A multicentric trial of loratadine and cetirizine in urticaria

Two hundred and ten patients with chronic urticaria were divided into two groups; one group was treated with Loratadine 10mg daily while the other with cetirizine 10mg daily. The total duration of treatment was four weeks. Pretreatment and post-treatment evaluations were made. It was noticed that loratadine was superior to cetirizine in terms of a rapid onset of actions, overall clinical efficacy and minimal side effects.     

Effect of cetirizine on cutaneous reactions to PAF, kallikrein and serum in patients with chronic urticaria

The effects of oral administration of the antihistamine cetirizine on the weal and flare caused by intradermal injection of platelet activating factor (PAF-acether), kallikrein, histamine and the patient's own serum were investigated in 10 patients with chronic urticaria. Cetirizine markedly reduced the weal and flare induced by all these agents as measured 12 min after the injections. The delayed reactions observed after injection of PAF, kallikrein and serum were also inhibited by cetirizine at 6 hours. In addition, reactions which were present 20 h after injection of the agent before administration of cetirizine were found to be inhibited at the same point in time after cetirizine treatment. These effects might explain the good inhibitory clinical effect of cetirizine on the patients' urticaria. No side-effects were noted during the treatment.     

荨麻疹患者血清特异性IgE过敏原检测及两种氯雷他定的疗效比较

目的:了解322例荨麻疹患者的致病因素及各种因素之间的相互关系,比较2种氯雷他定治疗84例慢性特发性荨麻疹患者的疗效。方法:采用德国“敏筛”定量过敏原检测系统对322例荨麻疹患者进行了特异性IgE及过敏原的检测和分析,应用2种氯雷他定片治疗84例慢性特发性荨麻疹患者,并进行疗效对比和随访观察。结果:322例患者中有159例至少对1项过敏原阳性,阳性率为49.4%。平均阳性过敏原为(1.36±1.70)项;78例患者血清特异性总IgE阳性,阳性率为24.2%。2种氯雷他定片治疗前后患者症状和体征评分指数下降差异无统计学意义。治疗后,治疗组基愈率为37.2%,有效率为72.2%;对照组基愈率为39.0%,有效率为78.0%,两组疗效比较差异无统计学意义。结论:德国“敏筛”定量过敏原检测系统能较简便地检测特异性IgE和过敏原;国产氯雷他定治疗慢性特发性荨麻疹安全有效。     

仙特敏、甲氰咪呱和潘生丁联合治疗慢性荨麻疹疗效观察

报道仙特敏、甲氰咪呱和潘生丁联合应用治疗５７例慢性荨麻疹的疗效观察。结果：联合组显效率和总有效率分别为７９％和９１．２％，仙特敏单用组显效率和总有效率分别为５１．４％和７７．１％，两组比较有显著性差异（Ｐ＜０．００１）。本文提示这三种药联用是治疗慢性荨麻疹安全和有效的方法。     

Candida spp. colonization and serum anticandidal antibody levels in patients with chronic urticaria

BACKGROUND: The role of Candida infections in the pathogenesis of chronic urticaria (CU) is debatable. Objective. In this study, we investigated the role of Candida spp. colonization and infection in patients with CU. METHODS: In total, 38 patients with CU and a control group of 42 healthy individuals consented for inclusion in the study. Stool and oral specimens from all participants were cultured and evaluated quantitatively. Candida albicans ELISA IgG/IgM/IgA test kits were used for the detection of antibodies against C. albicans in the sera of patients and controls. RESULTS: Yeasts were isolated from the stools of 60.5% of the patients and 50.0% of the controls (P = 0.78, Student's t-test) and from oral specimens in 47.4% and 42.9% (P = 0.85, Student's t-test), respectively. Colony counts in the positive specimens of both groups were not significantly different. IgG, IgM and IgA antibodies were positive in 36.8%, 23.8% and 5.3% of the patients and in 42.9%, 19.1% and 4.8% of the controls, respectively. The qualitative and quantitative results of the antibodies were not significantly different between the two groups (chi2 test). CONCLUSION: Intestinal and oral colonization of Candida spp. and serological evidence of Candida infections were not significantly different between patients with CU and controls. Claims of triggering of CU by Candida spp. should be explored in studies that measure allergic reactivity to Candida, and also in those that include eradication therapy.     

