Humans ; Rhinitis, Allergic ; drug therapy ; Sublingual Immunotherapy

Evidence-Based Medicine ; Humans ; Rhinitis, Allergic, Perennial ; drug therapy ; Rhinitis, Allergic, Seasonal ; drug therapy

Drug Therapy, Combination ; Humans ; Rhinitis, Allergic ; drug therapy

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

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

OBJECTIVETo investigate the influence of inhaled glucocorticoid on the pathological change of the nasal mucosa in allergic rhinitis.

METHODSOne hundred and eighty Sprague-Dawley (SD) rats were selected. According to the random number table, these animals were randomly divided into two groups: the control Group A and the experimental group. There were 60 rats in Group A and 120 rats in experimental group. First of all, the rats in experimental group were sensitized by intra-peritoneal injection with ovalbumin (OVA), enhanced and local stimulated. Next, the rats in the experimental group were randomly divided into B and C groups. The number of rats in each group was 60. Group B still had the intranasal dropping on each side with OVA in the same volume and concentration twice a week. The rats in Group C also had the intranasal dropping on each side with OVA in the same volume and concentration twice a week. But, at the same time, these animals had fluticasone propionate (FP) nasal spray each side 50 microl/per day. While doing intra-peritoneal injection with physiological saline in the same volume and intranasal dropping on the rats in normal Group A. Ten rats from each group were randomly selected to be killed at the end of first, second, fourth, eighth, twelfth and sixteenth weeks after treatment. One from the ten rats in each group was used for micro-vascular casting of nasal mucosa, and the remaining nine were used for pathological examination.

RESULTSThe model of the rats in experimental group was established successfully. After allergen stimulation, the nasal mucosa showed metaplasia of the goblet cells, epithelial denudation, inflammatory cells infiltration especially eosinophils, hyperplasia of the number of gland and density of micro-blood vessels. The capillary became netted. Cilia of epithelial shed to different extent and were uneven, and the layers of reticular formation of basal membrane became thick, and collagen deposition and fabric hyperplasia were seen under the electron microscope. In Group B, due to continuously contact with allergen, the mucosa remodeling enhanced. In Group C, glucocorticoid controlled the symptoms of allergic rhinitis better, but the cilia of epithelial shed, metaplasia of the goblet cells, inflammatory cells infiltration, hyperplasia of gland and micro-blood vessels, collagen deposition and fabric hyperplasia also could be seen in rat nasal mucosa.

CONCLUSIONSThe pathological change of the nasal mucosa was found in allergic rhinitis. If the allergen was continuously contacted, the pathological change aggravated. Glucocorticoid could control the symptoms of allergic rhinitis better and reverse the mucosa pathological change to some extent, but it could not retro-converse or repair the nasal mucosa while the irreversibile change had occurred.

Administration, Intranasal ; Animals ; Glucocorticoids ; therapeutic use ; Nasal Mucosa ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; drug therapy

OBJECTIVETo review the major progress in mechanism of traditional Chinese medicine (TCM) in the treatment of allergic rhinitis (AR).

METHODSContents about the treatment mechanism of TCM in the therapy of AR in this article were obtained from 22 original articles and reviews published in Chinese- and English-language journals. All of the references were searched by use of Pubmed (1997 - 2012).

RESULTSAR is one of the most common and most serious public health problems in children and young people. Many AR patients were worried about the possible adverse effects of synthetic drugs they were taking. Thus, they seek complementary and alternative therapy, such as TCM. TCM emphasized on the importance of holistic convalescence, not just the disease itself. The favorable safety profile of TCM makes well-acceptance by the general population. In the recent decade, more and more studies of TCM for AR are developed. These studies indicated that the treatment of allergic disorders with TCM therapy including herbal medicines and acupuncture are of safety and efficacy. The mechanism of TCM in the treatment of AR has been discussed. It has been reported that a number of the herbs in the Chinese herbal formulae used in the treatment possess anti-allergic, anti-inflammatory or immune modulation activity. Such function include the inhibition of the release or the activity of mast cell mediators (such as histamine), inhibition the induction of inflammation reaction by chemical agents, and down regulation of serum (immunoglobulin E) IgE levels or the activity of lymphocyte and/or macrophage.

