Pharmacogenomics for the efficacy and side effects of antihistamines

Abstract

Antihistamines, especially H1 antihistamines, are widely used in the treatment of allergic diseases such as urticaria and allergic rhinitis, mainly for reversing elevated histamine and anti‐allergic effects. Antihistamines are generally safe, but some patients experience adverse reactions, such as cardiotoxicity, central inhibition and anticholinergic effects. There are also individual differences in antihistamine efficacy in clinical practice. The concept of individualized medicine has been deeply rooted in people's minds since it was put forward. Pharmacogenomics is the study of the role of inheritance in individual variations in drug response. In recent decades, pharmacogenomics has been developing rapidly, which provides new ideas for individualized medicine. Polymorphisms in the genes encoding metabolic enzymes, transporters and target receptors have been shown to affect the efficacy of antihistamines. In addition, recent evidence suggests that gene polymorphisms influence urticaria susceptibility and antihistamine therapy. Here, we summarize current reports in this area, aiming to contribute to future research in antihistamines and clinical guidance for antihistamines use in individualized medicine.

Pathogenesis of allergic diseases and implications for therapeutic interventions

“…In addition, there are individual differences in the efficacy of antihistamines in clinical practice. 473 INCS are effective in combating nasal and ocular symptoms and improving quality of life, and are safe for short-term use, but long-term safety data are lacking. Although generally well tolerated, adverse events can be observed that may lead to serious ocular complications.…”

Temporary prolongation of the QT interval in acute ebastine intoxication due to challenge video on TikTok in a girl

“…According to the results of the studies mentioned earlier, the reasons why ebastine prolongs the QT interval in some patients and does not in others may be due to the different age groups of the studies, different doses of drugs, drug-drug interactions, and polymorphisms in the genes encoding the P450 cytochrome enzyme systems and histamine receptors of the study individuals. 15…”

Immunomodulatory properties of mesenchymal stem cells: A potential therapeutic strategy for allergic rhinitis

“…48,49 H1 antihistamines are widely used in the treatment of AR and are generally safe; however, some patients experience adverse reactions, such as cardiotoxicity, central inhibition, and anticholinergic effects. 50 The new-generation antihistamines have proven to be safer, feature faster or equivalent onset of action, and are superior in efficacy compared with first-generation antihistamines, which are recommended by many international bodies as first-line treatment for allergic disease. 51…”

“…Due to the effects of histamine‐H1 receptor signaling on the regulation of DC maturation, Th1/Th2 cell balance, eosinophil activity, and cytokine release, H1 antihistamines could also attenuate the symptoms associated with late‐phase allergic reactions 48,49 . H1 antihistamines are widely used in the treatment of AR and are generally safe; however, some patients experience adverse reactions, such as cardiotoxicity, central inhibition, and anticholinergic effects 50 . The new‐generation antihistamines have proven to be safer, feature faster or equivalent onset of action, and are superior in efficacy compared with first‐generation antihistamines, which are recommended by many international bodies as first‐line treatment for allergic disease 51 …”