Individualized treatment for allergic rhinitis based on key nasal clinical manifestations combined with histamine and leukotriene D4 levels / Tratamento individualizado para a rinite alérgica baseado nas principais manifestações clínicas nasais e dos níveis de histamina e leucotrieno D4

Abstract Introduction The types of allergic rhinitis are roughly classified based on the causative antigens, disease types, predilection time, and symptom severity. Objective To examine the clinical typing and individualized treatment approach for allergic rhinitis and to determine the optimal treatment method for this disease using various drug combination therapies. Methods A total of 108 participants with allergic rhinitis were divided into three groups based on symptoms. Subsequently, each group was further categorized into four subgroups based on the medications received. The efficacy of the treatments was evaluated using the visual analog scale VAS scores of the total and individual nasal symptoms, decline index of the symptom score, histamine and leukotriene levels, and mRNA and protein expression levels of histamine 1 and cysteinyl leukotriene 1 receptors. Results Loratadine + mometasone furoate and loratadine + mometasone furoate + montelukast significantly improved the sneezing symptom and reduced the histamine levels compared with the other combination therapies (p < 0.05). Meanwhile, montelukast + mometasone furoate and montelukast + mometasone furoate + loratadine considerably improved the nasal obstruction symptom and decreased the leukotriene D4 levels compared with the other combination therapies (p < 0.05). Conclusion Clinical symptom evaluation combined with experimental detection of histamine and leukotriene levels can be an objective and accurate method to clinically classify the allergic rhinitis types. Furthermore, individualized treatment based on allergic rhinitis classification can result in a good treatment efficacy.

Resumo Introdução A rinite alérgica é basicamente classificada de acordo com os antígenos causadores, tipos de doença, peridiocidade e gravidade dos sintomas. Objetivo Avaliar os tipos clínicos e a abordagem terapêutica individualizada para cada tipo de rinite alérgica e determinar o método de tratamento ideal utilizando várias terapias de combinação de fármacos. Método Um total de 108 participantes com rinite alérgica foram divididos em três grupos com base nos sintomas. Posteriormente, cada grupo foi subsequentemente categorizado em quatro subgrupos com base nos medicamentos recebidos. A eficácia dos tratamentos foi avaliada utilizando os escores da escala visual analógica EVA dos sintomas nasais totais e individualmente, índice de declínio do escore de sintomas, níveis de histamina e leucotrienos e níveis de expressão de mRNA e proteína dos receptores de histamina 1 e cisteinil-leucotrieno 1. Resultados As associações entre loratadina + furoato de mometasona, assim como a de loratadina + furoato de mometasona + montelucaste melhoraram significativamente o sintoma de espirros e reduziram os níveis de histamina em comparação às outras terapias combinadas (p < 0,05). Por outro lado, a associação montelucaste + furoato de mometasona, assim como a associação montelucaste + furoato de mometasone + loratadina melhoraram consideravelmente o sintoma de obstrução nasal e diminuíram os níveis de leucotrieno D4 em comparação com as outras combinações (p < 0,05). Conclusão A avaliação clínica dos sintomas combinada com a detecção experimental dos níveis de histamina e leucotrieno pode ser um método objetivo e preciso para classificar clinicamente os tipos de rinite alérgica. Além disso, o tratamento individualizado baseado na classificação da rinite alérgica pode resultar no aumento da eficácia do tratamento.

Effect of high-voltage electrical stimulation on the albumin and histamine serum concentrations, edema, and pain in acute joint inflammation of rats

