Effects of loratadine and cetirizine on serum levels of neuropeptides in patients with chronic urticaria

Abstract

H1-receptor inhibiting drugs, namely loratadine and cetirizine, were frequently used in treatment of chronic urticaria. Urticarial weal and flare reactions, a neurogenic reflex due to neuropeptides, were reported to be more effectively inhibited by cetirizine than loratadine. The aim of this study was to determine and compare the effects of systemic loratadine and cetirizine treatments on serum levels of selected neuropeptides in chronic urticaria. Treatment groups of either systemic loratadine or cetirizine (10 mg/d), consisting of 16 and 22 patients, respectively, were included. Serum levels of stem cell factor (SCF), neuropeptide Y (NPY), calcitonin gene-related peptide (CGRP), nerve growth factor (NGF), vasoactive intestinal peptide (VIP), and substance P (SP) were detected before and after one week of treatment with antihistamines. Serum NPY and VIP levels were significantly decreased when compared before and after treatment with antihistamines (P < 0.001 and P < 0.01, respectively). SCF and NGF values were also decreased after antihistamine treatment (P < 0.05). Post-treatment levels of CGRP were significantly higher compared with pretreatment values, while no significant difference was detected between pre and post treatment levels of SP. Cetirizine was significantly more effective than loratadine on lowering serum levels of SCF among the other neuropeptides. Systemic loratadine and cetirizine treatments in patients with chronic urticaria precisely caused variations in serum levels of neuropeptides. The predominant effect of cetirizine compared to loratadine on reducing serum SCF levels might be explained with anti-inflammatory properties of cetirizine.

Effects of Desloratadine Citrate Disodium on Serum Immune Function Indices, Inflammatory Factors and Chemokines in Patients with Chronic Urticaria

“…3,4 A second-generation antihistamines turned loratadine is one of the most commonly used medicines for clinical treatment of chronic urticaria. 5,6 Desloratadine citrate disodium is the latest antihistamine agent. Pharmacological pharmacokinetic studies have shown that it has higher solubility than other second-generation antihistamines with better safety, so it may have better efficacy for the treatment of chronic urticaria.…”

Looking forward to new targeted treatments for chronic spontaneous urticaria

“…For example, Metz et al found that serum SP is upregulated in CSU, and levels were correlated with disease activity [58, 69 ]. Serum levels of neuropeptides such as neuropeptide Y, vasoactive intestinal peptide, stem cell factor and nerve growth factor were shown to be significantly decreased after treatment with H1 antihistamines in CSU patients [70, 71 ].…”

Synergistic Effect of H1-Antihistamines on Topical Corticosteroids for Pruritus in Atopic Dermatitis: A Systematic Review and Meta-Analysis

“…An RCT showed that levocetirizine and desloratadine were able to reduce the plasma levels of pro-inflammatory cytokines, including IL-1β and IL-8, in patients with allergic rhinitis 15 . Other antihistamines, such as loratadine and cetirizine, have been reported to reduce serum neuropeptides, including neuropeptide Y, vasoactive intestinal peptide stem cell factor, and NGF 16 . A study of stimulated NGF secretion by histamine from cultured astrocytes showed that the H1-histamine receptor was involved in the signal transduction pathway of NGF 17 .…”