H<sub>1</sub>‐ and H<sub>2</sub>‐antagonists in allergic and pseudoallergic diseases

Ring, Johannes; Behrendt, H.

doi:10.1111/j.1365-2222.1990.tb02460.x

Cited by 19 publications

(7 citation statements)

References 35 publications

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“…For that reason, a combination of H 1 and H 2 antagonists has been tested in the prophylaxis and treatment of some allergic and pseudo‐allergic reactions. For example, a beneficial effect of a combination of these two types of drugs has been observed in the prophylaxis of anaphylactoid reactions evoked by urea‐linked gelatin solutions or by radiographic contrast media [9]. Other studies have shown a beneficial effect of this combination in patients with CU.…”

Section: Pharmacotherapy Of Urticariamentioning

confidence: 99%

Antihistamines in urticaria

Kapsenberg¹,

Hilkens²,

Wierenga³

et al. 1999

Clin Experimental Allergy

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Urticaria is one of the most common and, in its chronic course, excruciating dermato-allergic diseases. Apart from the dermatological diagnosis, the identification and evaluation of causal triggering factors is of utmost importance. Here a 'three-step guideline' (according to Ring and Przybilla) has gained acceptance, ranging a general basic examination via an intensive investigation until oral provocation tests for food allergy and oral provocation tests for idiosyncrasy (OPTI) against food additives. Apart from true IgE-mediated allergies, pseudo-allergic reactions against food additives as well as food contents represent a major problem in chronic urticaria. Recently gastric mucosal colonization with Helicobacter pylori as the trigger of chronic urticaria has received attention. New pathophysiological concepts describe autoantibodies that are directed either against IgE or against the high-affinity IgE-receptor on the surface of mast cells and basophil leucocytes. In the intradermal test with autologous serum positive wheal and flare reactions can be observed (Greaves' test). In many patients with chronic urticaria considerable psychosomatic involvement is also observed. Histamine is one of the major mediators of most forms of urticaria although in some cases, especially physical urticaria, other mediators seem to play a role. Therefore antihistamines, and mainly H1 antihistamines, are the mainstay of antiurticaria therapy. Some studies have shown a benefit of combined H1- and H2-antagonist treatment in special forms of urticaria namely urticaria factitia. Similarly pretreatment with combined H1 and H2 antagonists has been proven to reduce effectively the frequency of pseudo-allergic reaction to some histamine-releasing drugs used in radiology or surgery. More than 50 years after the first introduction of an antihistamine into allergy therapy, antihistamines still represent modern and exciting agents contributing to the continuous improvement of antiallergic therapy. Antihistamine therapy can be performed with either the classical or second generation antihistamines. Classical antihistamines are connected with considerable side-effects especially sedation and anticholinergic effects. New non-sedating antihistamines have been developed that do not cross the blood-brain barrier. The efficacy of mizolastine, a new non-sedating H1 antagonist, has been evaluated in several placebo-controlled and comparative clinical trials. Overall, mizolastine 10 mg/day was found to be significantly more effective than placebo and as effective as other second generation antihistamine drugs in the management of patients with chronic urticaria, with a rapid and sustained action.

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Section: Pharmacotherapy Of Urticariamentioning

confidence: 99%

Antihistamines in urticaria

Kapsenberg¹,

Hilkens²,

Wierenga³

et al. 1999

Clin Experimental Allergy

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“…33,34 H2 antihistamines have also been used in the treatment of urticaria, especially refractory chronic urticaria, generally in combination with H1 receptor antagonist therapy. [35][36][37][38][39] Human skin blood vessels might possess H1 and H2 histamine receptors, which both play a role in mediating urticaria due to histamine. 40 Human skin mast cells that store histamine also express H2 histamine receptors.…”

Section: H2 Antihistaminesmentioning

confidence: 99%

Pharmacogenomics for the efficacy and side effects of antihistamines

Peng

Chen

et al. 2022

Experimental Dermatology

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Antihistamines, especially H1 antihistamines, are widely used in the treatment of allergic diseases such as urticaria and allergic rhinitis, mainly for reversing elevated histamine and anti‐allergic effects. Antihistamines are generally safe, but some patients experience adverse reactions, such as cardiotoxicity, central inhibition and anticholinergic effects. There are also individual differences in antihistamine efficacy in clinical practice. The concept of individualized medicine has been deeply rooted in people's minds since it was put forward. Pharmacogenomics is the study of the role of inheritance in individual variations in drug response. In recent decades, pharmacogenomics has been developing rapidly, which provides new ideas for individualized medicine. Polymorphisms in the genes encoding metabolic enzymes, transporters and target receptors have been shown to affect the efficacy of antihistamines. In addition, recent evidence suggests that gene polymorphisms influence urticaria susceptibility and antihistamine therapy. Here, we summarize current reports in this area, aiming to contribute to future research in antihistamines and clinical guidance for antihistamines use in individualized medicine.

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“…Insbesondere ist nicht klar, ob es sich um einen kumulativen Effekt oder lediglich um eine höhere Bioverfügbarkeit des H 1 -Antagonisten handelt [49]. Insbesondere ist nicht klar, ob es sich um einen kumulativen Effekt oder lediglich um eine höhere Bioverfügbarkeit des H 1 -Antagonisten handelt [49].…”

Section: Kombination Mit H 2 -Antagonistenunclassified