BACKGROUND: The mechanism by which high-voltage electrical stimulation (HVPC) acts on edema reduction is unknown. OBJECTIVE: To assess the effect of HVPC with negative polarity (-) applied to the ankle of rats with acute joint inflammation. METHOD: Sixty-four rats were divided into four groups (n=16): inflamed+HVPC(-), 0.03 mL application of ι-carrageenan (3%) to the tibiotarsal joint plus HVPC(-); inflamed+HVPC placebo, carrageenan application and HVPC placebo; normal+HVPC(-), HVPC application(-); and normal control, no intervention. The HVPC(-) 100 Hz at a submotor level was applied daily for 45 min on three consecutive days. The variables were pain, hind-foot volume, and serum histamine and albumin assessed before and during the 48 hours following inflammation. The variables were compared using the t test, one-way ANOVA, nested ANOVA for repeated measures, and the post hoc Bonferroni test. Analysis of covariance was applied to adjust the effects of HVPC(-) by measurements of pain, inflammation, albumin, and histamine at 24 h, and the final weight was compared to the other groups. The significance level was set at p<0.05. RESULTS: There were no differences between the inflamed+HVPC(-) and inflamed+HVPC placebo groups in terms of pain or edema (p>0.05). Albumin was reduced in the groups that received the intervention, but there was no differences between them. There was only a 24 hour increase in histamine with the normal+HVPC(-) (p=0.0001) and inflamed+HVPC placebo groups (p=0.01) compared to the normal control group. CONCLUSIONS: The results of the present study suggest that HVPC(-) with the parameters employed did not reduce pain or edema and did not change serum albumin or histamine levels,, which indicates the inability of this resource to have a positive effect when treating treat acute joint inflammation. .

Effect of German chamomile oil application on alleviating atopic dermatitis-like immune alterations in mice

Historically, German chamomile (GC) oil has been used for treatment of skin disorders. BALB/c mice were sensitized twice a week with 100 microL of 1% 2,4-dinitrochlorobenzene (DNCB) and challenged twice the following week with 100 microliter of 0.2% DNCB for atopic dermatitis induction. Thereafter, 3% GC oil was applied daily (70 microliter, 6 times week) on the dorsal skin for 4 weeks. Saline or jojoba oil was used for the control mice. Blood was collected after second DNCB challenge, and at 2 and 4 weeks after initiating oil application. Serum IgE levels were significantly lowered in the GC oil application group at the end of the 4-week application period. The GC oil application for 4 weeks resulted in reduction in serum IgG1 level compared with that after 2-week application. The GC oil application group showed a significantly lower serum histamine level than the control group 2 weeks after oil application. Scratching frequency of the GC oil application group was significantly lower than either control groups. This study is to demonstrate GC oil's immunoregulatory potential for alleviating atopic dermatitis through influencing of Th2 cell activation.

Allergic reactions in patients suffering from asthma induced by house dust mites which treatment by juvenile hormone

The effect of Juvenile hormone analogue, Admiral "pyriproxyfen", which acts as a protein de-naturing agent, on the protein patterns of D. farinae was studied on allergic reactions in patients with HDM asthma, and in mice injected twice [within 10 days] with mite crude extracts. Total protein concentrations and protein patterns were different in normal and admiral-treated mites. This may result in reducing the allergenic of treated mites. Histamine release, total immunoglobulin E [IgE], specific immunoglobulin E [S-IgE], eosinophil cationic protein [ECP], and absolute eosinophil count [AEC] were determined for moderate and severe HDM asthmatics compared to check cases. These parameters had higher levels in asthmatic patients than in normal [check] individuals. Injection of mice with normal adult extracts of D. farinae resulted in significantly higher levels of histamine, S-IgE and ECP than in the check animals. Skin reactions were observed in all of the mice injected with normal or treated D. farinae extracts

