Histamine-induced skin reactions using iontophoresis and H1-blockade

Neste, D. Van; Leroy, D.; Brouwer, B. de; Rihoux, Jean‐Pierre

doi:10.1007/bf03354083

Cited by 3 publications

(3 citation statements)

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“…Whether or not the combination of H 1 ‐ and H 2 ‐receptor antagonists is useful in the treatment of cold induced urticaria is still controversial [39–43]. Significant reduction in skin blood flow response to histamine iontophoresis after cetirizine treatment alone, without an H 2 ‐receptor antagonist, compared to placebo has been reported [19]. The reason for the discrepancy with our study appears to be mainly methodological.…”

Section: Discussioncontrasting

confidence: 56%

“…The reason for the discrepancy with our study appears to be mainly methodological. We constructed dose‐response curves to very low histamine doses with the highest dose of 2500 μA s cm −2 , whereas the single dose used by van Neste et al [19] was 17 times higher (42500 μA s cm −2 ); this caused significant local oedema, shown by the reduction of LDF in the centre of histamine iontophoresis. The significantly greater response to the highest dose of histamine in our experiments after treatment with cetirizine plus cimetidine compared with placebo illustrates the importance of the oedema in interpretation of the vasodilation: Vasodilation in the centre of histamine iontophoresis appears to be hidden under the wheal at the two highest histamine doses in the placebo phase.…”

Section: Discussionmentioning

confidence: 99%

“…Histamine provocation tests, such as the prick technique, are traumatic to the skin structure, provoking the release of vasoactive compounds which may confound the interpretation of histaminergic responses [17, 18]. Iontophoresis (local electrical current‐driven delivery of drugs into the dermis) is atraumatic, and permits investigation of the effects of selected, exogenously administered molecules [19, 20].…”

Section: Introductionmentioning

confidence: 99%

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Histamine response and local cooling in the human skin: involvement of H₁‐ and H₂‐receptors

Großmann

Jamieson

Kirch

1999

Brit J Clinical Pharma

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Histamine response and local cooling in the human skin: involvement of H₁‐ and H₂‐receptors

Großmann

Jamieson

Kirch

1999

Brit J Clinical Pharma

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Comparison of the Effects of Cetirizine and Ebastine on the Skin Response to Histamine Iontophoresis Monitored with Laser Doppler Flowmetry

et al. 1998

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Background: The administration of histamine with iontophoresis is an alternative method to skin prick tests or intradermal injections. Skin reactions obtained with this method can be recorded with laser Doppler flowmetry (LDF) and previous studies with this method have shown histamine-induced laser Doppler changes in the wheal area. Objective: In order to compare the influence of two H₁ receptor antagonists (cetirizine 10 mg vs. ebastine 10 mg) on the skin vascular responses to histamine introduced by iontophoresis, we designed a double-blind, randomized, two-period crossover trial in which 18 volunteers were randomized. Methods: Before and 2, 5 and 7 h after drug administration, iontophoresis (30 s, 1.4 mA/cm²) of histamine 10% was performed and followed by (1) monitoring of skin vascular responses with LDF at the administration site and at 1 cm from it, and (2) wheal and flare area measurements. Results: 2, 5 and 7 h after intake of the antihistaminic drug, there were significant differences between both drugs. Concerning LDF recordings, we noted at the histamine administration site an increase in perfusion unit (PU) values which is an effect known to be in proportion to the degree of inhibition of wheal reaction, and at 1 cm distal to the histamine administration site, there was a decrease in PU values. These changes were more marked under cetirizine. A greater suppressive effect of cetirizine on the wheal and flare reaction was consistently observed at all time points during the study, demonstrating its superior efficacy. Conclusion: We conclude that (1) cetirizine demonstrated a stronger antihistaminic effect compared to ebastine at all time points; (2) iontophoresis appears to be an appropriate method to study specific microvascular changes at the delivery site of histamine and hence to detect the earliest changes occurring at the site of agonist-antagonist competition in the skin.

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Second-Generation Antihistamines

Golightly

Greos²

2005

Drugs

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Antihistamines are useful medications for the treatment of a variety of allergic disorders. Second-generation antihistamines avidly and selectively bind to peripheral histamine H1 receptors and, consequently, provide gratifying relief of histamine-mediated symptoms in a majority of atopic patients. This tight receptor specificity additionally leads to few effects on other neuronal or hormonal systems, with the result that adverse effects associated with these medications, with the exception of noticeable sedation in about 10% of cetirizine-treated patients, resemble those of placebo overall. Similarly, serious adverse drug reactions and interactions are uncommon with these medicines. Therapeutic interchange to one of the available second-generation antihistamines is a reasonable approach to limiting an institutional formulary, and adoption of such a policy has proven capable of creating substantial cost savings. Differences in overall efficacy and safety between available second-generation antihistamines, when administered in equivalent dosages, are not large. However, among the antihistamines presently available, fexofenadine may offer the best overall balance of effectiveness and safety, and this agent is an appropriate selection for initial or switch therapy for most patients with mild or moderate allergic symptoms. Cetirizine is the most potent antihistamine available and has been subjected to more clinical study than any other. This agent is appropriate for patients proven unresponsive to other antihistamines and for those with the most severe symptoms who might benefit from antihistamine treatment of the highest potency that can be dose-titrated up to maximal intensity.

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Histamine-induced skin reactions using iontophoresis and H1-blockade

Cited by 3 publications

References 5 publications

Histamine response and local cooling in the human skin: involvement of H₁‐ and H₂‐receptors

Histamine response and local cooling in the human skin: involvement of H₁‐ and H₂‐receptors

Comparison of the Effects of Cetirizine and Ebastine on the Skin Response to Histamine Iontophoresis Monitored with Laser Doppler Flowmetry

Second-Generation Antihistamines

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Histamine-induced skin reactions using iontophoresis and H1-blockade

Cited by 3 publications

References 5 publications

Histamine response and local cooling in the human skin: involvement of H1‐ and H2‐receptors

Histamine response and local cooling in the human skin: involvement of H1‐ and H2‐receptors

Comparison of the Effects of Cetirizine and Ebastine on the Skin Response to Histamine Iontophoresis Monitored with Laser Doppler Flowmetry

Second-Generation Antihistamines

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Histamine response and local cooling in the human skin: involvement of H₁‐ and H₂‐receptors

Histamine response and local cooling in the human skin: involvement of H₁‐ and H₂‐receptors