M. Frieri et al., LATE-PHASE INFLAMMATION DURING NASAL GRASS AND RAGWEED CHALLENGE IN ADOUBLE-BLIND PLACEBO-CONTROLLED TRIAL WITH ASTEMIZOLE, American journal of rhinology, 9(3), 1995, pp. 169-173
Allergic rhinitis is an IgE-mediated inflammatory reaction characteriz
ed by an early ''classic'' immediate hypersensitivity response and/or
a subsequent late phase response. Nasal provocation to antigen challen
ge is a useful method of evaluating this dual response. Several H-1 an
tagonists may exhibit anti-inflammatory properties by diminishing hist
amine release or inhibiting eosinophil chemotaxis. To determine whethe
r astemizole has any anti-inflammatory characteristics, we studied 20
patients with allergic rhinitis in a double-blind placebo-controlled f
ashion after a 4-week course of treatment with this H-1 antagonist. Na
sal provocation over 30 minutes was performed out of season using incr
easing concentrations of grass or ragweed extract from 10-1000. PNU Pa
tients were evaluated for their clinical response, and nasal lavage se
cretions were analyzed over 6 hours by ELISA for alpha interleukin-1,
interleukin-8, albumin, and histamine levels. Total sneezing and other
symptom scores for rhinorrhea, nasal congestion, and pruritus were de
creased in astemizole-treated compared to placebo-treated patients bot
h at 30 minutes (early phase), and at 3 and 6 hours (late phase) after
nasal provocation. However, these results did not reach statistical s
ignificance. Nasal alpha IL-1 levels diminished from diluent control l
avage to a significantly greater degree in astemizole than in placebo-
treated patients (P < 0.05). This diminution in late phase alpha IL-1
suggests that astemizole may possess anti-inflammatory properties.