Role of mast cells in the pathogenesis of rheumatoid arthritis

To elucidate the involvement of mast cells in the pathogenesis of rheumatoid arthritis [RA] by finding out the cells in synovial tissue and their products in the synovial fluid. Also, by studying the ultrastructure of mast cells, in an attempt to throw light on possible new strategies in the management of this disease. Twenty RA patients and ten subjects with acute post traumatic knee effusion- who served as a control group- were recruited for this study. All synovial fluid [SF] samples were investigated for mast cell products: tryptase and histamine using radioimmunoassay [RIA]. Synovial tissue [ST] specimens were obtained from control subjects and RA patients. These specimens were stained with hematoxylin and eosin for assessment of lymphocytic infiltration and with the conventional mast cell stain "Toluidine blue". A study of the ultrastructure of synovial tissue specimens was done to further document changes of synovial mast cells. SF tryptase and histamine were highly significantly raised in RA patients in contrast to control subjects [p<0.001]. There was a statistically significant increase in ST mast cell scoring in rheumatoid synovium as compared to that of control subjects [p<0.01]. Ultrastructural study of rheumatoid synovial tissue revealed evidence of degranulation of some mast cells. There was a highly significant positive correlation between ST mast cell score, SF tryptase, SF histamine and the modified disease activity score [DAS] as well as with the severity of the disease as assessed by Larsen score [p<0.001]. A highly significant positive correlation was found between ST mast cell scoring and the histological inflammatory index [p< 0.001]. Mast cells are an important contributor of the rheumatoid process in synovium reflecting its role in disease activity and joint destruction. These findings might have important implications for understanding the pathogenesis of RA. Hence, drug therapy targeting mast cells may have a role in controlling the activity and severity of the disease

Enhanced Serum Neutrophil Chemotactic Activity was Noted in Both Early and Late Asthmatic Responses During Lysine-Aspirin Bronchoprovocation Test in ASA-Sensitive Asthmatic Patients

To investigate the pathogenic mechanism of late asthmatic response in comparison to early asthmatic response, changes of serum neutrophil chemotactic activity (NCA) using the Boyden chamber method and histamine level using the automated fluorometric analyzer were observed in 13 aspirin (ASA)-sensitive asthma subjects (group I: 7 early responders and group II: 6 dual responders) during lysine aspirin bronch-oprovocation test (L-ASA BPT). Sera were collected before, and 30 min and 240 min after L-ASA BPT. Serum NCA increased significantly after 30 min (p=0.02) and decreased significantly at 240 min (p=0.02) in group I, while serum NCA of group II increased significantly at 30 min (p=0.04), tending to increase further up to 240 min with no statistical significance. NCA at 240 min in group II subjects was significantly higher than baseline NCA (p=0.02). The serum NCAs collected before and 240 min were significantly higher in group II than in group I (p<0.05, respectively). There were no significant changes in serum histamine levels during L-ASA BPT in both groups. NCA derived from mast cell may contribute to the development of early asthmatic response induced by L-ASA inhalation. There may be a possible involvement of NCA derived from mononuclear cells during late asthmatic response.

Evaluation of the possible effects of microwaves on some vasoactive substances serotonin [Part I] and some metabolite [part II] steptozotocin induced diabetic rats

The objective of this study was the evaluation of the possible adverse effects of microwaves [e.g. mobile, microwave ovens, etc.] on some vasoactive substances as catecholamine [norepinephrine and epinephrine], 5 hydroxy tryptamine [serotonin] and histamine as well as histaminase enzyme activity and the possible role of Nigella sativa oil [NSO] administration in albino rats. Male adult albino rats were divided into control group [n=10], group II [n=10] received microwaves for 7 days consecutively at a dose of 170 mW/Cm2 and frequency of 2.06 GHz for 3 hours [acute group], the third group [group III] [n=10] received the same dose as group II but for 28 consecutive days [chronic group], the fourth group [group IV] was treated as group II with concomitant administration of Nigella sativa oil [NSO] 100 mg/kg/day/orally by gastric tube. The fifth group [n=10] was treated as group III with concomitant oral administration of Nigella sativa oil in the same dose as group IV for 28 days. At the end of experiments, the animals were sacrificed and blood examined for norepinephrine, epinephrine, serotonin, histamine and histaminase enzyme activity. The result of the present study showed that microwaves produced significant reduction of histaminase activity significant increase in histamine, serotonin, norepinephrine and epinephrine, all were highly significantly changed in acute group of irradiation

relation between histamine and serotonin plasma levels and renal diseases in children

