Effect of antihistamines on epithelial cells

Abstract

Antihistamines have mostly been used in the management of allergic rhinitis, primarily for their symptomatic relief. Recent studies, however, have suggested that the non-sedating second-generation antihistamines also possess anti-inflammatory activity, and consequently may be useful in the management of inflammation in allergic airways disease. Several in vivo studies have demonstrated that antihistamines decrease inflammatory cell infiltration in allergic disease, mediator release from mast/basophil cells, and the expression of adhesion molecules on epithelial cells. Similarly, in vitro studies have demonstrated that antihistamines decrease the migration and activation of eosinophils and the release of pro-inflammatory mediators from mast/basophil cells, induced by immunological and non-immunological stimuli. More recent evidence suggests that the antihistamines may modulate airway inflammation by influencing the activity of airway epithelial cells, which due to their spatial arrangement and predominance in the airways, are thought to play a pivotal role in the aetiology of airway disease. We and others have demonstrated that antihistamines attenuate allergen- or chemical-induced expression and/or release of mediators which influence the activity of inflammatory cells, such as eosinophils, mast cells, basophils and lymphocytes, known to be involved in the pathogenesis of allergic airway diseases. Collectively, these studies suggest that second-generation H1-histamine receptor antagonists may have potential use either as safe anti-inflammatory alternatives to corticosteroids, or as rescue medication in combination with corticosteroids, for the management of severe airway disease.

The potential of active metabolites of antihistamines in the management of allergic disease

“…3). Similarly, in vitro studies have also demonstrated that several antihistamines, including astemizole, azelastine, ebastine, ketotifen, loratadine, and terfenadine, can inhibit stimulated release of histamine and/or other inflammatory mediators from human lung, skin, and tonsillar mast cells/cell lines ( 20, 61); basophils/basophilic cell lines ( 20, 61); and epithelial cells/cell lines ( 21, 62). Other studies have demonstrated that azelastine, ebastine, ketotifen, loratadine, or terfenadine can also inhibit the viability, migration, or activation of human eosinophils, neutrophils, or lymphocytes ( 20).…”

“…Although the antihistamines are not generally thought to influence the mechanisms underlying the pathogenesis of allergic disease, recent studies have shown that several antihistamines also possess anti‐inflammatory properties, in addition to their antihistaminic properties, suggesting that these drugs may be useful in the management of inflammation in allergic disease. Indeed, it has been suggested that, in view of their cationic amphiphilic nature, many of these compounds will readily associate with and perturb the function of other non‐H 1 ‐receptor cell membrane complexes and/or enzymes ( 20), possibly attenuating pathways which play a role in signalling and initiation of the inflammatory processes ( 21).…”

Midwifery Management of a Birthing Person with Cervical Edema During Labor

“…24 Studies have shown evidence that antihistamines decrease inflammatory cell infiltration in allergic disease on respiratory tract epithelial cells. 25 The cervix is composed of epithelial cells that share similar histamine-producing mast cell characteristics as those in the respiratory tract. 26 More specifically, the endocervix is lined by simple columnar epithelium, whereas the ectocervix is lined by stratified squamous epithelium, and the underlying layers are largely connective tissue fibers.…”

“…Diphenhydramine is an H1‐receptor antagonist, or antihistamine, which blocks inflammation‐producing histamine from binding to receptors in smooth muscle 24 . Studies have shown evidence that antihistamines decrease inflammatory cell infiltration in allergic disease on respiratory tract epithelial cells 25 . The cervix is composed of epithelial cells that share similar histamine‐producing mast cell characteristics as those in the respiratory tract 26 .…”