Azelastine is more potent than olopatadine n inhibiting interleukin-6 and tryptase release from human umbilical cord blood-derived cultured mast cells.

BACKGROUND: Mast cells are involved in early- and late-phase reactions by releasing vasoactive molecules, proteases, and cytokines. Certain histamine-1 receptor antagonists and other antiallergic drugs seem to inhibit the release of mediators from rat and human mast cells. OBJECTIVE: Azelastine and olopatadine are antiallergic agents present in the ophthalmic solutions azelastine hydrochloride (Optivar, Asta Medica/Muro Pharmaceuticals, Tewksbury, MA), and olopatadine hydrochloride (Patanol, Alcon Laboratories, Fort Worth, TX), respectively. We investigated the effect of these drugs on interleukin-6 (IL-6), tryptase, and histamine release from cultured human mast cells (CHMCs). METHODS: CHMCs were grown from human umbilical cord blood-derived CD34+ cells in the presence of stem cell factor and IL-6 for 14 to 16 weeks. Sensitized CHMCs were pretreated with various concentrations of azelastine or olopatadine for 5 minutes. CHMCs were then challenged with anti-immunoglobulin E, and the released mediators were quantitated. RESULTS: The greatest inhibition of mediator release was seen with 24 microM azelastine; this level of inhibition was matched with the use of 133 microM olopatadine. At this concentration, these drugs inhibited IL-6 release by 83% and 74%, tryptase release by 55% and 79%, and histamine release by 41% and 45%, respectively. Activated CHMCs were characterized by numerous filopodia that were inhibited by both drugs as shown by electron microscopy. CONCLUSIONS: These results indicate that azelastine and olopatadine can inhibit CHMCs activation and release of IL-6, tryptase, and histamine. On an equimolar basis, azelastine was a more potent inhibitor than olopatadine.     

Inhibition of allergic histamine release by azelastine and selected antiallergic drugs from rabbit leukocytes

The ability of azelastine to inhibit allergic histamine release from rabbit mixed leukocytes was studied and compared with selected antiallergic drugs. Azelastine, ketotifen, diphenhydramine, theophylline and disodium cromoglycate (DSCG) produced concentration-dependent inhibition of allergic histamine release from rabbit basophils. The concentrations inhibiting histamine release by 50% (IC50; microM) were as follows: azelastine = 4.5; ketotifen = 9.5; diphenhydramine = 18.9; theophylline = 56.9; DSCG = greater than 1,000. DSCG was added to the cells immediately prior to antigen challenge. All other drugs were preincubated for a period of 10 min prior to antigen challenge. At the IC50 level, azelastine is about 2, 4, 13 and greater than 200 times as effective as ketotifen, diphenhydramine, theophylline and DSCG, respectively. The IC50 of azelastine following 0, 10 and 30 min preincubation were 2.4, 1.9 and 3.5 microM, respectively. These observations showed: (1) azelastine is capable of acting rapidly on basophils and of inhibiting allergic histamine secretion, and (2) the prolongation of the preincubation time of azelastine up to 30 min with rabbit leukocytes did not exhibit any sign of tachyphylaxis (loss of activity). In conclusion, azelastine is a potent inhibitor of allergic histamine secretion from the leukocytes of ragweed-sensitized rabbits.     

Epigallocatechin-3-gallate inhibits secretion of TNF-alpha, IL-6 and IL-8 through the attenuation of ERK and NF-kappaB in HMC-1 cells

BACKGROUND: Epigallocatechin-3-gallate (EGCG) is a major form of tea catechin and has a variety of biological activities. In the present study, we investigated the effect of EGCG on the secretion of TNF-alpha, IL-6 and IL-8, as well as its possible mechanism of action by using the human mast cell line (HMC-1). METHODS: EGCG was treated before the activation of HMC-1 cells with phorbol 12-myristate 13-acetate (PMA) plus calcium ionophore (A23187). To investigate the effect of EGCG on PMA+A23187-stimulated HMC-1 cells, ELISA, Western blot analysis, electrophorectic mobility shift assay and luciferase assay were used in this study. RESULTS: EGCG (100 microM) inhibited PMA+A23187-induced TNF-alpha, IL-6 and IL-8 expression and production. EGCG inhibited the intracellular Ca(2+) level. EGCG attenuated PMA+A23187-induced NF-kappaB and extracellular signal-regulated kinase (ERK1/2) activation, but not that of c-Jun N-terminal kinase or p38 mitogen-activated protein kinase. CONCLUSION: EGCG inhibited the production of TNF-alpha, IL-6 and IL-8 through the inhibition of the intracellular Ca(2+) level, and of ERK1/2 and NF-kappaB activation. These results indicate that EGCG may be helpful in regulating mast-cell-mediated allergic inflammatory response.     