Plasma histamine and serotonin concentrations were measured using fluorimetric assay in 40 children with renal diseases, minimal change nephrotic syndrome, focal segmental go-merulosclerosis and acute poststreptococcal glomerulo-nephritis to determine the relation between plasma level of histamine and serotonin and these various types of renal diseases in children. Plasma histamine level was significantly increased in group of children with acute poststreptococcal glomerulonephritis Plasma serotonin levels were significantly increased in all 3 groups of patients when compared with those of controls. Raised plasma hisiamine in acute poststreptococcal glomerulonephritis group may be evidence of the acute immu-nological inflammation and defective renal excretion due to mild renal impairment in these children. Raised plasma serotonin in all 3 groups of patients may be due to diminished uptake and release of serotonin from platelets in children with nephrotic syndrome and focal segmental glomerulosclerosis and due to defective renal excretion in children with acute post-streptococcal glomerulonephritis

Vitamin C status in allergic children

This study was undertaken to assess vitamin C status in allergic children. Twenty-six allergic patients and 46 apparently healthy controls aged 7-16 years of both sexes were introduced. All patients were diagnosed being allergic based on their histories, physical examinations and laboratory findings. Blood samples were obtained between 09.00-11.00 to determine total serum immunoglobulin E, histamine, plasma vitamin C and complete blood cell count. Stool examinations and urinealysis were also done. Although total serum immunoglobulin E levels were significantly higher in patients than in controls, the serum histamine and plasma vitamin C levels showed no significant difference between the two groups. Surprisingly, patients with allergic dermatitis and food allergy had significantly lower plasma vitamin C levels than patients with asthma and rhinitis. Also, female patients tended to have higher plasma vitamin C but lower total serum immunoglobulin E levels compared to the male patients but none of these differences were significant. Healthy boys, on the other hand, had significantly higher plasma vitamin C than healthy girls. Our findings did not confirm the previous reports which showed decreased plasma vitamin C levels in allergic patients. We concluded that the plasma vitamin C levels in different allergies might be infuenced by such factors, such as sex, type and the stage of allergic disease, besides those affecting intake

Liposome entrapped allergen reduces plasma histamine in sensitized mice.

Immunotherapy of allergic diseases is associated with problems of adverse systemic reactions. We have shown earlier that liposome entrapped allergen (LEA) is effective in inducing IgG response and restricting IgE response in immunized mice. This mode of treatment may be more effective and safer if it can prevent anaphylaxis. To determine this feature, mice were administered allergen preparations repeatedly and later challenged with the same allergen. Mice given liposomal preparation showed lower specific IgE response as compared to the mice given free allergen or alum adsorbed allergen of Artemisia scoparia. Specific IgG response was higher in mice immunized with LEA. The mice immunized with liposomal preparation survived whereas others injected with free allergen or alum adsorbed allergen died probably due to anaphylaxis. High levels of histamine were observed in mice injected with free allergen as compared to the mice injected LEA. The increase in plasma histamine level may be the cause of anaphylaxis during allergen challenge. In conclusion, LEA could be used as a safe and effective mode of immunotherapy for allergy diseases, since it reduces plasma histamine levels considerably thereby reducing the chances of anaphylaxis.

Comparative study of platelet histamine and serotonin with their corresponding plasma oxidases in asthmatics with normals.

OBJECTIVE: Asthma is well controllable but non-curable disease. Exact pathophysiology involved is unresolved till today. Role of allergic hypersensitivity reaction in asthmatic on-set is well established. Present work is an effort to elucidate some basic points of unresolved pathophysiology of asthma taking platelets as marker. MATERIAL AND METHODS: A group of 52 normal human subjects in the age group of 20-60 years were studied for platelet histamine and serotonin levels and also for their plasma metabolising enzymes diamine oxidase (DAO) and monoamine oxidase (MAO). The data was collected for 79 asthmatic patients at different stages of asthma and accordingly were studied as four different groups of seventy nine asthmatics those were on regular treatment and were comfortable with drugs and were free from symptomatic attack formed gr. I; these (79) patients were followed-up during their symptomatic phase (gr. II) and same (79) patients immediately after their recovery from symptomatic stage studied as gr. III members. All the 79 asthmatic patients fall in gr. I, II and III in a serial manner i.e. all (n = 79) in each group. A separate group of thirty seven patients with known history of asthma but were symptom free and also off drugs for last 2-4 years formed gr. IV. RESULTS: Results showed mean platelet count in asthmatics at all four stages were in the normal range but were slightly low in comparison with normals. Both the enzymatic levels (DAO and MAO) in gr. I, II and III were significantly higher than normals but were same in the case of gr. IV patients. Low levels of platelet biogenic amines were observed in asthmatics (gr. I to gr. IV) than normals. CONCLUSIONS: Thus, study parameters showed significant difference in asthmatics and normals. Findings of the study have been utilized to understand unanswered hypersensitivity shown by the asthmatics over normal individuals (non-asthmatics).

