phenylephrine-hydrochloride and Urticaria

This review focuses on comorbidities between nose and skin allergies. For this purpose, allergic rhinitis and chronic rhinosinusitis (CRS) were selected as examples of nasal disorders and atopic dermatitis and urticaria as examples of allergic skin disorders and the individual entities of both localizations were evaluated and compared in relation to their prevalence and coincidence, underlying pathophysiological mechanisms, genetic data and shared therapy options.. The inter-relationships between atopic dermatitis and allergic rhinitis are the best studied, but even for the other comorbidities it was possible to demonstrate comparable pathomechanisms in addition to a high prevalence and coincidence, particularly in the case of atopically assisted forms. In this context, the interactions of IgE, mast cells and eosinophils play a special role, but genetic issues, the significance of epithelial barrier defects and colonization with Staphylococcus aureus are also important sharing issues.. Allergic skin disorders such as atopic dermatitis and urticaria are frequently associated with comorbidities of the nose as well as allergic rhinitis and CRS. By contrast, different manifestations of these diseases involve the nose and the skin. These are not separate diseases but are linked by complex and currently unclear/insufficiently defined inter-relationships.

Topics: Comorbidity; Dermatitis, Atopic; Eosinophils; Humans; Immunoglobulin E; Mast Cells; Nose; Respiratory Hypersensitivity; Rhinitis; Sinusitis; Skin; Staphylococcal Infections; Staphylococcus aureus; Urticaria

Levocetirizine and desloratadine are newer antihistamines indicated for the treatment of allergic rhinitis and chronic idiopathic urticaria.. This article discusses the pharmacokinetics and pharmacodynamics of levocetirizine and desloratadine and reviews studies that have directly compared the effects of these 2 drugs in allergic rhinitis and urticaria.. Relevant articles were identified through a search of MEDLINE from 1999 through 2004 using the main search terms levocetirizine and desloratadine.. Levocetirizine is absorbed rapidly and reaches a steady-state plasma concentration more quickly than does desloratadine. It is also metabolized to a lesser extent than desloratadine, has a lower V(d), and has higher specificity for histamine(1) receptors. Eight well-controlled trials were identified that directly compared the effects of levocetirizine and desloratadine in the skin and nose of healthy individuals and patients with allergic rhinitis. Drug activity was measured in terms of wheal, flare, and itch reactions; nasal symptoms or symptom scores; increases in concentrations of inflammatory markers; or facial thermography. In most of these trials, levocetirizine had a faster onset and greater consistency of effect than desloratadine. The differences in the pharmacokinetic and pharmacodynamic profiles of the 2 drugs may partially explain these clinical findings.. Levocetirizine may be preferred to desloratadine as a treatment option for allergic rhinitis because of its faster onset of action and greater consistency of effect. Although comparative studies in chronic idiopathic urticaria are not available, data from histamine-induced wheal and flare studies in healthy volunteers suggest that levocetirizine may be more effective in preventing itching than desloratadine.

Topics: Cetirizine; Histamine Antagonists; Humans; Loratadine; Nose; Piperazines; Quality of Life; Randomized Controlled Trials as Topic; Rhinitis, Allergic, Perennial; Rhinitis, Allergic, Seasonal; Skin; Urticaria

In addition to their increased potency as H1 blockers and their nonsedating effects, the second-generation antihistamines have other unusual and potentially beneficial properties. Evidence is accumulating from several laboratories that at least one of these agents under investigation, cetirizine, may be effective in inhibiting the late reaction. The Johns Hopkins group showed that during the cutaneous late phase response (LPR), histamine release was not altered by cetirizine, 20 mg, pretreatment. The most dramatic effect of cetirizine was attenuation of inflammatory cell migration into the chamber. Eosinophils, neutrophils, and basophils were reduced by about 75% during hours 6 to 8. It can be concluded that cetirizine influences the LPR by causing a reduction in the inflammatory cell infiltrate. Cetirizine, 10 mg, orally once a day also induced a significant decrease in the wheal and flare skin reactions caused by pollen, histamine, and compound 48/80. Cetirizine inhibited eosinophil recruitment and platelet-activating factor (PAF) in skin chambers 24 hours after pollen challenge. We and others have studied the mechanisms of this effect. The release of eosinophil peroxidase induced by PAF and formyl-methionyleucyl/phenylalanine was not attenuated by cetirizine. At therapeutic concentrations, however, cetirizine has a potent inhibitory action in vitro on eosinophil chemotaxis induced either by formyl-methionyleucyl/phenylalanine or PAF and also on IgE-dependent stimulation of platelets. In a separate study in patients with chronic urticaria, cetirizine markedly reduced both the immediate wheal and flare induced by PAF and the delayed reaction at six hours. These results suggest that cetirizine acts on eosinophil migration to inhibit the late reaction.

Topics: Cetirizine; Histamine Antagonists; Histamine H1 Antagonists; Humans; Hydroxyzine; Hypersensitivity; Hypersensitivity, Delayed; Nose; Skin; Urticaria

Topics: Amylopectin; Amylose; Angioedema; Humans; Moscow; Nose; Oryza; Plant Proteins; Receptor Protein-Tyrosine Kinases; Starch; Starch Synthase; Urticaria

Topics: Animals; Antibodies; Antibody Formation; Antigen-Antibody Complex; Antigen-Antibody Reactions; Cattle; Cholera Vaccines; Complement System Proteins; Cytoplasmic Granules; Desensitization, Immunologic; Guinea Pigs; Histamine H1 Antagonists; Histamine Release; Humans; Hypersensitivity; Intestinal Mucosa; Leukocytes; Lung; Mast Cells; Mice; Myocardium; Nose; Pertussis Vaccine; Polyps; Rats; Skin; Urticaria