calls for need of large scale investigation to identify the local allergens.