Effect of some antioxidant [vitamin A, vitamin E, vitamin C] on plasma and tissues histamine concentrations in diabetic rats

The present study was carried out on adult male albino rats, experimentally made diabetics, to clarify whether some of the antioxidants exemplified by vitamin A, vitamin E and vitamin C, had any effect on the elevated plasma and aortic histamine concentrations suggested to be [at least partially] contributing to the early development of atherosclerotic changes in diabetics. In addition, an investigation of their possible effect on the activities of the aortic enzymes, histidine decarboxylase [HDC] and diamine oxidase [DAO] was included as well. Diabetes was induced in rats using alloxan. The animals [confirmed to become diabetics] were treated with the above mentioned drugs for 2 months. Plasma and aortic tissue histamine concentrations, aortic HDC and DAO enzymes activities were determined. Results of the present study had shown a statistically significant alteration in these parameters in the direction of the values recorded in the non-diabetic normal animals groups

Interaçäo entre exercício físico e suplementaçäo de ácido ascórbico sobre a histamina tecidual do músculo esquelético e cardíaco de cobaias sedentárias e treinadas / Interaction between physical exercise and ascorbic acid supplementation on the histamine tissue of skeletal and cardiac muscles of sedentary and trained guinea-pigs

O presente estudo objetivou avaliar em cobaias ("Cavia porcellus"), fêmeas, com três meses de idade, sedentárias (SED) e treinadas (TRE = nataçäo, 30 min/dia, durante sete semanas) o comportamento da concentraçäo tecidual de histamina muscular e cardíaca, em resposta ao exercício agudo (E = exercício agudo - nataçäo, 30 minutos, R = repouso) e à suplementaçäo de ácido ascórbico (SU = suplementados - 35 mg/kg de peso, NS = näo suplementados). Foram constatadas a seguintes diferenças significativas (p<0,05) : a) no grupo sedentário, aumento da histamina muscular e cardíaca tanto nos subgrupos näo suplementados como nos suplementados, o mesmo ocorrendo entre os animais treinados-exercitados agudamente somente naqueles suplementados; b) maior aumento de histamina muscular nos animais treinados - näo suplementados - exercitados agudamente quando comparados a seus respectivos controles e de histamina cardíaca nos animais sedentários - suplementados - exercidados agudamente, quando comparados aos näo suplementados, na mesma condiçäo, e c)diminuiçäo da histamina cardíaca nos animais sedentários, em repouso e suplementados

Síndrome de hiper IgE: revisión bibliográfica / Hyper IgE syndrome: bibliography review

El síndrome de hiper IgE (SHIE) es una rara entidad que se caracteriza por presentar infecciones cutáneas y respiratorias, sobre todo neumonías a estafilococo, con posterior formación de neumatoceles, disturbios en el metabolismo óseo y una IgE sumamente elevada. En el presente artículo se trata de actualizar el tema en sus aspectos fisiopatológicos, inmunológicos y nuevas conductas de tratamiento

Changes in Ige, histamine and esinophils in laryngotracheobronchitis

The present study included 45 children aged 1.5-5 years with laryngotracheobronchitis [the most common form of croup] 15 of them suffered from a single attack and the remaining 30 suffered from recurrent attacks of the disease. The study also included 20 children with bronchial asthma aged 3-6 years and 20 apparently healthy children aged 1-6 years as controls. Plasma IgE and histamine levels and blood esinophil count were significantly higher in laryngotracheobronchitis and asthma children than in controls. Asthma children showed a significantly higher plasma IgE, plasma histamine and blood esinophil count than those with laryngotracheobronchitis. No significant difference could be found in the levels of plasma IgE, plasma histamine and blood esinophil count between children with a single attack and those with recurrent attacks of laryngotracheobronchitis. Changes of plasma IgE, plasma histamine and blood esinophil count in children with laryngotracheobronchitis appear to be related to the basic underlying pathology rather than to allergy