Loratadine and cetirizine in the treatment of chronic urticaria

Aim This study was designed to compare loratadine and cetirizine in controlling the symptoms of chronic urticaria. Subjects One hundred and sixteen adult patients with chronic urticaria. Methods In this double-blind study the patients were randomly divided into three therapeutic groups: 38 received loratadine (10 mg), 40 cetirizine (10 mg) and 38 placebo tablets once daily for 28 days. Steroid-dependent subjects and patients with physical urticaria or with angioncurotic hereditary oedema as well as pregnant or breast-feeding women were excluded from the study. A suitable wash-out period was observed in case of previous treatments for the same disease. Itching, erythema, number of lesions and diameter of the largest one were evaluated according to a scale from 0 (absent) to 3 (severe). The minimum entry study score for itching plus number of lesions had to be at least equal to three. Control visits were scheduled after 3, 7 and 14 days of therapy. Symptoms, disease status, therapeutic response, side effects and compliance were evaluated at each visit. Diary cards were filled in by patients at home. Results Active drugs compared to placebo significantly reduced global clinical symptoms (p < 0.05). Loratadine was more rapid in developing its activity than the other two agents (p < 0.01 at day 3). Each single symptom showed the same trend. At the end of the study 24 (63%) patients treated with loratadine, 18 (45%) with cetirizine and 5 (13%) with placebo were free from symptoms. Four failures occurred with loratadine, six with cetirizine and seventeen with placebo. The tolerability profile was similar for all three groups. One patient receiving cetirizine dropped out due to severe gastric pain. Conclusions Loratadine is more active and safer than cetirizine in the treatment of chronic urticaria.     

慢性特发性荨麻疹患者血清IL-2、4、6、8、10、12及IFN-γ的检测及临床意义

目的探讨慢性特发性荨麻疹患者血清细胞因子水平测定的临床意义。方法随机选择慢性特发性荨麻疹患者48例,健康检查的正常A．48例,分为两组,分别测定其血清中IL-2、4、6、8、10、12及IFN-γ的含量。结果慢性特发性荨麻疹患者组血清中IL-4、IL-8水平显著高于正常对照组（P〈0．01）;IL-6、IL-10水平略高于对照组,但差异无统计学意义（P〉0．05）;IL-2、IL-12、IFN-γ水平明显低于正常对照组（P〈0．01）。结论慢性特发性荨麻疹患者血清IL-2、IL-4、IL-8、IL—12及IFN-γ水平异常,提示慢性特发性荨麻疹的发病与免疫相关。     

Treatment of chronic urticaria with cetirizine dihydrochloride a non-sedating antihistamine

The efficacy of cetirizine dihydrochloride, a new H₁-antagonist with minimal sedative or anticholinergic side effects was evaluated in 30 patients with chronic idiopathic urticaria. In the first part of the study, cetirizine 10 mg and placebo were compared in a double-blind cross-over trial. In the second part, patients who did not respond adequately in the first part were randomized, still double-blind, to receive 10 mg cetirizine either once daily or twice daily. In the first part, treatment was discontinued by 17 patients on placebo and two patients on cetirizine because of lack of efficacy. Cetirizine dihydrochloride was found significantly to reduce occurrence of weals, erythema and pruritus compared with placebo (P <0.001). Twenty-six of the patients improved on cetirizine and two on placebo. Mild sedation was noted by two patients on cetirizine and by one on placebo.     

Comparative efficacy of cetirizine and levocetirizine in chronic idiopathic urticaria

H1 receptor antagonists are the mainstay of treatment for chronic idiopathic urticaria. Newer hydroxyzine derivatives such as cetirizine and levocetirizine have been found to be equally efficacious in preclinical studies in patients with chronic idiopathic urticaria. In this study, the clinical efficacy of cetirizine and levocetirizine has been studied sequentially in individual patients. Fifty chronic idiopathic urticaria patients received 10 mg of levocetirizine daily for 6 weeks. Some 45 patients out of these showed reasonably good clinical efficacy on a visual analog scale to qualify for comparison with levocetirizine. A total of 30 patients completed the study period of 6 weeks each of cetirizine and levocetirizine sequentially. Thus, the clinical efficacy of cetirizine and levocetirizine was comparable with a marginal advantage of better antipruritic effect with levocetirizine, probably at the cost of increased sedation.     

