To investigate the relationship between single nucleotide polymorphisms (SNPs) of CACNA1C (SNPs rs58619945, rs7316246 and rs216008) and susceptibility of chronic spontaneous urticaria (CSU) as well as the curative effect of non-sedating antihistamine drugs.
 Methods: Peripheral blood were extracted from 191 CSU patients to collect DNA. Urticaria Activity Score 7 (UAS7) and Dermatology Life Quality Index (DLQI) changes were collected from these patients with different non-sedating antihistamine drugs. PubMed retrieval system was used to select the 3 SNPs (rs58619945, rs7316246 and rs216008) of CACNA1C. Susceptibility of CSU and curative effect of non-sedating antihistamine drugs (desloratadine, mizolastine, fisofenadine) in 189 CSU patients and 105 controls with different SNPs were compared with Chi-squared test. Data of 105 southern Chinese controls were extracted from the 1 000 genome database.
 Results: Frequency of rs58619945 G allele in the CSU patients was significantly higher than that in the controls [OR(95%CI)=0.660(0.470-0.925), P=0.016]. However, there was no significant differences in rs7316246 and rs216008 between the CSU patients and the controls. Meanwhile there was no significant difference in general curative effect of the 3 drugs in the 3 SNPs (rs58619945: OR=0.843, P=0.454; rs7316246: OR=2.103, P=0.102; rs216008: OR=0.237, P=0.363). There was significant difference in different alleles of rs216008 in the patients administered by desloratadine [OR(95%CI)=0.480(0.247-0.933), P=0.029]. No difference was shown in the 3 SNPs in patients administered by mizolastine.
 Conclusion: The rs58619945 A/G might be related to susceptibility of CSU, and the rs216008 mutation might affect drug response of desloratadine.
Calcium Channels, L-Type ; genetics ; Chronic Disease ; Genetic Predisposition to Disease ; Histamine H1 Antagonists, Non-Sedating ; therapeutic use ; Humans ; Loratadine ; analogs & derivatives ; therapeutic use ; Polymorphism, Single Nucleotide ; Prognosis ; Retrospective Studies ; Urticaria ; drug therapy ; genetics

Levocetirizine is a second-generation nonsedative antihistaminic agent that has been demonstrated to be safe and effective for treating allergic disease. There was only one case report of levocetirizine-induced liver toxicity, but a liver biopsy was not performed. In this article, we present the first case of levocetirizine-induced liver injury with histologic findings. A 48-year-old man was hospitalized with jaundice and generalized pruritus that had developed after 2 months of therapy with levocetirizine for prurigo nodularis. Laboratory findings revealed acute hepatitis with cholestasis. A liver biopsy demonstrated portal inflammation and hepatitis with apoptotic hepatocytes. The patient fully recovered 3 weeks after withdrawing levocetirizine. Although levocetirizine is safe and effective, physicians should be aware of its potential hepatotoxicity.
Cetirizine/*adverse effects/therapeutic use ; Chemical and Drug Induced Liver Injury/*diagnosis/pathology ; Histamine H1 Antagonists, Non-Sedating/*adverse effects/therapeutic use ; Humans ; Hypersensitivity/drug therapy ; Jaundice/etiology ; Liver/pathology ; Male ; Middle Aged ; Pruritus/etiology

OBJECTIVE: To determine if greater efficacy could be achieved with the intranasal antihistamine azelastine and the intranasal corticosteroid fluticasone propionate used concurrently in the treatment of nasal obstruction of persistent non-allergic rhinitis. METHOD: A total of 162 persistent non-allergic rhinitis cases with moderate to severe nasal obstruction were randomized to treatment with the following: the combination therapy or nasal corticosteroids monotherapy. Efficacy was assessed by change from baseline in nasal obstruction score at week 2 and week 6 visits. The perceptions of global treatment satisfaction(convenience, side effects, cost and effectiveness) in both groups were analyzed. RESULT: In both groups, the nasal obstruction score assessment descended significantly at week 2 and week 6 visits versus at baseline (all P < 0.01). At week 2 and week 6 visits, the nasal obstruction score in the combination therapy groups were significantly improved than that in nasal corticosteroids monotherapy groups (all P < 0.01). The perceptions of global treatment satisfaction in the combination therapy groups were significantly better (P < 0.05). CONCLUSION Azelastine nasal spray and intranasal corticosteroid in combination may provide a substantial therapeutic benefit for patients with persistent non-allergic rhinitis, especially nasal obstruction. The combination therapy was well tolerated and safety.
Administration, Intranasal ; Adrenal Cortex Hormones ; therapeutic use ; Drug Therapy, Combination ; Histamine H1 Antagonists ; therapeutic use ; Humans ; Nasal Obstruction ; Phthalazines ; therapeutic use ; Rhinitis ; 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