Inhibition of allergic and nonallergic leukotriene C4 formation and histamine secretion by azelastine: implication for its mechanism of action

Azelastine, an orally effective antiasthmatic agent, has been reported to inhibit antihistamine-resistant, leukotriene-mediated allergic bronchoconstriction in guinea pigs. This suggests that azelastine might act through inhibition of leukotriene (LT) C4/D4 synthesis. We have examined the effect of azelastine on allergic and nonallergic histamine secretion and LTC4 formation. Azelastine and the known 5-lipoxygenase inhibitors, nordihydroguaiaretic acid and AA-861, exerted concentration-dependent inhibition of allergic LTC4 formation in chopped lung tissue from actively sensitized guinea pigs and calcium ionophore A23187-stimulated LTC4 synthesis in mixed peritoneal cells from rats. Azelastine also produced concentration-dependent inhibition of allergic and nonallergic histamine secretion from rat peritoneal mast cells. The ability of azelastine to inhibit allergic and nonallergic histamine secretion and LTC4 generation may contribute to its mode of action and its therapeutic efficacy.     

Effect of Dracocephalum argunense on mast-cell-mediated hypersensitivity

BACKGROUND: Stimulation of mast cells starts the process of degranulation resulting in release of mediators such as histamine and an array of inflammatory cytokines. In this report, we investigated the effect of an aqueous extract of Dracocephalum argunense Fisch. (Labiatae) (DAAE) on immediate-type hypersensitivity and studied its possible mechanisms of action, focusing on histamine release and proinflammatory cytokine expression in mast cells. METHODS: An in vivo model of systemic and local allergic reaction was investigated. Compound 48/80- or IgE-induced histamine release from mast cells was measured. The expression of proinflammatory cytokines such as TNF-alpha and IL-6 was measured by RT-PCR and ELISA. The level of intracellular calcium was measured by spectrofluorometry. NF-kappaB activation was measured by Western blot, EMSA and luciferase assay. RESULTS: DAAE inhibited systemic anaphylaxis, local allergic reactions, and serum histamine release in a dose-dependent manner in mice. DAAE dose-dependently reduced histamine release from mast cells activated by compound 48/80 or IgE. The inhibitory effect of DAAE on histamine release was mediated by the modulation of intracellular calcium. In addition, DAAE decreased TNF-alpha and IL-6 gene expression and production in human mast cells stimulated by phorbol-12-myristate-13-acetate (PMA) plus calcium ionophore A23187. The inhibitory effect of DAAE on the TNF-alpha and IL-6 expression was NF-kappaB dependent. CONCLUSION: Our findings provide evidence that DAAE inhibits mast-cell-derived immediate-type hypersensitivity. Taken together, the anti-allergic effect of DAAE in vivo and in vitro suggests a possible clinical use of this agent in immediate-type hypersensitivity.     

Ocular anti-allergic compounds selectively inhibit human mast cell cytokines in vitro and conjunctival cell infiltration in vivo

