Comparison of the Efficacy of Topical Antihistamine/Mast Cell Stabilizers in vitro

PURPOSE: To investigate the biologic effects of topical anti-allergic agents with H1-receptor antagonism and inhibition of histamine release from mast cells in the cultured conjunctival cells of patients with vernal keratoconjunctivitis in vitro. METHODS: Conjunctival cells of vernal keratoconjunctivitis were exposed to the anti-allergic agents SCD-P101 (Fexofenadine, Samchundang, Korea), Patanol(R) (Alcon, USA), Zaditen(R) (Novartis, USA), and Azelan(R) (Taejoon, Korea). Efficacy of the topical antihistamine/mast cell stabilizers was evaluated using the MTT assay, measuring the concentration of procollagen and inflammatory cytokines. Cell damage was determined using the lactate dehydrogenase (LDH) assay with dilution rates of 10, 20, and 30% and compared with the balanced salt solution-treated group. Cellular morphologic results were examined by inverted light microscopy and transmission electromicroscopy. RESULTS: Metabolic activity of conjunctival cells decreased at higher concentrations and longer exposure durations, except for the SCD-P101 agent. The procollagen, laminin, IL-6 and IL-8 titers tended to be lower than that of the control in the eyes exposed to all the anti-allergic drugs tested in this study, but the concentration of TNF-beta was similar to that of the control group. Zaditen(R) and Azelan(R) tended to show a greater LDH titer and edema, as well as cytoplasmic and nuclear degeneration of the conjunctival cells than did SCD-P101 or Patanol(R). CONCLUSIONS: Cellular metabolic activity was the highest in the new anti-allergic agent SCD-P101. SCD-P101 and Patanol(R) caused marginally less damage to cultured conjunctival cells than did Zaditen(R) and Azelan(R).

Efecto del fumarato de ketotifeno tópico sobre la concentración de IgE total en lágrimas y la expresión de HLA DR en pacientes con conjuntivitis alérgica / Effect of the topic ketotifeno fumarato on the total concentration of IgE in tears and the expression of HLA-DR in conjunctivitis allergic patients

La conjuntivitis alérgica es una hipersensibilidad tipo I o inmediata mediada por la IgE y su efecto sobre la liberación y activación de mediadores inflamatorias por los mastocitos. Objetivo: Determinar la presencia de sintomatología y concentración de IgE total en lagrimas antes y después del tratamiento con fumarato de ketotifeno en pacientes con conjuntivitis alergica. Metodos: A 12 pacientes con conjuntivitis alérgica que acudieron al Instituto de investigaciones Optometritas de la Universidad de la Salle, se les realizó examen oftalmológico y determinación de IgE total en lágrimas. A estos pacientes se les trató con zaditem 0.025 por ciento, 1 gota cada doce horas, durante un mes, al cabo del cual se les realizó nuevamente examen oftalmológico, determinación de IgE y expresión de HLA-DR en citología de impresión. Resultados: los pacientes con conjuntivitis alérgica presentaron signos y síntomas como papilas, prurito, edema, ardor e hiperemia, los niveles de IgE fueron superiores a 5UI/l con una media de 23,75 UI/l; después del tratamiento con Zaditen no hubo presencia de sintomatología y los niveles de IgE disminuyeron significativamente (t= 3,30) con una P

Allergic conjunctivitis is a hypersensitive type I orimmediate by the IgE ands its effect regarding theliberation and activation of inflammatory mediatorsby mastocitos. The purpose was to determine thepresence of symptomatology and IgE totalconcentration in tears before and after treatment withketotifeno fumarato in conjunctivitis allergicpatients. 12 conjunctivitis allergic patients attendedto the Optometric Research Institute of theUniversidad de La Salle, and an ophthalmologicalexam was carried out and a total IgE in tears wasdetermined. These patients were treated withzaditem 0.025 percent, a tear every 12 hours, for a month.At the end of this treatment an ophthalmologicalexam was carried out again, the IgE was determined,as well as the presence of HLA-DR in an impressioncytology. Results found that conjunctivitis allergicpatients had signs and symptoms such papillas,pruritus, edema, ardor and hyperemia, the IgE levelswere higher to 5UI/1 with a measure of 23.75 UI/1.After the treatment with zaditen there were nosymptomatology and the IgE levels significantlydecreased (t= 3.30) with a P

The Effects of Anti-allergic Ophthalmic Agents on the Cultured Rabbit Conjunctival Cells

PURPOSE: To investigate the biological effects and cytotoxicity of anti-allergic ophthalmic agents on the cultured conjunctival cells of rabbit in vitro. METHODS: Conjunctival cells of rabbit were exposed to anti-allergic ophthalmic agents. Azelan(R) (Taejoon, Korea), Zaditen(R) (Novartis, USA), Patanol(R) (Alcon, USA) at a concentration 10, 20 and 30% for a period of 30 minutes, 4, 12, and 24 hours respectively. Cell injury assay was performed using lactate dehydrogenase (LDH) leakage assay. We checked the composition, pH, osmolarity of three anti-allergic agents. Light and transmission electron microscopy were performed to compare the cellular damage of rabbit conjunctival cells under various culture treatments. RESULTS: In cultured conjunctival cells of rabbit, the LDH titers increased up to 4 hours after exposure, maintained until 12 hours and then decreased 12 hours after exposed. Azelan(R) and Zaditen(R) showed a higher LDH titer and severe cellular damage of the conjunctival cells, compared with Patanol(R). Of anti-allergic solutions, Azelan(R) and Zaditen(R) revealed markedly lower Na+, Cl- and pH levels than Patanol(R). However, there was no difference in the concentration of preservative or osmolarity of the eye solution among the three anti-allergic agents. CONCLUSIONS: Patanol(R) caused markedly more damage to cultured rabbit conjunctival cells than Azelan(R) and Zaditen(R). If these anti-allergic these agents are clinically used for long periods of time, they may induce the cellular damage of conjunctival cells depending on the composition and pH of anti-allergic drugs.