Evaluation of nasal symptoms induced by platelet activating factor, after nasal challenge in both healthy and allergic rhinitis subjects pretreated with rupatadine, levocetirizine or placebo in a cross-over study design
Tóm tắt
Platelet-activating factor (PAF) is produced by most inflammatory cells and it is involved in inflammatory and allergic reactions. We aimed to assess the anti-PAF effects of rupatadine and levocetirizine in the upper airways. Healthy volunteers (HV, N = 10) and seasonal allergic rhinitis (SAR, N = 10) asymptomatic patients were treated out of the pollen season with either rupatadine 20 mg, levocetirizine 10 mg, or placebo once a day during 5 days prior to the PAF nasal challenge. Total 4-nasal symptom score (T4SS) and nasal patency (Vol2-5, by acoustic rhinometry) were assessed from 0 to 240 minutes after a repeated PAF challenge. In SAR patients but not in HV, both rupatadine and levocetirizine showed a trend to decrease PAF-induced T4SS from 60 to 120 minutes. Rupatadine but not levocetirizine caused a significant reduction (p < 0.05) of T4SS area under the curve compared to placebo. Rupatadine and levocetirizine caused no significant changes on nasal patency compared to placebo. These results suggest that both rupatadine and levocetirizine showed a tendency decrease toward nasal symptoms, but only rupatadine significally reduces the overall nasal symptoms (AUC) induced by PAF in SAR patients.
Tài liệu tham khảo
Simons FE, Simons KJ: Histamine and H(1)-antihistamines: celebrating a century of progress. J Allergy Clin Immunol. 2011, 128 (6): 1139-1150. 10.1016/j.jaci.2011.09.005. e4
Merlos M, Giral M, Balsa D, Ferrando R, Queralt M, Puigdemont A, Garcia Rafanell J, Forn J: Rupatadine, a new potent, orally active dual antagonist of histamine and platelet activating factor (PAF). J Pharmacol Exp Ther. 1997, 280: 114-121.
Leggieri E, Tedeschi A, Lorini M, Bianco A, Miadonna A: Study of the effects of paf-acheter on human nasal airways. Allergy. 1991, 6: 466-471.
Tedeschi A, Palumbo G, Milazzo N, Miadonna A: Nasal neutrophilia and esosinophilia induced by challenge with platelet activating factor. J Allergy Clin Immunol. 1994, 2: 526-533.
Klementsson H, Andersson M: Eosinophil chemotactic activity of topical PAF on the human nasal mucosa. Eur J Clin Pharmacol. 1992, 3: 295-299.
Muñoz-Cano R, Valero A, Roca-Ferrer J, Bartra J, Sánchez-López J, Mullol J, Picado C: Platelet-activating factor nasal challenge induces nasal congestion and reduces nasal volume in both healthy volunteers and allergic rhinitis patients. Am J Rhinol Allergy. 2013, 27: 1-5.
Uzzaman A, Metcalfe DD, Komarow HD: Acoustic rhinometry in the practice of allergy. Ann Allergy Asthma Immunol. 2006, 6: 745-751.
Barrón S, Ramis I, García-Rafanell J, Merlos M: Inhibitory activity of rupatadine on pro-inflammatory cytokine production, relationship with binding affinity. Methods Find Exp Clin Pharmacol. 2005, 27 (2): 161-162.
Queralt M, Merlos M, Giral M, Puigdemont A: Dual effect of a new compound, rupatadine, on edema induced by platelet activating factor and histamine in dogs: comparison with antihistamines and PAF antagonists. Drug Dev Res. 1996, 39: 12-18. 10.1002/(SICI)1098-2299(19960901)39:1<12::AID-DDR2>3.0.CO;2-N.
Church MK: Efficacy and tolerability of rupatadine at four times the recommended dose against histamine and PAF induced flare responses and ex vivo platelet aggregation in healthy males. Br J Dermatol. 2010, 163 (6): 1330-1332. 10.1111/j.1365-2133.2010.10029.x.
Kajiwara N, Sasaki T, Bradding P, Cruse G, Sagara H, Ohmori K, Saito H, Ra C, Okayama Y: Activation of human mast cells thorough the patelet-activating factor receptor. J Allergy Clin Immunol. 2010, 5: 1137-1145. e1136
Tedeschi A, Milazzo N, Miadonna A: Nasal eosinophilia induced by PAF acether is accompanied by the release of eosinophil cationic protein. Eur Respir J. 1994, 7 (8): 1445-1451. 10.1183/09031936.94.07081445.
Miadonna A, Tedeschi A, Arnoux B, Sala A, Zanussi C, Benveniste J: Evidence of PAF-acether metabolic pathway activation in antigen challenge of upper respiratory airways. Am Rev Respir Dis. 1989, 140 (1): 142-147. 10.1164/ajrccm/140.1.142.
Maniscalco M, Sofia M, Faraone S, Carratu L: The effect of platelet-activating factor (PAF) on nasal airway resistance in healthy subjects is not mediated by nitric oxide. Allergy. 2000, 55: 757-761. 10.1034/j.1398-9995.2000.00603.x.
Greiner AN, Hellings PW, Rotiroti G, Scadding GK: Allergic rhinitis. Lancet. 2011, 378 (9809): 2112-2122. 10.1016/S0140-6736(11)60130-X.
Maiti R, Rahman J, Jaida J, Allala U, Palani A: Rupatadine and levocetirizine for seasonal allergic rhinitis: a comparative study of efficacy and safety. Arch Otolaryngol Head Neck Surg. 2010, 136 (8): 796-800. 10.1001/archoto.2010.128.
Maiti R, Jaida J, Raghavendra B, Goud P, Ahmed I, Palani A: Rupatadine and levocetirizine in chronic idiopathic urticaria: a comparative study of efficacy and safety. J Drugs Dermatol. 2011, 10 (12): 1444-1450.