title: Late phase response during nasal challenge: effect of astemizole on leukotriene B4 levels.
abstract: Nasal provocation (NP) in allergic rhinitis patients can elicit a late phase inflammatory response in which interleukins (IL), leukotrienes (LT), and neutrophils have been implicated. Certain antihistamines have been shown to have anti-inflammatory properties. The objective was to determine whether astemizole at 10 mgs/day has any anti-inflammatory characteristics. We clinically evaluated 20 patients with allergic rhinitis and measured nasal IL-8 and LTB4 during NP with increasing doses of grass and ragweed antigen in a double-blind placebo-controlled fashion after a 4-week course of treatment. Clinical symptom scores for sneezing, pruritus, and rhinorrhea were evaluated. Nasal fluid was examined by ELISA and RIA for IL-8 and LTB4 levels along with neutrophil assessment before NP and at 3, 6, and 8 hours. Symptom scores for nasal sneezing, pruritus, rhinorrhea, and nasal LTB4 levels at 6 and 8 hours and IL-8 at 3, 6, and 8 hours were generally lower in astemizole-treated patients compared to those on placebo. Nasal IL-8 levels corresponded to LTB4 levels at diluent and at 6 hours in the placebo group (P = 0.01). The percentage of neutrophils correlated with LTB4 levels at baseline, coefficient = 0.76, P = 0.02 and at 6 hours, coefficient = 0.62, P = 0.035 in the placebo group. This study is the first to demonstrate an effect of astemizole during NP on IL-8 and LTB4 levels with a significant correlation of neutrophil numbers in untreated patients during the nasal late phase response.
authors.affiliation: Department of Pathology and Surgery, Nassau County Medical Center, State University of New York at Stonybrook, USA.
authors.forename: N S
authors.initials: NS
authors.lastname: Kumar
authors.forename: P A
authors.initials: PA
authors.lastname: Schaefer
authors.forename: G
authors.initials: G
authors.lastname: Lark
authors.forename: M
authors.initials: M
authors.lastname: Frieri
mesh_terms: D000328:Adult; D000485:Allergens; D018926:Anti-Allergic Agents / Q000494:pharmacology*; D016589:Astemizole / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000032:analysis; D007975:Leukotriene B4 / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D017817:Nasal Lavage Fluid / Q000737:chemistry* / Q000166:cytology; D009297:Nasal Mucosa / Q000187:drug effects* / Q000378:metabolism; D009504:Neutrophils; D012220:Rhinitis / Q000503:physiopathology*
chemical_list: D000485:Allergens; D018926:Anti-Allergic Agents; D016209:Interleukin-8; D007975:Leukotriene B4; D016589:Astemizole