慢性湿疹和荨麻疹患者血清过敏原检测

报告了2000年3月－2001年3月对128例慢性湿疹，慢性荨麻疹患者进行血清过敏原特异性IgE抗体检测，并与40名正常人对照。结果128例患者血清过敏原反应阳性97例，对一种过敏原呈阳性反应24例，对2种以上过敏原呈阳性反应73例。阳性率较高的过敏原是屋尘，尘螨，多价霉 ，牛羊肉。40名正常人血清过敏原反应全部阴性。血清总IgE值：128例患者有94例＞50IU／mL，对照组均＜20IU／mL。     

慢性自发性荨麻疹患者血清维生素D与基质金属蛋白酶9的检测

目的 探讨慢性自发性荨麻疹患者血清25羟维生素D［25（OH）D］与基质金属蛋白酶9（MMP?9）的水平及意义。方法 用高效液相色谱?串联质谱法检测56例慢性自发性荨麻疹患者和25例健康对照血清25（OH）D水平,用酶联免疫吸附试验检测血清MMP?9水平。采用独立样本t检验或秩和检验分析两组间指标水平的差异,Spearman秩相关分析评估各检测指标之间的相关性及其与病情的关系。结果 患者组中轻度19例,中度26例,重度11例。患者组血清25（OH）D水平为（21.74 ± 6.04） μg/L,健康对照组为（30.17 ± 2.21） μg/L;患者组MMP?9水平中位数（P25 ~ P75）为291.55（166.18,594.46） μg/L,健康对照组为138.46（94.27,233.12） μg/L,两组间25（OH）D、MMP?9水平差异均有统计学意义（P < 0.05）。患者组血清25（OH）D与MMP?9水平呈负相关（rs = -0.26,P < 0.05）,MMP?9水平与症状严重程度呈正相关（rs = 0.27,P < 0.05）,25（OH）D水平与症状严重程度无明显相关关系（rs = -0.20,P > 0.05）。结论 维生素D、MMP?9在慢性自发性荨麻疹的发病过程中起一定作用。     

特异性免疫治疗对慢性荨麻疹患者血清白介素-18和白介素-10水平的影响

目的:检测慢性荨麻疹患者特异性免疫治疗(specific immunotherapy SIT)前后Th1型细胞因子白介素-18(IL-18)和Th2型细胞因子白介素-10(IL-10)血清水平。方法:ELISA法检测30例变应原皮肤试验阳性荨麻疹患者特异性免疫治疗前后及20例正常人血清IL-18和IL-10水平。结果:慢性荨麻疹患者SIT前IL-18水平低于正常人(P<0.05),SIT后升高(P<0.05);SIT前IL-10水平高于正常人(P<0.05),SIT后下降(P<0.05)。结论:变应原皮试阳性荨麻疹患者IL-18降低,IL-10升高,Th1/Th2失衡在慢性荨麻疹的发病中具有重要作用。特异性免疫治疗可能通过调节Th1/Th2平衡而发挥治疗作用。     

依匹斯汀和西替利嗪治疗慢性特发性荨麻疹对照观察

我们于2005年7月至2006年12月,分别用依匹斯汀、西替利嗪治疗慢性特发性荨麻疹(chronic idiopathic urticaria,CIU),进行随机、开放、对照的临床疗效观察,现报道如下.     