BACKGROUND: Conjunctival mast cells (MCs) are important effector cells in seasonal allergic conjunctivitis, via histamine and cytokine secretion. Several new anti-allergic eye drops stabilize MCs and block histamine receptors, but their anti-inflammatory effects are unclear. OBJECTIVE: Anti-allergic drugs were compared for their anti-inflammatory effects in an in vitro model of human MC activation and in an experimental murine model of allergic conjunctivitis. METHODS: Human cord blood stem cell-derived (CBMC) and conjunctival biopsy-derived MCs were stimulated via FcepsilonRI, degranulation and histamine release were assayed at 1 h and cytokine secretion at 24 h using multiplex arrays. Mice sensitized to short ragweed pollen were given anti-allergics topically before allergen challenge, and conjunctival immuno-staining was performed at 24 h. RESULTS: After a 1 h stimulation, 80% of the CBMC had degranulated and secreted histamine (27.9+/-4.7 ng/10(6) cells; P<0.05). Pre-treatment by all drugs significantly reduced histamine and TNF-alpha, whereas IL-5, IL-8, IL-10 and TNF-beta profiles were differentially decreased. For conjunctival biopsy-derived cultures (n=11), FcepsilonR1 stimulation increased histamine, TNF-alpha, TNF-beta, IL-5 and IL-8 levels and the production of IL-5, IL-6 (P<0.05), histamine and IL-8 (P<0.01) was inhibited by epinastine. In vivo, epinastine and olopatadine pre-treatment significantly reduced the clinical scores and eosinophil numbers (n=6; P<0.05) while epinastine also reduced neutrophils (P<0.02). CONCLUSION: Differential effects on MC cytokine inhibition were observed, with epinastine inhibiting MC secretion of IL-5, IL-8, IL-10 and conjunctival neutrophil infiltration. The anti-allergic drugs have anti-histamine and mast-cell stabilizing properties but might differ in clinical improvement depending on the individual and the cytokines involved.     

The interaction of azelastine with human lung histamine H1, beta, and muscarinic receptor-binding sites

Azelastine has previously been demonstrated to inhibit histamine release, to antagonize histamine-mediated responses, and to be a bronchodilator. To determine the mechanism by which azelastine has antihistaminic and bronchodilatory actions, we studied its interaction with relevant human lung receptors. We performed competitive radioligand binding assays and determined the affinity of azelastine for [3H]pyrilamine (histamine H1), [125I]pindolol (beta), and [3H]quinuclidinyl benzilate (muscarinic) binding sites. Azelastine had a relatively high affinity for histamine H1 receptors with IC50 values consistently as low or lower than values measured for other antihistamines. In contrast, azelastine had a very low affinity for both beta-receptors and muscarinic receptors with IC50 values greater than 2 logs greater than those determined for beta-agonists and muscarinic antagonists, respectively. Thus, bronchodilatory activity of azelastine does not appear to result from either beta-agonist or muscarinic-antagonist properties. Azelastine does, however, have the ability to inhibit the release of histamine and to bind to histamine H1 receptors, thereby effectively antagonizing histamine H1 receptor-mediated responses in the lung. These characteristics make azelastine a potentially very useful drug to treat allergic responses in the respiratory tract.     

Azelastine inhibits IgE-mediated human basophil histamine release

To examine the mechanism potentially contributing to therapeutic efficacy of azelastine in allergic rhinitis and asthma, we studied the effect of azelastine on stimulated histamine release from basophils prepared as a mixed leukocyte suspension from human blood. Azelastine was found to significantly inhibit anti-IgE-stimulated basophil histamine release. Time-course experiments indicated that the inhibitory effect of azelastine was immediate and that preincubation of basophils in azelastine was not necessary. In dose-response experiments with azelastine, 1 to 100 mumol/L, significant inhibition of histamine release was consistently observed in azelastine concentrations greater than or equal to 10 mumol/L. This inhibition was dose dependent (r = 0.96; p less than 0.001) with maximal mean inhibition of 91 +/- 8% at 100 mumol/L of azelastine.     

IL-4 production by human basophils found in the lung following segmental allergen challenge

