In vivo anti‐inflammatory effects of fexofenadine in chronic idiopathic urticaria

Cellular adhesion molecules in chronic urticaria: modulation of serum levels occurs during levocetirizine treatment

“…Treatment with levocetirizine 5 mg daily for 6 weeks produced in all subjects with urticaria a decrease in serum CAMs that paralleled a subjective improvement in these same patients. The inhibitory effects of antihistamines on CAMs have already been established in allergic diseases, 17,18,26 and our results seem to confirm this role for the new molecule levocetirizine. The mechanism by which anti‐H1 drugs counteract the effects of histamine is mainly dependent on binding and stabilizing the inactive form of the receptor, but recent studies also suggest that desloratadine and loratadine directly influence ICAM‐1 mRNA production via inhibition of nuclear factor κ B (NF‐ κ B) in target cells during rhinovirus infection 27 .…”

“…Some studies have also detected CAMs in skin specimens from patients with CU 12,13,17,25 . ICAM‐1, ELAM‐1 and VCAM‐1 showed an upregulation in wealing skin, but the most relevant finding at the cutaneous level seemed to be the strong production of CAMs also in apparently unaffected skin, that one could interpret as a sign of the latent MPI in patients with urticaria.…”

“…ICAM‐1 is promptly produced on nasal and conjunctival epithelia after allergen exposure, 8,9 but is also detected when patients are symptom free, therefore representing a reliable marker of both clinical and minimal persistent inflammation (MPI) 10 . Moreover, it seems clear that CAM upregulation also plays a pivotal role in cutaneous allergic diseases 11–13 and that newer antihistamines such as fexofenadine, cetirizine, loratadine and desloratadine can efficaciously modulate this part of the immunological mechanisms involved in disease pathogenesis 14–18 …”

“…10 Moreover, it seems clear that CAM upregulation also plays a pivotal role in cutaneous allergic diseases [11][12][13] and that newer antihistamines such as fexofenadine, cetirizine, loratadine and desloratadine can efficaciously modulate this part of the immunological mechanisms involved in disease pathogenesis. [14][15][16][17][18] Levocetirizine is the R-enantiomer or active isomer of the racemate cetirizine. It has twice the affinity for the H1 receptor compared with cetirizine and its potency as an antihistamine has been investigated by inhibition of histamine-induced weal and flare reactions.…”

mRNA profiles of cytokine receptor in unstimulated peripheral blood mononuclear cells from patients with chronic idiopathic urticaria

“…found that mast cell degranulation occurred in early lesions in the autologous serum-induced wheals of CIU patients and T lymphocytes, perivascular neutrophils and eosinophils increased from 30 min to 2 h. At 24 h, CD4 + cells significantly outnumbered other types of cells and at 48 h, the neutrophils were clearing, but eosinophils and lymphocytes persisted. Similar findings were reported by other authors[17]–[20]. Except for CD4 + T cells, CD8 + T cells and CD4/CD8 ratio, the proinflammatory cytokines[21]–[23] or chemokines[24],[25] in CIU were studied.…”