Effects of acrivastine, loratadine and cetirizine on histamine-induced wheal and flare responses

It is accepted that studies evaluating histamine-induced wheal and flare reactions in the skin represent a simple and reliable method for demonstrating pharmacodynamic activity and pharmacokinetics of the H1-receptor antagonists. In this study, the effects of single oral doses of acrivastine (8 mg), loratadine (10 mg) and cetirizine (10 mg) on the histamine-induced wheal and flare reactions were compared in 60 healthy volunteers. The wheal and flare responses were produced by prick test using 1% histamine solution. Measurements were performed before the ingestion of antihistamines (baseline values) and afterwards at 15, 30, 90, 240, 360 min and 24 h. The values obtained for each antihistamine were compared with each other and with baseline values. Cetirizine was found to be superior to acrivastine and loratadine for the suppression of wheal and flare responses at 240, 360 min and 24 h (P < 0.05) and acrivastine was superior to the other two antihistamines for the suppression of flare response at 30 min (P < 0.05). Our results indicate that a single dose of cetirizine provides a more effective and long acting suppression on wheal and flare reactions in urticaria when compared to acrivastine and loratadine.     

慢性荨麻疹患者血清25羟基维生素D水平检测及意义

目的 检测慢性荨麻疹患者血清25羟基维生素D水平,探讨25羟基维生素D（25HVD）在慢性荨麻疹（CU）发病中的作用。方法 收集50例CU患者及40例健康对照血清,同时应用CU症状评分标准（UAS）对疾病进行评分;用 ELISA测定血清25HVD、干扰素γ（IFN?γ）、白细胞介素4（IL?4）、免疫球蛋白E（IgE）水平。所得数据采用t检验、秩和检验、直线相关回归分析进行统计学分析。结果 CU组血清25HVD水平［（15.20 ± 7.72） μg/L］明显低于对照组［（21.54 ± 8.31） μg/L,t = 3.75,P < 0.05］,且两组25HVD水平分布比较,差异有统计学意义（H = 17.9,P < 0.05）。UAS评分重度组25HVD水平［（15.57 ± 7.38） μg/L］与轻度组［（14.86 ± 6.28） μg/L］差异无统计学意义（t = 0.37,P > 0.05）。CU组血清IFN?γ水平明显低于对照组（t = 15.34, P < 0.05）,但血清IL?4和IgE水平明显高于对照组（t值分别为6.54, 4.88,均P < 0.05）。CU组血清25HVD水平与IFN?γ水平呈正相关（r = 0.738,P < 0.05）,与IL?4水平呈负相关（r = -0.689,P < 0.05）,与IgE水平无相关性（r = -0.271,P > 0.05）。结论 CU患者血清25HVD水平明显降低,可能通过介导Th1细胞/Th2细胞失衡参与CU的发生。     

咪唑斯汀联合粉尘螨注射液对慢性荨麻疹患者血清CC型趋化因子水平的影响

目的：研究粉尘螨特异性免疫治疗对慢性荨麻疹患者CC型趋化因子表达水平的影响，探讨特异性免疫治疗的作用机制。方法：将64例粉尘螨过敏的慢性荨麻疹患者随机分为两组，分别采用粉尘螨注射液联合咪唑斯汀治疗或单用咪唑斯汀治疗。应用双抗体夹心酶联免疫吸附试验（ELISA）检测治疗前、后以及正常对照血清中调节激活正常T细胞表达和分泌的细胞因子（RANTES）及单核细胞趋化蛋白-1（MCP-1）的水平。结果：两组慢性荨麻疹患者治疗前血清RANTES和MCP-1的水平均显著高于各自治疗后第16周末（P分别〈0．001和0．05）及正常对照（P均〈0．001）；联合治疗组在治疗后第16周末的RANTES和MCP-1水平以及每周咪唑斯汀用量的评分均显著低于单用咪唑斯汀组（P〈0．01）。结论：RANTES和MCP-1在慢性荨麻疹的发病中起重要作用，特异性免疫治疗对慢性荨麻疹的治疗效果可能与其使RANTES和MCP-1下调的作用有关。     

Evaluation of D-dimer serum levels among patients with chronic urticaria,psoriasis and urticarial vasculitis

BACKGROUND

It has been demonstrated that neutrophils, eosinophils and monocytes, under appropriated stimulus, may express tissue factor and therefore, activate the extrinsic pathway of coagulation. We performed a transversal and case-control study of patients with chronic urticaria and patients with psoriasis, in our outpatient clinic to evaluate the production of D-dimer.