BACKGROUND: Human blood basophils secrete high levels of IL-4 following activation with specific allergen, yet their role as cytokine-producing cells in allergic lesions has not been described. OBJECTIVE: Our objective was to investigate whether and under what conditions basophils infiltrating allergic lesions in the lung secrete IL-4 in vitro. METHODS: Bronchoalveolar lavage (BAL) cells were recovered 20 hours after segmental allergen challenge. Basophils were enriched with Percoll using a protocol commonly used for blood basophils. IL-4 and histamine were measured in culture supernatants following activation with a variety of stimuli. Two-color flow cytometry was performed to detect intracellular IL-4. RESULTS: IL-4 protein was detected in all basophil culture supernatants following a 4- to 5-hour incubation in medium alone; the levels obtained did not significantly increase with the addition of anti-IgE. BAL basophils failed to release histamine in response to specific allergen but showed nearly 60% histamine release with N-formyl-methionyl-leucyl-phenylalanine, suggesting that they were desensitized to IgE-mediated stimuli as a result of their activation in vivo. Using these same conditions, IL-4 was not detected in BAL cell fractions enriched for lymphocytes and eosinophils. Ionomycin induced IL-4 secretion by BAL basophils, and this response was reduced with the addition of phorbol myristate acetate. In contrast, phorbol myristate acetate promoted the secretion of IL-4 by BAL cells enriched for lymphocytes; both findings are identical to those reported for basophils and lymphocytes purified from blood. Flow cytometry confirmed the secretion of IL-4 by BAL basophils. CONCLUSIONS: These data suggest that basophils migrating to the lung following allergen challenge represent a major source of IL-4.     

Acute stress results in skin corticotropin-releasing hormone secretion,mast cell activation and vascular permeability,an effect mimicked by intradermal corticotropin-releasing hormone and inhibited by histamine-1 receptor antagonists

BACKGROUND: Mast cells play an important role in allergic inflammation by releasing vasoactive molecules, proteases and cytokines. Corticotropin-releasing hormone (CRH) and its structural analogue urocortin (Ucn) were shown to trigger skin mast cell activation and vascular permeability. We investigated the effect of acute stress on rat skin vascular permeability and CRH secretion, as well as the effect of intradermal CRH, and that of two histamine-1 receptor antagonists, azelastine and olopatadine, on vascular permeability. METHODS: Rats were stressed by restraint and vascular permeability was assessed by extravasation of (99)Tc-gluceptate, while mast cell activation was determined by skin rat mast cell protease-1 (RMCP-1) content. Skin CRH content was evaluated by ELISA. The effect of intradermal injection of CRH and Ucn, as well as that of two histamine-1 receptor antagonists, azelastine and olopatadine, was assessed by Evan's blue extravasation. Purified rat peritoneal mast cells (RPMCs) were also pretreated with azelastine (24 microM) or olopatadine (133 microM) for 5 min before challenge with compound 48/80 (0.5 microg/ml) for 30 min. Histamine secretion was measured fluorometrically. Intracellular Ca(2+) ions were evaluated in RPMCs loaded with calcium crimson and stimulated with compound 48/80. RESULTS: Acute stress increased skin vascular permeability and CRH content, while it decreased RMCP-1. Intradermal injection of CRH or Ucn induced substantial Evan's blue extravasation that was inhibited by pretreatment with azelastine (24 microM) and olopatadine (133 microM). Both antihistamines also inhibited histamine release and intracellular increase of Ca(2+) ions from RPMCs stimulated by compound 48/80. CONCLUSIONS: These results indicate that acute stress increases skin CRH that can trigger mast cell-dependent vascular permeability, effects inhibited by certain histamine-1 receptor antagonists, possibly acting to reduce intracellular Ca(2+) ion levels.     

Nasal ocular reflexes and eye symptoms in patients with allergic rhinitis.

BACKGROUND: Allergic patients often complain of eye symptoms during the allergy season. A possible mechanism for these eye symptoms is a nasal ocular reflex. OBJECTIVE: To demonstrate eye symptoms after nasal allergen challenge. METHODS: In a double-blind, placebo-controlled, crossover, clinical trial, 20 patients with seasonal allergic rhinitis were challenged in 1 nostril with antigen, and the response was monitored in both nostrils and in both eyes. Symptoms were recorded. Filter paper disks (intranasally) and Schirmer strips (intraocularly) were used for collecting secretions, which were subsequently eluted for the measurement of histamine and albumin levels. Patients were treated once topically at the site of challenge with azelastine or placebo. RESULTS: After placebo treatment, ipsilateral nasal challenge caused nasal symptoms and an increase in secretion weights; both were blocked by treatment with azelastine. Histamine and albumin levels increased only at the site of nasal challenge. Azelastine pretreatment inhibited the increase in albumin but not histamine levels. Symptoms of itchy and watery eyes increased significantly compared with symptoms with sham challenge after nasal allergen and were blocked by azelastine use. Ocular secretion weights increased bilaterally after placebo use and were not inhibited by azelastine use. CONCLUSIONS: Nasal allergen challenge releases histamine at the site of the challenge, which probably initiates a nasonasal and a nasal ocular reflex. This reflex is reduced by an H1-receptor antagonist applied at the site of the challenge. The eye symptoms associated with allergic rhinitis probably arise, in part, from a naso-ocular reflex.     

