A study of the effect of various drugs on the whealing reaction

Newman

Pixley

et al. 1988

Brit J Clinical Pharma

On three separate occasions 12 atopic subjects were injected intradermally with two doses of antigen and one of saline as control. Pretreatment with terfenadine 60 mg orally significantly inhibited the flare response to both the lower dose of antigen and to saline (P less than 0.05). Ingestion of enalapril 5 mg orally 3 h before increased the flare response to both doses of antigen. Neither enalapril nor terfenadine affected the weal response when compared with placebo. Both endogenous histamine and bradykinin appear to be released during the intradermal flare response but are not important in the weal reaction to antigen.

Section: Discussionsupporting

confidence: 49%

The importance of bradykinin and histamine in the skin response to antigen.

Newman

Pixley

et al. 1988

Brit J Clinical Pharma

“…Systemically administered jS2-agonists, theophylline and corticosteroids have previously been shown to have no influence on the skin response to either intradermal antigen or histamine [1][2][3][4]. However, if the area of skin to be challenged is pre-treated with an injection of a jS2-agonist, then this high local concentration attenuates the response to intradermal antigen [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Systemic adrenaline attenuates skin response to antigen and histamine

Clin Experimental Allergy

McCusker

Fuller

1988

Summary Six atopic subjects received either adrenaline (0.3 ml of 1 mg/ml), subcutaneously over the deltoid muscle, or saline on 2 separate days. After 10 min, histamine and antigen were injected intradermally in the forearm. Adrenaline significantly inhibited the flare of histamine and both the flare and weal of antigen (P< 0.05). This anti‐allergic action of adrenaline occurred with a dose that we have previously shown produces plasma concentrations at the upper limit of the physiological range in resting normal subjects.

“…It may be that a higher dose of salbutamol is needed since previous studies with oral Iadrenoceptor agonists have shown no suppression of skin test responses (Galant et al, 1973;Spector, 1978;Abramowitz et al, 1980), although the topical application or local injection of these drugs attenuates the response to intradermal antigen presumably by higher local concentrations (Mosko & Marshall, 1954;Ting et al, 1983;Gronneberg et al, 1980). However, the dose of salbutamol used in the present study caused greater systemic side effects than adrenaline and the difference in efficacy between adrenaline and salbutamol in suppressing weal remains unexplained.…”

Section: Discussionmentioning

confidence: 56%

Importance of beta 2‐adrenoceptor stimulation in the suppression of intradermal antigen challenge by adrenaline.

Pixley

Dollery

1989

Brit J Clinical Pharma

1 Seven atopic subjects received two injections of antigen and one of saline intradermally in the back on each of 4 separate days. They were pretreated with four different drug combinations: (a) adrenaline 0.3 mg subcutaneously over the deltoid muscle (b) subcutaneous adrenaline preceded by 5 mg of the specific ,32-adrenoceptor antagonist ICI 118,551 orally (c) 8 mg of salbutamol orally (d) placebo. Tablets were given 2 h before and subcutaneous injections 15 min before the intradermal injections of saline and antigen. 2 The median flare response to intradermal low dose antigen and high dose antigen after pretreatment with adrenaline was 4% and 49% of the response seen following pretreatment with placebo (P < 0.001). When adrenaline was preceded by ICI-118,551, the corresponding median flare responses were 2% and 44% (P < 0.001) of the placebo response. The flare response after pretreatment with salbutamol was not significantly different from placebo.3 Adrenaline suppressed the median weal response to the higher dose of antigen to 52% of the response after pretreatment with placebo (P < 0.05). This suppression by adrenaline was blocked by pretreatment with ICI 118,551. The median weal response after the highest dose of antigen was suppressed by salbutamol to 66% of the response seen after placebo, although this was not significant even when a further three subjects were studied with either salbutamol or placebo. 4 These results confirm that a small dose of systemic adrenaline attenuates the weal and flare response to intradermal antigen. This suppression of the weal response is blocked by a P2-adrenoceptor antagonist although it is only partially mimicked by high dose oral salbutamol. The suppression of the flare response may involve a-adrenoceptor stimulation.