Protective Effect of Loratadine on Late Phase Reaction Induced by Conjunctival Provocation Test

Ciprandi, Giorgio; Buscaglia, S; Marchesi, Emanuela; Danzig, Melvyn R.; Cuss, Francis M.; Canonica, Giorgio Walter

doi:10.1159/000236407

Cited by 47 publications

(18 citation statements)

References 11 publications

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“…The method is easy to perform, low-priced, rarely elicits systemic reactions and is also independent of the examiner's experience and the patient's compliance [10,11,14,15]. The CPT makes it possible to assess the therapeutic (pharmacological) effect on the severity of allergic reactions [16], determine optimal treatment doses in immunotherapeutic dose-finding studies and define the current status of a patient's allergic severity. For patients with pronounced conjunctivitis, one can objectify the treatment results or the current allergy status using digital image processing when the reddening of the challenged eyes is documented with high-resolution photos.…”

Section: Introductionmentioning

confidence: 99%

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

Gloistein

Astvatsatourov²,

Allekotte³

et al. 2015

Int Arch Allergy Immunol

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Background: Allergic reactions in patients with seasonal or perennial rhinoconjunctivitis mediated by airborne allergens can be effectively assessed with the conjunctival provocation test (CPT). The CPT is a fast and easy diagnostic procedure that challenges the ocular mucosa with instillations of allergen solutions into the conjunctival region. This paper aimed to investigate the possible influence of repeated diagnostic CPT procedures on the patient's clinical presentation, i.e. to analyze desensitization effects caused by diagnostic solutions and to show the reproducibility of CPT results. Methods: Treatment progress in 120 placebo-treated patients from 2 immunotherapeutic dose-finding studies was estimated and documented, as based on the CPT which was applied at 4 visits with intervals of 4, 8 and 16 weeks. High-resolution digital photos collected as part of the CPT documentation were analyzed by an external observer and by digital analysis software to determine conjunctival redness, completely independent of the subjectivity of investigators and patients. Results: Two extremal scenarios of the redness changes were considered after provocation with 10,000 standard quality units/ml. A maximal decrease of about 3% (t test: p = 0.0002; U test: p = 0.001) and a minimal decrease of about 1% (t test: p = 0.254; U test: p = 0.431) were found. Conclusions: The observed decrease in conjunctival hyperemia can be explained by local desensitization or by placebo effect. Due to the setup of both studies considered, we could not ascertain how these factors influence the decrease in redness. In order to attribute the observed effects to local conjunctival desensitization with certainty, further pilot studies are needed.

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Section: Introductionmentioning

confidence: 99%

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

Gloistein

Astvatsatourov²,

Allekotte³

et al. 2015

Int Arch Allergy Immunol

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“…It is generally easy to perform, inexpensive, rarely associated with systemic reactions, and largely independent of the patient's compliance and examiner's experience [7,20,22,60]. It is considered as an approved tool for analyzing pathomechanisms of allergic diseases and assessment of pharmaceutical effects on the allergic reaction [61]. …”

Section: Introductionmentioning

confidence: 99%

Objectifying the Conjunctival Provocation Test: Photography-Based Rating and Digital Analysis

Dogan

Astvatsatourov

Deserno

et al. 2013

Int Arch Allergy Immunol

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Background: Patients with allergic rhinoconjunctivitis are susceptible to both nasal and ocular symptoms. The conjunctival provocation test (CPT) is an established diagnostic procedure used in allergic rhinoconjunctivitis, particularly to document a patient's current reactivity to allergens. To date, there are no international guidelines defining the CPT. No approved evaluation method exists for interpreting CPT results. This paper aims to establish the digital analysis of macroimages as an objective, validated and standardized method for interpreting CPT results. Methods: In a clinical immunotherapy trial with 155 patients, treatment progress was documented based on the CPT. Local investigators used a symptom score to grade tearing, reddening and the patients' subjective perception of symptoms (mucosal irritation). A central observer rated conjunctival hyperemia via digital photography. Digital image analysis software was utilized to determine conjunctival hyperemia. Results: Spearman's correlation between the local investigators' and the central observer's ratings was r = 0.729 (p < 0.001); the percentage of total agreement was 48% (based on 739 photos). Digital image analysis (based on 48 photos) had a high percentage of total agreement with the central observer's ratings (69%) but a low percentage of total agreement with the investigators' ratings (38%). The corresponding correlations were r = 0.264 and 0.064, respectively. Conclusion: Photography-based rating by a central observer may represent a valuable supplement to the local investigator's assessment for making an objective evaluation of CPT results. Digital image analysis possesses the potential of being an objective evaluation method compared to the wide-spread subjective evaluation by the investigators.

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“…It has been reported that marked infiltrations of eosinophils and neutrophils into conjunctival tissue were seen in patients with allergic conjunctivitis [25][26][27][28]. However, different from the intraperitoneally sensitised guinea pigs, neutrophils but not eosinophils migrated outside the conjunctiva of the topically sensitised animals.…”

Section: Discussionmentioning

confidence: 89%

An experimental allergic conjunctivitis induced by topical and repetitive applications of Japanese cedar pollens in guinea pigs

Yasuda¹,

Kato²,

Nabe³

et al. 1999

Inflamm. res.

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The present sensitisation/challenge procedures are unique in terms of topical application of antigen. The lack of any correlation between the levels of the anaphylactic antibodies and severity of anaphylactic symptoms, and the difference of CIS between the left and right eyes of an individual strongly suggest that the anaphylactic antibodies are formed in locally limited tissue surrounding an eye. The present method should be useful for analysing the mechanisms of allergic conjunctivitis.

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Protective Effect of Loratadine on Late Phase Reaction Induced by Conjunctival Provocation Test

Cited by 47 publications

References 11 publications

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

Digitally Analyzed Conjunctival Redness: Does Repeated Conjunctival Provocation Intrinsically Cause Local Desensitization of the Eye?

Objectifying the Conjunctival Provocation Test: Photography-Based Rating and Digital Analysis

An experimental allergic conjunctivitis induced by topical and repetitive applications of Japanese cedar pollens in guinea pigs

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