Nerve growth factor or IL-3 induces more IL-13 production from basophils of allergic subjects than from basophils of nonallergic subjects.

BACKGROUND: Studies show that nerve growth factor (NGF) exhibits immunomodulatory activity. This neurotrophin is found at high levels in the serum of asthmatic individuals, is released during allergic reactions, and is reported to augment in vitro histamine and leukotriene C4 release by human basophils. OBJECTIVE: Because basophils represent a substantial source of IL-4 and IL-13, we tested the effects of NGF on the secretion of these cytokines by cells prepared from allergic subjects and cells prepared from nonallergic subjects. METHODS: Cytokine and histamine were measured in culture supernatants by ELISA and fluorimetry, respectively. Both real-time RT-PCR and conventional RT-PCR were used to measure IL-13 mRNA expression. NGF receptor expression was determined by 2-color flow cytometry. RESULTS: Basophil suspensions from allergic subjects secreted some 2.5-fold greater levels of IL-13 when cultured with NGF than did cells prepared from normal control subjects. Flow cytometry revealed no significant differences in TrkA receptors on basophils to explain these findings. The levels of IL-13 secreted by the 2 groups of donors also differed when cells were activated with IL-3 but not when they were activated with anti-IgE antibody. Both NGF and IL-3 failed to induce IL-13 in cell cultures depleted of basophils, suggesting that the measurable IL-13 was indeed basophil-derived. Real-time RT-PCR showed an average induction of IL-13 message above medium control that was 4.3 (+/- 1.7)-fold with NGF and 8.9 (+/- 3.7)-fold with IL-3. Finally, NGF priming resulted in a remarkable enhancement of IL-13 induced by anti-IgE. This was significantly greater than the priming observed for either the IL-4 or histamine when this stimulus was used. CONCLUSION: NGF (like IL-3) can both directly stimulate IL-13 secretion and modulate IgE-mediated responses in basophils. Its enhanced effect on cells from allergic individuals raises the importance of this cytokine in the pathogenesis of allergic disease.     

Induced expression of mRNA for IL-5, IL-6, TNF-alpha, MIP-2 and IFN-gamma in immunologically activated rat peritoneal mast cells: inhibition by dexamethasone and cyclosporin A.

We examined the capacity of purified rat peritoneal connective tissue-type mast cells (PMC) to express mRNA for several cytokines. Stimulation of PMC with anti-IgE for 4 hr induced the expression of mRNA encoding interleukin-5 (IL-5), IL-6, tumour necrosis factor-alpha (TNF-alpha), macrophage inflammatory protein-2 (MIP-2) and interferon-gamma (IFN-gamma). Unstimulated PMC expressed detectable mRNA for TNF-alpha but not for the other four cytokines. Incubation of PMC with cyclosporin A (CsA) or dexamethasone (DEX), each at 10(-6) M for 24 hr, significantly inhibited the induced expression of mRNA for each of the five cytokines, and also inhibited release of biologically active TNF-alpha. Throughout these experiments mRNA levels of the housekeeping gene G3PDH were not altered by stimulation with anti-IgE or incubation with CsA or DEX. We conclude that immunological activation of rat PMC induces gene expression of several cytokines and that expression of these genes can be inhibited by immunosuppressive drugs.     

Histamine skin test reactivity following single and multiple doses of azelastine nasal spray in patients with seasonal allergic rhinitis.