OBJECTIVE: To investigate the changes of leukotriene D4 (LTD4) in nasal discharge and plasma of patients with persistent allergic rhinitis (AR) and the effects of antihistamine. METHOD: The investigation was a prospective, randomized controlled trial. Forty AR patients (group C) were divided randomly into two subgroup. One group received oral antihistamine 10 mg everyday for one week (group CA) and another group received no loratadine tablets 10 mg everyday for one week (group CB). Fifteen age matched healthy (group D) people were enrolled as control. The level of LTD4 and interleukin-5 (IL-5) in both nasal discharge and plasma by using enzyme linked immunosorbent assay (ELISA) and enzyme immunoassay (EIA), cell counts and cell differentials in nasal discharge, were measured before and after three month. The clinical symptom and life quality scores of group C were also investigated. RESULT: The concentrations of LTD4 in nasal discharge [(794 +/- 305) pg] and plasma [(5219 +/- those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P 1185) ng/L] in group C were significantly higher than those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P < 0.05]. The level of LTD4 in nasal discharge was positively correlated with the percentage of neutrophil (r = 0.453, P < 0.05) and IL-5 (r = 0.364, P < 0.05). The pre- and post-therapy concentrations of nasal discharge and plasma in group CA were (812 +/- 1592) pg, (657 +/- 495) pg and (5422 +/- 935) ng/L, (4589 +/- 1057) ng/L respectively; While in group CB the concentrations were (776 +/- 227) pg, (860 +/- 194) pg and (5074 +/- 1850) ng/L, (6063 +/- 450) ng/L, respectively. There were no significant difference either in the level of LTD4 in nasal discharge or in plasma in both groups (all P > 0.05). CONCLUSION The results suggested that LTD4 was involved in airway inflammation in AR. Antihistamine was not effective enough in decreasing the levels of LTD4 in both nasal discharge and plasma of AR patients.
Adult ; Anti-Allergic Agents ; pharmacology ; Bodily Secretions ; chemistry ; Female ; Histamine H1 Antagonists ; pharmacology ; Humans ; Leukotriene Antagonists ; therapeutic use ; Leukotriene D4 ; analysis ; blood ; metabolism ; Male ; Middle Aged ; Plasma ; chemistry ; Prospective Studies ; Rhinitis, Allergic, Perennial ; blood ; drug therapy ; metabolism

OBJECTIVETo investigate the therapeutic effect and safety of acupuncture at points of The Liver and Gallbladder Meridians for treatment of migraine.

METHODSMulti-central, randomized and controlled trial was used and 253 cases of migraine were divided into an acupuncture group and a western medicine group. The acupuncture group was treated with acupuncture at points of The Liver and Gallbladder Channels with Taichong (LR 3), Yang-lingquan (GB 34), Fengchi (GB 20), Ququan (LR 8) selected as main points, and the western medicine group with oral administration of Flunarizine tablets for 4 therapeutic courses. The total therapeutic effects 3 and 6 months after the treatment, the scores of various symptoms of migraine before and after treatment, and the stability of therapeutic effect in one-year following-up survey were observed in the two groups.

RESULTSAfter treatment, mean times and duration of the headache attack were significantly improved in the two groups (all P < 0.01) with the acupuncture group better than the western medicine group (P < 0.05). The total effective rates for stopping pain after treatment, 3 months and 6 months after treatment in the acupuncture group were 93.0%, 93.0% and 87.7%, respectively, which were better than 85.6%, 86.5% and 69.2% in the western medication group (all P < 0.01). One year later, the stability of the therapeutic effect in the acupuncture group was better than that in the western medicine group (P < 0.05); the adverse reaction and the compliance in the acupuncture group were significantly superior to those in the western medicine group.

CONCLUSIONAcupuncture at points of The Liver and Gallbladder Meridians for treatment of migraine is safe, effective, and with stable long-term therapeutic effect.

Acupuncture Points ; Acupuncture Therapy ; methods ; Administration, Oral ; Adolescent ; Adult ; Aged ; Female ; Flunarizine ; administration & dosage ; therapeutic use ; Gallbladder ; pathology ; Headache ; prevention & control ; Histamine H1 Antagonists ; administration & dosage ; therapeutic use ; Humans ; Liver ; pathology ; Male ; Meridians ; Middle Aged ; Migraine Disorders ; drug therapy ; pathology ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo assess the therapeutic effects on acupuncture preventive treatment of no-aura migraine and its influence on the QOL (quality of life) of the patients.

METHODSRandomized controlled, double-blind and double-dummy research methods were adopted, 60 cases were randomly divided into an observation group and a control group, 30 cases in each group. The observation group was treated with acupuncture combined with oral administration of Flunarizine Hydrochloride vacuity capsules, and Baihui (GV 20), Shenting (GV 24) and Benshen (GB 13) were selected as main points. The control group was treated with oral administration of Flunarizine Hydrochloride capsules combined with acupuncture at placebo-points, thrice each week, for 4 weeks. The SF-36 QOL Scale and effective rate were used for assessment of therapeutic effects before treatment, after treatment and 3 months later.

RESULTSThere were significant differences in each dimension scores of SF-36 at 3 time points between the two groups (all P < 0.05). The dimension of the physiological function in the observation group was superior to that of the control group after treatment (P < 0.05), and there was no significant difference in other 7 dimensions between the two groups (all P > 0.05). After treatment and 3 months later, the effective rates were 68.0%, 68.0% in the observation group and 24.0%, 32.0% in the control group, respectively, with significant differences between the two groups (all P < 0.05).

