While histamine plays an important role in the pathogenesis of allergic diseases, such as allergic rhinitis, H1-antihistamines, which have been using in the treatment of allergic diseases for more than 70 years, are considered as the cornerstone of the medication of allergic diseases. In this review, we discuss the history of histamine studies and anti-histamine discovery, the histamine receptors, as well as the mechanisms and the safety of H1-antihistamines.
Anti-Allergic Agents ; therapeutic use ; Histamine H1 Antagonists ; therapeutic use ; Humans ; Rhinitis, Allergic, Perennial ; drug therapy

Anti-Allergic Agents ; therapeutic use ; Chronic Disease ; Humans ; Rhinitis, Allergic, Perennial ; drug therapy ; Sinusitis ; drug therapy

Anti-Allergic Agents ; therapeutic use ; Drug Therapy, Combination ; Glucocorticoids ; administration & dosage ; therapeutic use ; Histamine Antagonists ; administration & dosage ; therapeutic use ; Humans ; Rhinitis, Allergic ; drug therapy

Adult ; Anti-Allergic Agents ; therapeutic use ; Dyspepsia ; drug therapy ; Humans ; Male ; Omalizumab ; therapeutic use ; Urticaria ; drug therapy

OBJECTIVETo systematically evaluate the efficacy of intranasal antihistamine in the treatment of allergic rhinitis.

METHODSThe randomized controlled trials (RCT) about intranasal antihistamines for the treatment of allergic rhinitis between January 1985 and January 2014 were searched in OVID, PubMed, EMBASE, CNKI, WanFang Data and Cochrane Library. Two reviewers independently screened the literatures, extracted the data, and evaluated the methodological quality, then meta-analysis was performed by using RevMan 5.1 software.

RESULTSA total of thirteen RCTs were included. The results of meta-analysis showed that the efficacy of intranasal antihistamine group was superior to the placebo group in total nasal symptom scores (TNSS), the difference was significant[WMD = -1.96, 95%CI (-2.06;-1.85), P < 0.01], and individual nasal symptom scores (blocked nose, rhinorrhea, and sneezing) [WMD = -0.18, 95%CI (-0.28;-0.08); WMD = -0.45, 95%CI (-0.52;-0.38); WMD = -0.41, 95%CI (-0.58;-0.24), all P < 0.01], with significant differences. There was no significant difference between the intranasal antihistamine group and the corticosteroid group in TNSS [WMD = -1.51, 95%CI (-3.51;0.49), P = 0.14], but the intranasal antihistamines group was superior to the corticosteroid group in individual nasal symptom scores (blocked nose, rhinorrhea, and sneezing) [WMD = -0.23, 95%CI (-0.40;-0.06); WMD = -0.35, 95%CI (-0.65;-0.05); WMD = -0.25, 95%CI (-0.42;-0.08), all P < 0.05], with significant differences. The intranasal antihistamine group was superior to the oral antihistamines group in TNSS [WMD = -0.88, 95%CI (-1.51;-0.25), P < 0.01].

CONCLUSIONIntranasal antihistamine is effective in the control of nasal symptoms in AR patients.

Administration, Intranasal ; Adrenal Cortex Hormones ; Anti-Allergic Agents ; administration & dosage ; therapeutic use ; Histamine Antagonists ; Histamine H1 Antagonists ; Humans ; Nasal Obstruction ; Rhinitis, Allergic ; drug therapy ; Rhinitis, Allergic, Seasonal ; Software

OBJECTIVE: To evaluate the efficacy and safety of Aerius to seasonal allergic rhinitis. METHOD: Using randomized, controlled method, treatment group 40 cases, oral administration Aerius 5 mg/d for 12 days; control group 35 cases, oral administration Aerius 5 mg/d for 12 days, investigating their efficacy and safety. RESULT: The total effective rate of treatment group was 92.50%, while control group was 85.71%, there was significant difference between them (P<0.05). Significant improvements of seasonal allergic rhinitis nasal obstruction were seen in treatment group after using Aerius (P<0.05). The incidence of side effect of treatment group was 2.50%. CONCLUSION Aerius is safe and can effectively reduction in nasal and nonnasal symptoms in patients with seasonal allergic rhinitis.
Adolescent ; Adult ; Anti-Allergic Agents ; adverse effects ; therapeutic use ; Child ; Female ; Histamine H1 Antagonists ; adverse effects ; therapeutic use ; Humans ; Loratadine ; adverse effects ; analogs & derivatives ; therapeutic use ; Male ; Middle Aged ; Rhinitis, Allergic, Seasonal ; drug therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of loratadine, a new generation of antihistaminics, in the treatment of childhood asthma.

METHODSThe papers related to loratadine treatment for childhood asthma were searched in the database of PubMed, MEDLINE, EMBASE, Cochrance, CNKI and CBMdisc (January 1990 to December 2010) electronically and manually. According to the Cochrane reviewer's handbook, the quality of the enrolled papers was assessed and a systematic review was performed.

RESULTSA total of 179 papers were obtained. Eleven randomized controlled trials met the criteria and were included in this study. The 11 trials included 317 children with asthma: 159 cases in the loratadine treatment group and 158 cases in the control group. All included studies belonged to the B class according to the quality evaluation criteria. Meta analysis showed that the clinical symptoms were improved more, the forced expiratory volume in 1 second (FEV1) 4 and 8 weeks posttreatment and the peak expiratory flow rate (PEFR) 8 weeks posttreatment were higher in the loratadine treatment group than in the control group. The treatment-related adverse effects, fatigue, tachycardia and palpitation, occurred less in the loratadine treatment group compared with the control group.