OBJECTIVE: To determine whether azelastine nasal spray suppresses the dermal response to epicutaneous histamine in allergic patients and the duration of suppression after azelastine use is discontinued. METHODS: Seventy-eight patients with seasonal allergic rhinitis were entered into this randomized, double-blind, parallel-group, placebo-controlled study. Patients received either azelastine nasal spray (2 sprays per nostril twice daily) or placebo nasal spray for 14 days. Skin tests were performed 5 hours after the first dose of study drugs to determine the effect of a single dose of azelastine nasal spray on the wheal-and-flare response to histamine. At the end of the 14-day treatment period, skin tests were performed 5 hours after the last dose of study drugs and at 24-hour intervals thereafter, until each patient's wheal-and-flare response to histamine (1.0 and 5.0 mg/mL) returned to within 20% of baseline values. RESULTS: A single dose of azelastine nasal spray did not significantly alter the wheal-and-flare response to histamine. The wheal response was within 20% of the baseline value in 82% and 88% (1.0 and 5.0 mg/mL of histamine, respectively) of the patients 5 hours after discontinuing 14 days of treatment with azelastine nasal spray. Wheal responses were within 20% of baseline values 48 hours after treatment was discontinued, whereas flare responses returned to within 20% of baseline within 48 hours in 92% of the patients. CONCLUSIONS: Azelastine nasal spray should be discontinued for at least 48 hours before beginning allergy skin test procedures.     

Curcumin attenuates the expression of IL-1beta, IL-6, and TNF-alpha as well as cyclin E in TNF-alpha-treated HaCaT cells; NF-kappaB and MAPKs as potential upstream targets

TNF-alpha induces some proinflammatory cytokines including IL-1beta, IL-6, IL-8, and itself by activation of NF-kappaB or MAPKs (p38, JNK, ERK). These cytokines play important roles in various inflammatory skin diseases, such as psoriasis. Recently it was also reported that expression of cyclin E is up-regulated by ERK pathway after TNF-alpha treatment. However, it was unknown whether curcumin, showing inhibitory effects on NF-kappaB and MAPKs, attenuates the expression of TNF-alpha-induced IL-1beta, IL-6, IL-8, and TNF-alpha as well as cyclin E expression in HaCaT cells. In this study, we investigated the inhibitory effect of curcumin on expression of proinflammatory cytokines and cyclin E in TNF-alpha-treated HaCaT cells. We found that curcumin inhibited the expression of TNF-alpha-induced IL-1beta, IL-6, and TNF-alpha, but not IL-8, in TNF-alpha-treated HaCaT cells as well as the TNF-alpha-induced cyclin E expression. In addition, curcumin inhibited the activation of MAPKs (JNK, p38 MAPK, and ERK) and NF-kappaB in TNF-alpha-treated HaCaT cells. Taken together, curcumin exerts anti-inflammatory and growth inhibitory effects in TNF-alpha-treated HaCaT cells through inhibition of NF-kappaB and MAPK pathways.     

The in vivo potency and selectivity of azelastine as an H1 histamine-receptor antagonist in human airways and skin

Azelastine is a novel histamine H1 antagonist with putative antileukotriene activity in guinea pigs. With three different doses of oral azelastine, we have performed a dose-response study to determine its protective effect on the airways against histamine-induced bronchoconstriction in 12 patients with mild, atopic asthma. On 4 separate days, patients undertook standardized inhalation-challenge tests with increasing concentrations of histamine (0.03 to 32 mg/ml) 4 hours after placebo or azelastine, 4.4, 8.8, and 17.6 mg, administered double blind and in random order. On 2 additional days, patients underwent methacholine challenge tests after placebo or azelastine, 17.6 mg. Baseline FEV1 between treatment days and 4 hours after placebo and azelastine did not change significantly. The three doses of azelastine, 4.4, 8.8, and 17.6 mg, increased the concentration of histamine required to cause a 20% fall in FEV1 (PC20) from 0.16 mg/ml geometric mean (GM) after placebo to 1.98 (p less than 0.01), 8.8 (p less than 0.01), and 8.1 (p less than 0.01) mg/ml, respectively. GM potency ratios derived from the PC20 values obtained for each patient indicated that the three increasing doses of azelastine displaced the histamine dose-response curve to the right by factors of 12.8, 54.4, and 50.2. Azelastine had no effect on the airway response to methacholine with GM PC20 values of 0.16 and 0.19 after placebo and azelastine, 17.6 mg. Azelastine is a potent H1 histamine-receptor antagonist on human airways in vivo without demonstrable anticholinergic effect.     