CONCLUSIONAcupuncture preventive treatment can effectively improve the life quality of the patients with migraine and reduce the migraine attack. There is no significant difference in improving the physical and psychological health of the migraine patients between acupuncture and Flunarizine Hydrochloride, and acupuncture is more effective in reducing the migraine attack days.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Double-Blind Method ; Female ; Flunarizine ; administration & dosage ; therapeutic use ; Histamine H1 Antagonists ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Migraine without Aura ; prevention & control ; therapy ; Quality of Life ; Surveys and Questionnaires ; Treatment Outcome ; Young Adult

OBJECTIVETo search for an effective therapy for cold erythema multiforme in ham.

METHODSOne hundred and eighty cases with cold erythema multiforme in ham were randomly divided into a Santong group (n=90) and a western medicine group (n=90). The Santong group was treated by He's Santong needling methods and Huantiao (GB 30), Fengshi (GB 31), Zusanli (ST 36), etc. were selected. The western medicine group was treated by oral administration of Cinnarizine, Cyproheptadine and Vitamin E. Two weeks later, their therapeutic effects were observed.

RESULTSThe cured rate was 68.9% and the recurrence rate was 11.3% in the Santong group, and 33.3% and 53.3% in the western medicine group, with significant differences in the cured rate and the recurrence rate between the two groups (both P<0.01).

CONCLUSIONHe's Santong needling methods can increase the cured rate and reduce the recurrence rate of cold erythema multiforme in ham.

Acupuncture Therapy ; Adolescent ; Adult ; Cinnarizine ; therapeutic use ; Cyproheptadine ; therapeutic use ; Erythema Multiforme ; drug therapy ; therapy ; Female ; Histamine H1 Antagonists ; therapeutic use ; Humans ; Male ; Treatment Outcome ; Young Adult

OBJECTIVE: To compare the efficacy and safety of histamine H1 receptor antagonist loratadine with Leukotriene receptor antagonist Ibudilast in steroid resistant allergic rhinitis in a randomized controlled clinical trial. METHOD: Thirty-five cases were treated by Ibudilast, and 34 cases by loratadine. Score system was used to compare the therapeutic effect of these two drugs on clinical symptoms and signs. RESULT: Ibudilast shows a better curative effect than loratadine in the improvement of the total scores on clinical symptom and signs(P<0.05). Scores of symptoms and signs in Ibudilast group after 3, 7, 14 days decreased significantly by means of square analysis of single factor (P<0.01). No complication was observed. CONCLUSION Ibudilast can effectively alleviate the clinical symptoms and signs of steroid resistant allergic rhinitis with confirmed efficacy and safety, thus is recommended in steroid resistant allergic rhinitis. Increased doses or prolonged treatment of steroid is inappropriate.
Adolescent ; Adult ; Aged ; Anti-Allergic Agents ; therapeutic use ; Female ; Histamine H1 Antagonists, Non-Sedating ; therapeutic use ; Humans ; Leukotriene Antagonists ; therapeutic use ; Loratadine ; therapeutic use ; Male ; Middle Aged ; Pyridines ; therapeutic use ; Rhinitis, Allergic, Perennial ; drug therapy ; Rhinitis, Allergic, Seasonal ; drug therapy ; Steroids ; pharmacology ; Young Adult

OBJECTIVE: To assess the effect of desloratadine on quality of life (QOL) in patients with seasonal allergic rhinitis. METHOD: A randomized, double-blind, placebo-controlled study was designed on fifty patients with seasonal allergic rhinitis. The patients were randomly divided into three groups: A group: taking desloratadine by mouth and taking spraying of normal sodium; B group: placebo group, taking placebo by mouth and taking spraying of normal sodium; C group: taking desloratadine by mouth and taking spraying of Nasonex. Rhinitis quality of life (RQOL) questionnaire was used to evaluate QOL of patients with seasonal allergic rhinitis. The method of taking tabella was one tablet, one time a day; the method of taking spraying was one spray each nostril, once a day. The investigation lasted for two weeks. The RQOL questionnaire was administered at the start of the treatment and after one and two weeks of treatment by the telephone follow-up investigation. RESULT: After 1 and 2 weeks of treatment, symptoms scores were significantly decreased in the A group and C group compared with the placebo group (P < 0.05). After 1 and 2 weeks of treatment by the methods of A and C, the QOL of patients with seasonal allergic rhinitis was significantly improved compared with placebo group (P < 0.05). There was no QOL improvement in the placebo group. CONCLUSION Desloratadine could decrease symptom scores and improve QOL in patients with seasonal allergic rhinitis. The RQOL questionnaire could help doctor to effectively evaluate QOL in patients with seasonal allergic rhinitis, because of its integrity and convenience.
Adolescent ; Adult ; Double-Blind Method ; Female ; Histamine H1 Antagonists, Non-Sedating ; therapeutic use ; Humans ; Loratadine ; analogs & derivatives ; therapeutic use ; Male ; Middle Aged ; Quality of Life ; Rhinitis, Allergic, Seasonal ; drug therapy ; Treatment Outcome ; Young Adult