CONCLUSIONSTCM are frequently used concurrently to improve the clinical efficacy. This review is focuses on the description of the actions mechanism of Chinese medicine's approach relevant to the treatment of AR.

Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; 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 observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale（VAS） of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from （8.89±3.31） on day 0 to （3.71±2.51） on day 14（P<0.001）, VAS score of nasal symptoms decreased from （24.86±7.40） on day 0 to （6.84±5.94） on day 14（P<0.001）, VAS score of rhinorrhoea decreased from （6.88±2.06） on day 0 to （1.91±1.81） on day 14（P<0.001）. Rhinoconjunctivitis quality of life questionnaire（RQLQ） score decreased from （94.63±33.35） on day 0 to （44.95±32.28） on day 14（P<0.001）. The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.
Male ; Female ; Humans ; Adult ; Rhinitis, Allergic, Seasonal/drug therapy* ; Nasal Sprays ; Quality of Life ; Administration, Intranasal ; Rhinorrhea ; Double-Blind Method ; Treatment Outcome ; Rhinitis, Allergic/drug therapy*

OBJECTIVETo evaluate the treatment outcomes of leukotriene receptor antagonists (LTRA) as monotherapy or combined with the second-generation oral H1-histamines in the treatment of allergic rhinitis (AR), and to provide a basis for optimizing clinical therapeutic strategies.

METHODSPubMed,EMBASE, CBMdisc and CJFD databases, retrieving randomized controlled trials (RCTs) of AR therapy literatures were searched. Based on the literature inclusion and exclusion criteria, the related literatures were selected and the quality was evaluated by using the Jadad scale. Meta-analysis was performed by Stata 12.1 software.For continuous outcomes, the weighted mean difference (WMD) and its 95% confidence intervals (CI) were calculated. The forest plots were drawn. The treatment outcomes included daytime nasal symptom scores (DNSS), nighttime symptom scores (NSS), composite symptom scores (CSS), daytime eye symptom scores (DESS), and the rhinoconjunctivitis quality of life questionnaire (RQLQ) were used to evaluate the therapeutic effects of LTRA on seasonal and perennial AR.

RESULTSEleven of clinical RCTs including 14 809 cases of AR patients, aged 15 to 85 years old, were available for Meta-analysis. Montelukast, a drug of LTRA, was primarily evaluated in the study. The results of Meta-analysis showed: (1) Compared with the placebo, montelukast statistically significantly reduced the DNSS,NSS, CSS, and RQLQ scores in patients with seasonal and perennial AR, as well as the DESS in patients with seasonal AR.(2) There were no statistical differences in the improvement of the CSS,DESS, and RQLQ scores in patients with seasonal AR after the treatment by montelukast compared with loratadine, a second-generation oral H1-histamine.(3) Montelukast statistically significantly reduced the NSS, but not DNSS, in patients with seasonal AR compared with loratadine.(4) The combination therapy of montelukast and loratadine statistically significantly improved the CSS compared with either montelukast or loratadine monotherapy.

CONCLUSIONSMontelukast, a representative drug of LTRA, can be used as first-line therapy for AR, with comprehensive improvement of the nasal and ocular symptoms and the quality of life in AR patients. Montelukast combined with loratadine can significantly improve the diurnal and nocturnal symptoms for patients with seasonal AR, and the curative effect is better than the single use of montelukast or loratadine.

Acetates ; therapeutic use ; Drug Therapy, Combination ; Humans ; Leukotriene Antagonists ; therapeutic use ; Loratadine ; Nose ; Quality of Life ; Quinolines ; therapeutic use ; Rhinitis, Allergic ; drug therapy ; Rhinitis, Allergic, Perennial ; Rhinitis, Allergic, Seasonal ; Surveys and Questionnaires ; Treatment Outcome