Serotonin, histamine and platelets in vascular disease with special reference to peripheral vascular disease

Cardiovascular disease is a major cause of death. There is evidence that this disease is predicted and its progression influenced by various factors (e.g. hyperlipidaemia). In this review, we consider aspects of platelet structure and function which may explain how this cell type contributes to the pathogenesis of vascular disease. The platelet also contains bioamines (serotonin, 5-HT; histamine) which are potent vasoactive substances. Studies involving patients with peripheral vascular disease (PVD) where abnormalities in platelet function (platelet aggregation and platelet shape change) and in bioamine status (vascular, platelet and plasma bioamine concentrations) are reviewed. We also discuss how platelet activation (in vitro) and plasma lipids influence intraplatelet bioamine status. Finally, we report in vitro evidence of the effect of two drugs prescribed to PVD patients: aspirin and naftidrofuryl. Aspirin is an ineffective inhibitor of 5-HT-induced whole blood platelet aggregation whereas naftidrofuryl is effective in the presence or absence of aspirin. By identifying and altering the factors which contribute to the pathogenesis of atherosclerosis we will be better equipped to prevent, reverse or retard this process

Plasma histamine in asthmatic children in relation to plasma IgE level

This study included 35 asthmatic children and 10 controls. Ages of patients and controls ranged from 4-8 years. They were recruited from the out-patients clinic of the pediatric Departement, Assiut University Hospital. The following investigations were done for both patients and controls: Plasma IgE level, plasma histamine level, total and differential white blood cell count, urine and stool examination. Plasma histamine level was significantly elevated in asthmatic than in control children. At the same time plasma histamine level was significantly elevated in asthmatic children with normal plasma IgE than in asthmatics with raised plasma IgE. Absolute blood esinophil count was significantly elevated in asthmatic children with elevated plasma IgE than both controls and asthmatics with normal plasma IgE. No significant difference could be found in the absolute blood basophil count could be found between asthmatics children and controls. It appears from this study that histamine may be an important mediator of bronchial asthma in children irrespective of the plasma IgE level

Influence of smoking on blood histamine induced lung functional changes due to cotton dust exposure in textile mills

Cigarette smoking has a supplementary effect in producing ventilatory functional deficit in cotton dust exposed workers. Exaggerated airway reactivity produced by autocoid [histamine] was also reported in smokers in experimental studies. Here, acute changes in FEV1 and PEFR over a shift and chronic changes as observed by the percentage of predicted FEV1 and PEFR values and blood histamine levels were compared in control and exposed [nonbyssinotics and byssinotics] workers according to smoking habits. Higher airway reactivity associated with elevated histamine levels was found in exposed workers and even higher in smokers than nonsmokers. Similar observations were also demonstrated with regard to chronic changes. The data shows that smoking has a cumulative effect over histamine induced fail in FEV1 and PEFR in cotton dust ex

Effect of praziquantel on blood and liver granuloma histamine and brain serotonin contents in experimental schistosomiasis

The effects of schistosoma mansoni infection and praziquantel treatment on blood and liver granuloma histamine contents and brain and liver granuloma serotonin contents were studied in mice experimentally infected each with 60 cercariae of an Egyptian strain of S. mansoni. Praziquantel [5x250 mg/kg] was- administered 8 and 12 weeks after infection and mice were sacrificed 2 weeks after treatment. Infection produced a transient increase in blood histamine and brain serotonin contents 10 weeks after infection. Praziquantel has no effect on the previously mentioned parameters. Liver granulomas up to 200 mg wet weight showed no serotonin contents. Local increase in granuloma histamine contents with chronicity of infection was observed amounting to 0.584 +/- 0.04 and 3.027 +/- 0.244 ug/g. Net weight 10 and 14 weeks after infection respectively. Praziquantel administered 12 weeks after infection produced significant increase in liver granuloma histamine contents