Montelukast alone or in combination with antihistamines gave a gradual increase in nasal symptom improvement within 6 weeks of treatment in patients with persistent AR.
Histamine is one of the most important biogenic amines in medicine and biology but its role in allergy, autoimmune and neoplastic diseases has not yet been fully defined. The last few years have brought many discoveries concerning important modulatory effects of histamine and its receptors on basic mechanisms of the immunological processes. The role of histamine H1 and H2 receptors in immunomodulation has been established. The immunomodulatory function of a newly described histamine H4 receptor has been revealed. One of the most important modulatory effects of histamine currently studied is its influence on T lymphocyte differentiation and function. Our present knowledge suggests that histamine may have a wider influence on various immunological processes than is now accepted; therefore, we need further studies to fully clarify the role of histamine and its receptors. This knowledge can bring new therapeutic solutions in allergies, autoimmune diseases and malignancies.
Despite recommendations in most countries for giving inactivated influenza vaccine to people with asthma, only a minority currently receive it. One reason for low vaccine coverage has been concern that vaccination may induce exacerbations of asthma. In this randomized trial, 291 patients between 18 and 65 years of age received either an inactivated influenza vaccine followed 14 days later by a saline placebo or placebo followed by the vaccine. Each patient received 1 dose of vaccine and 1 dose of placebo. The percentage of patients reporting at least one asthma exacerbation within 14 days after injection was similar following vaccine or placebo (28.3% and 25.5%, respectively). The combined exacerbation rate during the first 14-day interval was higher (31.5%) than that during the second 14-day interval (22.4%, P = 0.0135), indicating that the occurrence of exacerbations was not likely to be related to the sequence of injections. The percentages of individuals with solicited systemic symptoms were 56.6% and 44.8% after vaccine or placebo injection, respectively. We conclude that influenza vaccination did not increase the incidence of asthma exacerbations compared to placebo in this study and the vaccine was well tolerated. The results thus support annual influenza vaccination in patients with asthma.
The common cause of exacerbations in asthmatics are viral infections. Infl uenza infection especially increases the risk of respiratory exacerbations. The ACIP report puts asthma among indications to regular infl uenza vaccinations. In practice, many physicians doubt in effectiveness and safety of vaccination in patients suffering from allergy. It caused such procedures were not included in asthma guidelines published by other authors. Our study confi rmed the safety of infl uenza split vaccine vaccination in asthmatics. We proved that vaccination had not any infl uence on asthma control in 14-day period after injection. We showed also high frequency of, mostly local, side effects. These events were generally mild and transient.
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