氮卓斯丁喷鼻剂治疗过敏性鼻炎的临床疗效观察

氮卓斯丁是一种新型抗组胺药,为考察氮卓斯丁喷鼻剂治疗过敏性鼻炎的疗效和安全性,进行了本项临床试验。采用多中心、随机、双盲、平行对照的方法,对照药为左卡巴斯丁喷鼻剂,受试者为中重度过敏性鼻炎患者,季节性过敏性鼻炎和常年性过敏性鼻炎分别连续给药14d和28d。共有136例完成了临床试验,氮卓斯丁组67例,左卡巴斯丁组69例。氮卓斯丁组总有效率82．1％,其中显效40．3％,左卡巴斯丁组则分别为76．8％和20．3％。两组均未发现严重不良反应。氮卓斯丁组与左卡巴斯丁组的不良反应发生率分别为22．1％和31．5％。氮卓斯丁组主要副作用为鼻干8．8％、口苦8．8％,左卡巴斯丁组主要副作用为鼻干16．4％、口干9．6％。氮卓斯丁喷鼻剂治疗过敏性鼻炎有较好的疗效和安全性。     

The effect of intranasal azelastine, Rhinolast®, on nasal airways obstruction and sneezing following provocation testing with histamine and allergen

The effect of single dose topical nasal therapy with azelastine hydrochloride (azelastine) on the response of nasal airways resistance (NAR) to provocation testing was studied in 36 patients with seasonal allergic rhinitis. Nasal provocation testing (NPT) with histamine or grass pollen was performed after a single dose of azelastine, 0.28 mg to each nostril, or placebo. NAR was assessed by rhinomanometry for 10 hr following NPT. Compared to placebo the NAR response to histamine was inhibited at both 1 and 2 hr following azelastine administration, significant at 1 hr (P less than 0.02) and 2 hr (P less than 0.0001). No such effect was observed in relation to allergen-induced changes in NAR. Azelastine also inhibited numbers of sneezes for up to 10 hr following both histamine NPT (P less than 0.02) and allergen NPT (P less than 0.05), when compared to placebo. Forty-seven per cent of participants experienced bitter or unpleasant taste sensations after azelastine administration but no other unwanted effects were clearly related to azelastine therapy.     

Inhibition of IgE-induced activation of human mast cells by IL-10

BACKGROUND: IL-10 exhibits anti-inflammatory effects on activated rodent mast cells (MC) in vitro and inhibits allergen-induced airway inflammation in vivo in murine models. The effects of IL-10 on the allergic activation of human MC are presently unknown. OBJECTIVE: In light of the well-known heterogeneity of mast cell reactivity between animal species, one cannot readily predict the response of human MC to IL-10. Moreover, the impact of IL-10 on MC-derived proinflammatory mediators is still unknown. Thus, the objective of this study was to investigate the effects of IL-10 on the release of inflammatory mediators by IgE/anti-IgE-challenged human cord blood-derived mast cells (CBMC), used as an in vitro model of MC phenotypically similar to human lung MC. MATERIALS AND METHODS: Highly purified human MC were obtained by a first step of long-term culture of cord blood mononuclear cells in the presence of human recombinant stem cell factor (rhSCF) and of human recombinant IL-6 (rhIL-6), followed by a second step of purification by depletion of contaminating cells with an immunomagnetic METHOD: The cells were treated with human IgE, then challenged with anti-human IgE, in the presence or the absence of recombinant rhIL-10 used at various concentrations. Histamine, tumour necrosis factor-alpha (TNF-alpha), IL-5 and IL-8 were measured in the various supernatants collected at different times after the beginning of the challenge. RESULTS: IL-10 inhibited the release of TNF-alpha and of IL-8, but not of IL-5, by activated CBMC. Interestingly, IL-10 also inhibited the release of histamine by activated CBMC, contrasting with data reported for rodent MC. CONCLUSIONS: These findings suggest that IL-10 might have anti-inflammatory effects on IgE/anti-IgE-challenged human MC by inhibiting their release of TNF-alpha, IL-8 and histamine. These data provide new insights into the control of human mast cell activation and might lead to a better knowledge of the cellular mechanisms controlling allergic reactions.