OBJECTIVE

To evaluate D-dimer serum levels in patients with chronic urticaria and its possible correlation with disease activity.

PATIENTS AND METHODS

The study was conducted from October 2010 until March 2011. We selected 37 consecutive patients from our Allergy Unit and Psoriasis Unit, and divided them into three groups for statistical analysis: (i) 12 patients with active chronic urticaria (CU); (ii) 10 patients with chronic urticaria under remission and (iii) 15 patients with psoriasis (a disease with skin inflammatory infiltrate constituted by neutrophils, lymphocytes and monocytes). Another five patients with urticarial vasculitis were allocated in our study, but not included in statistical analysis. The serum levels of D-dimer were measured by Enzyme Linked Fluorescent Assay (ELFA), and the result units were given in ng/ml FEU.

RESULTS

Patients with active chronic urticaria had the highest serum levels of D-dimer (p<0.01), when compared to patients with CU under remission and the control group (patients with psoriasis).

CONCLUSIONS

Patients with active chronic urticaria have higher serum levels of D-dimer, when compared to patients with chronic urticaria under remission and patients with psoriasis. We found elevated serum levels of D-dimer among patients with urticarial vasculitis.     

慢性荨麻疹患者血清ECP水平的测定

用法玛西亚CAPECP荧光酶标法测定30例慢性荨麻疹患者和20名正常人血清嗜酸细胞阳离子蛋白(ECP)水平。结果 ,慢性荨麻疹患者血清ECP值为25.76±2.45μg/L,正常对照组为3.3±0.74μg/L。患者组明显高于正常组(P<0.01)。因此 ,在荨麻疹的发病过程中 ,ECP可能起着一定的作用。     

Raised serum levels of β-endorphin in chronic urticaria

Background Attempts to elucidate the pathophysiology of chronic urticaria and its relation with stress have implicated many factors among which the increased activity of the opioid system seems to be particularly interesting. Material and Methods We determined the β-endorphin serum levels in 14 patients with chronic urticaria and 15 healthy members of the medical staff of comparable age. Results The mean β-endorphin levels of our patients (15.95 ± 2.75 pmol/l) were statistically elevated (P < 0.001) compared to those of controls (8.53 ± 2.53 pmol/l). Conclusions It is suggested that the opioid system of patients with chronic urticaria is strongly activated in the chronic stage of the disease.     

Effect of levothyroxine treatment on clinical symptoms and serum cytokine levels in euthyroid patients with chronic idiopathic urticaria and thyroid autoimmunity

Background. Screening for thyroid autoimmunity in patients with chronic idiopathic urticaria (CIU) is generally recommended. However, there are not yet sufficient data as to whether levothyroxine treatment is beneficial for the clinical symptoms of CIU in patients with thyroid autoimmunity. Aim. We investigated the effect of levothyroxine treatment on clinical symptoms and serum tumour necrosis factor (TNF)‐α, interleukin (IL)‐10 and interferon (IFN)‐γ levels in euthyroid patients with CIU and thyroid autoimmunity. Methods. In total, 15 patients with CIU and positive thyroid autoantibodies were randomized to receive either levothyroxine plus 5 mg/day desloratadine (suppression group, n = 8) or 5 mg/day desloratadine alone (control group, n = 7) for 12 weeks. Clinical symptoms of CIU, thyroid hormone levels, thyroid antibodies and serum cytokine levels were assessed at baseline and after the treatment. Results. There were significant improvements in pruritus score and severity of weals in both groups compared with baseline values, but when the two groups were compared, there was no significant difference in the patients’ clinical symptoms. Thyroid antibody titres were not different according to intragroup and intergroup analysis. In the suppression group, serum IFN‐γ and TNF‐α levels were increased after treatment with levothyroxine compared with baseline values and there was a borderline statistical significance (P = 0.05 for both). Conclusions. These results suggest that levothyroxine treatment is not a reasonable option in euthyroid patients with CIU and thyroid autoimmunity. Augmentation of cytokine production after levothyroxine treatment seems to be related to the immunomodulatory effects of TSH‐suppressive treatment.