Histamina, receptores de histamina e anti-histamínicos: novos conceitos / Histamine, histamine receptors and antihistamines: new concepts

As drogas com ação anti-histamínica estão entre as medicações mais comumente prescritas na prática dermatológica diária, tanto em adultos como em crianças. Este artigo aborda os novos conceitos da função dos receptores de histamina (receptores H1) e discute os efeitos anti-inflamatórios dessas drogas. A segunda geração de anti-histamínicos difere da primeira geração devido a sua elevada especificidade e afinidade pelos receptores H1 periféricos e devido a seu menor efeito no sistema nervoso central, tendo como resultado menores efeitos sedativos. Embora a eficácia dos diferentes anti-histamínicos H1 (anti-H1) no tratamento de doentes alérgicos seja similar, mesmo quando se comparam anti-H1 de primeira e de segunda geração, eles são muito diferentes em termos de estrutura química, farmacologia e propriedades tóxicas. Consequentemente o conhecimento de suas características farmacocinéticas e farmacodinâmicas é importante para a melhor prática médica, especialmente em gestantes, crianças, idosos e doentes com comorbidades.

Drugs with antihistamine action are the most commonly prescribed medication in daily dermatologic practice, both to adults and children. This article addresses new concepts of the role of histamine receptors (H1 receptors) and discusses the anti-inflammatory effects of these drugs. Second generation antihistamines differs from first generation because of their high specificity and affinity for peripheral H1-receptors. Second generation antihistamines are also less likely to produce sedation because they have less effect on the central nervous system. Although the efficacy of the various H1-antihistamines in the treatment of allergic patients is similar, even when comparing first- and second-generation drugs, these drugs are still very different in terms of their chemical structure, pharmacology and toxic properties. Consequently, knowledge of their pharmacokinetic and pharmacodynamic characteristics is essential for a better medical care, especially that offered to pregnant women, children, the elderly, and patients with comorbidities.

Participación de receptores histaminérgicos involucrados en la permeabilidad vascular / Participation of histaminergic receptors involved in vascular permeability

La permeabilidad vascular puede ser modificada por la liberación de histamina endógena como resultado de la presencia de ciertos tiobarbitúricos (tiopental) en el organismo. Esta modificación en la permeabilidad es mediada por la activación del receptor histaminérgico H1, pero es incierta la participación del receptor H2. En este trabajo se evalúa la participación de receptores H1 y H2 durante los cambios de permeabilidad vascular inducidos por histamina, a través de la determinación de concentraciones séricas de albúmina, proteínas totales y globulinas, que indirectamente lo indican. Se formaron 5 grupos de organismos; un control y 4 experimentales denominados grupo A, B, C y D. A los organismos del grupo A se les aplicó histamina IV, 10 µg/Kg de peso, y finalmente al grupo D se le inyectó simultáneamente 0.16 mg/Kg de peso; al grupo C se le inyectó ranitidina IV, 0.13 mg/Kg de peso, y finalmente al grupo D se le inyectó simultáneamente 0.16 mg/Kg de peso y 0.13 mg/Kg de peso de astemizol y ranitidina IV, respectivamente. El grupo A mostró un decremento significativo en las concentraciones de albúmina, proteínas totales y globulinas. En los grupos B, C y D se observó una disminución en la concentración de proteínas totales y globulinas, pero no de albúmina. Estos resultados muestran que los receptores H1 y H2 están involucrados en el aumento de permeabilidad vascular a la albúmina, pero tal vez exista un proceso de permeabilidad diferencial en el cual el paso de globulinas desde la luz vascular hasta el intersticio esté regulado por otro mecanismo

Effect of histaminergic drugs on tail melanophores of tadpole, Bufo melanostictus.

The H1 and H2 receptor agonist histamine caused a powerful aggregation of B. melanostictus tail melanophores, which was completely blocked by metiamide, a specific H2 receptor antagonist, while mepyramine an H1 receptor blocker partially blocked the aggregating response. The strong melanin aggregating effect of 4-methyl histamine a specific H2 receptor agonist and its complete blockade by metiamide further supports the conclusion that there exists a dominant population of H2 type of histamine receptors along with sparse population of H1 receptor on the tail melanophores of the toad, which mediate centripetal movement of melanin granules within the pigment cells leading to blanching of the animal.

Evidence for histamine and 5-hydroxytryptamine like effects of MK-212 on guinea pig ileum, taenia coli and rat fundus strip.

MK-212 (1 x 10(-7)M -- 1 x 10(-5)M) produced dose-dependent contractions of guinea pig ileum, taenia coil and rat fundus strip. The responses to MK-212 in all three preparations were blocked competitively by cyproheptadine (1 x 10(-8)M) a 5-HT receptor antagonist. Mepyramine (1 x 10(-8)M)-H1 receptor antagonist also inhibited competitively the responses of guinea pig ileum and taenia coli to MK-212. However, it failed to block significantly the responses of rat fundus strip to MK-212. Metiamide (1 x 10(-6)M), propranolol (1 x 10(-6)M) or atropine (1 x 10(-6)M) did not produce any significant effects on MK-212 induced contractile responses of guinea pig ileum, taenia coli and rat fundus strip. Our findings suggest that MK-212 produces both 5-HT as well as histamine like effects on the guinea-pig ileum, taenia coli and rat fundus strip.

Evidence for both H and H2-histamine receptors in rabbit atria.

Spontaneously beating isolated atria of rabbits responded to histamine (0.5-16 micrograms/ml) with positive chrono- and inotropism. However, the inotropic response was greater than chronotropic one. The concentration-response curve of histamine for chronotropic effect was markedly shifted to the right in the presence of 0.5 micrograms/ml metiamide (H2-receptor antagonist), which per se augmented the control contractile amplitude in all the experiments. The rightward shift of chronotropic concentration response curve with mepyramine (H1-antagonist) was, however, moderate. On the contrary, the inotropic concentration response curve of histamine was shifted to much greater extent to right with mepyramine (0.62 micrograms/ml) than with metiamide, thus suggesting a greater share of H1 than H2-receptors in the mediation of positive inotropic effect of histamine. The chronotropic effect appears to be mediated predominently by H2-receptors. Unlike metiamide, mepyramine did not alter the spontaneous frequency or amplitude of contraction. The present study, thus lends support for dual histamine receptors in rabbit atria.

Histamine receptors in guinea-pig isolated urinary bladder.

Spasmogenic action of histamine, 2-(2-aminoethyl) pyridine (H1 receptor agonist) and 4 methyl-histamine (H2 receptor agonist), have been studied in guinea pig isolated urinary bladder in the presence of mepyramine (H1 antagonist) and metiamide (H2 antagonist) to identify the presence of H1 and H2 receptors. The study suggested the presence of H1 as well as H2 receptors in this preparation.