CONCLUSIONSLoratadine is safe and effective for the treatment of childhood asthma.

Anti-Allergic Agents ; therapeutic use ; Asthma ; drug therapy ; physiopathology ; Forced Expiratory Volume ; Humans ; Loratadine ; adverse effects ; therapeutic use ; Peak Expiratory Flow Rate

OBJECTIVE: To observe the curative effect of Jieminqufeng decoction to the rats of allergic rhinitis and study the mechanism by which it treats allergic rhinitis. METHOD: Forty wistar rats were divided into 4 groups at random. There are Jieminqufeng decoction group, cetirizine group, model control group and normal control group. The rats of allergic rhinitis were established with ovalbumin. We surveyed the behavioral changes of rats, searched eosinophilic granulocytes in the nasal secretion, detected the contents of cAMP and cGMP in the blood plasma and nasal mucosa. RESULT: The model control group had typical symptoms of allergic rhinitis and the eosinophilic granulocytes could be found more frequently. The contents of cAMP and cAMP/cGMP rose in the blood plasma and nasal mucosa (P < 0.01). However, the changes of jieminqufeng decoction group were small. CONCLUSION The jieminqufeng decoction is an effective drug to allergic rhinitis. Its possible mechanism is that it changes the contents of cAMP and cGMP, lessens inflammatory reaction and blocks up the allergy.
Animals ; Anti-Inflammatory Agents ; therapeutic use ; Cyclic AMP ; analysis ; Cyclic GMP ; analysis ; Drugs, Chinese Herbal ; therapeutic use ; Male ; Phytotherapy ; Rats ; Rats, Wistar ; Rhinitis, Allergic, Perennial ; drug therapy

OBJECTIVE: To investigate the effects of prophylactic drugs on allergic rhinitis. METHOD: Thirty patients diagnosed as allergic rhinitis based on mugwort allergen were randomly divided into three groups: budesonide group (n = 10), saline group (n = 10) and control group (n = 10). The patients in budesonide group and saline group respectively received budesonide nasal spray (64 microg per, 256 microg once daily) and saline nasal spray twice daily starting two weeks before the date which the patient onset last year and continuing up to the end of the pollen season. The patients in control group were treated without any processing. The nasal symptom scores and attack times of the three groups was recorded. RESULT: During the pollen season, 2 patients attacked in the budesonide group (20%), and all the patients attacked in saline group and control group (100%). Statistical significance was found among the three groups (P < 0.01), and between budesonide group and the other two groups (P < 0.01). The budesonide group had lower symptom score than the other two groups and a postponed attack time. All the differences had Statistical significance (Value of chi-square statistic = 21. 558, P < 0.01, Fisher exact test P < 0.01). CONCLUSION Prophylactic administration of budesonide, starting two weeks before the date which the patient onset may release symptom and even avoid the attack of the allergic rhinitis based on mugwort allergen.
Adolescent ; Adult ; Aged ; Anti-Inflammatory Agents ; therapeutic use ; Budesonide ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Pollen ; Rhinitis, Allergic, Seasonal ; drug therapy ; immunology ; prevention & control ; Young Adult

Allergic rhinitis (AR) clinically expressed by sneezing, rhinorrhea, nasal itching and congestion is an allergen-driven mucosal inflammatory disease which is modulated by immunoglobulin E. Epidemiological studies have indicated that prevalence of AR continues to increase, and it has been a worldwide health problem that places a significant healthcare burden on individuals and society. Given the evolving understanding of the process by which an allergen is recognized and the roles of mediators which account for AR progress, the pathogenesis of AR has become clearer. Current studies have demonstrated local allergic rhinitis (LAR) that patients with both sug- gestive symptoms of AR and a negative diagnostic test for atopy may have local allergic inflammation is a prevalent entity in patients evaluated with rhinitis, but further research remains needed. Management of AR includes aller- gen avoidance, pharmacological treatment and allergen-specific immunotherapy. Recently montelukast has exhibited previously undocumented anti-inflammatory properties, leukotriene receptor antagonists therefore may serve a more important role in the treatment of AR. Not only has immunotherapy proved its efficacy, but also been able to alter disease course and thereby mitigate progression to asthma. Thus immunotherapy can be initiated while receiving pharmacotherapy, especially in children with AR. As clinical guidelines, the ARIA (Allergic Rhinitis and its Impact on Asthma) provides basic principles of effective treatment of AR. Besides, choosing an appropriate treatment strategy should be based on the severity and chronicity of patient's symptom. The aim of this review was to provide an update mainly on the pathophysiology, epidemiology, and management of AR.
Acetates ; therapeutic use ; Allergens ; Anti-Inflammatory Agents ; therapeutic use ; Asthma ; prevention & control ; Child ; Humans ; Hypersensitivity, Immediate ; diagnosis ; physiopathology ; Immunoglobulin E ; immunology ; Immunotherapy ; Inflammation ; physiopathology ; Leukotriene Antagonists ; therapeutic use ; Prevalence ; Quinolines ; therapeutic use ; Rhinitis, Allergic ; diagnosis ; immunology ; physiopathology