BackgroundThe aim of the study is to evaluate the effect of H1 antihistamines on symptoms and pro-inflammatory cytokines plasmatic level in patients with persistent allergic rhinitis (PAR), after 4 weeks treatment, during continuous exposure to allergens.Methods79 patients, mean age 30.44 ± 9.90 years, diagnosed with PAR were included in the study, divided into 2 groups: 39 patients were under treatment with Desloratadine 5 mg/day and 40 patients received Levocetirizine 5 mg/day for 4 weeks. The patients were evaluated before and after the treatment, regarding rhinitis symptoms (sneezing, rhinorrhea, nasal congestion, nasal and ocular itching), total symptoms score, type of sensitisation (indoor or outdoor allergens), plasmatic levels of IL-6 and IL-8. The obtained data were analised using SPSS 15 and GraphPad Prism 4 programs, using Wilcoxon Signed Rank and Mann Whitney test, with a significant P values < 0.05.ResultsBoth Desloratadine and Levocetirizine reduce total symptoms score (8.35 versus 1.97, P = 0.0001, respectively 8.67 versus 1.97, P = 0.0001), especially nasal congestion in patients with allergic rhinitis (1.76 versus 1.02, P = 0.001 and 1.72 versus 0.87, P = 0.0001). IL-6 and IL-8 have no different plasmatic level in patients with allergic rhinitis compared with the values obtained in healthy volunteers. Levocetirizine reduces plasmatic level of IL-6 (1.19 versus 1.006, P = 0.0097) and IL-8 (8.90 versus 6.90, P = 0.0003) after 4 weeks treatment, while Desloratadine has influence only IL-6 level (1.68 versus 1.36, P = 0.0038). The intergroup analysis revealed no significant difference between these 2 drugs regarding IL-6 (P = 0.36) and IL-8 (P = 0.25).ConclusionsBoth studied H1 antihistamines present anti-inflammatory effect in patients with PAR after 4 weeks treatment.
BackgroundThe prevalence of pollen allergy is estimated around 40% in general population. Ragweed (ambrosia artemisiifolia) pollen represents a major source of allergen but was rare in Romania. The aim is to evaluate the symptoms and associated factors in patients with allergic rhinitis to ragweed pollen in the northwest region of Romania.Methods74 patients (pts) (mean age 27.97 ± 13.85 years) with allergic rhinitis to ragweed pollen were included in the study. The patients were clinically evaluated regarding the severity of the symptoms on a scale from 0 to 3 and their duration. A total score over 6 indicates a moderate/severe form of rhinitis. We evaluated the association with other allergic manifestations (asthma and urticaria). All the patients had skin prick tests to inhalant allergens. The obtained data were statistically analyzed using Anova, Chi-square and Fischer tests, with a significance of P < 0.05.Results50.94% of the pts were female. 58.1% of them presented mild allergic rhinitis, while 41.9% moderate severe forms. 27% of the pts were monosensitised to ragweed pollen and 73% of the pts were polisensitised. The patients monosensitised to ragweed had moderate/severe forms of rhinitis (14 vs 86%, P = 0.004) compared with polisensitised group. The symptoms score was higher in pts with monosensitisation compared with polisensitisation pts (7.05 vs 5.28, P = 0.02). In monosensitized group the ocular szmptoms were more frequently present (65 vs 18%, P = 0.02) and were more severe (0.65 vs 0.33, P = 0.01). The number of pts with association of allergic rhinitis and asthma was higher in the polisensitised group compared to the monosensitised one (44.4 vs 11.11%, P = 0.029). The interval between the onset of the symptoms and diagnosis of rhinitis is higher in polisensitised pts and significantly increased in pts with asthma. There is no correlation between environment (rural–urban), age, sex, family and personal allergic history and the type of sensitisation and severity of the symptoms.ConclusionsRagweed produces intense allergogen pollen and determines severe forms of allergic rhinitis and also the presence of ocular symptoms. Polisensitisation increases the risk of associated asthma and also increases the interval betweeen the onset of the symptoms and diagnosis.
BackgroundSoluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular adhesion molecule-1 (sVCAM-1) play and important role in eosinophilic inflammation in allergic rhino-conjunctivitis (ARC). ICAM-1 and VCAM-1 have been identified as key molecules in allergic inflammatory diseases and in a few studies there was an increased value of those molecules in patients with allergic rhinitis. Treatment with H1 antihistamines is known to improve symptoms in allergic rhinitis and in vitro reduces the levels of adhesion molecules.ObjectTo evaluate serum levels of sICAM-1 and sVCAM-1 in pts with ARC to grass pollen and the response to different antihistamines.Methods50 pts with allergic rhino-conjunctivitis to grass pollen were evaluated regarding levels of sICAM-1 and sVCAM-1. The serum sICAM-1 and sVCAM-1 were evaluated during pollen season before and after antihistaminic terapy. Quantikine R&D System was used. Normal mean values in healthy volunteers were 208 ng/mL for sICAM and 557 ng/mL for sVCAM-1. 54% of pts were women and 88% from urban area.ResultsMean levels of sICAM-1 and sVCAM-1 were elevated before therapy of the pts compared with mean values in healthy subjects (235 ng/mL vs 208 ng/mL for sICAM and 966 ng/mL vs 557 ng/mL for sVCAM. 42% of pts received desloratadine therapy and 58% of them received levocetirizine. In both treated groups’ levels of sICAM-1 and sVCAM-1 increased after one month of antihistaminic therapy but no statistical significance. Was obtained: in desloratadine group sICAM-1 (P = 0.066) and sVCAM-1 (P = 0.096); in levocetirizine group sICAM-1 (P = 0.681) and sVCAM-1 (P = 0.4060. Patients with high levels of sICAM-1 and sVCAM-1 at the tended to have increased sICAM-1 and sVCAM-1 levels at one month (P = 0.000). No statistical difference was obtained between the 2 treated groups after one month regarding the levels of sICAM-1 and sVCAM-1.ConclusionsIn patients with allergic rhino-conjunctivitis to grass pollen levels of sICAM-1 and sVCAM-1 are higher than in healthy subjects. Levels of sICAM-1 and sVCAM-1 in serum tend to increase during pollen season despite antihistaminic therapy.
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