Inhibitory effects of azelastine hydrochloride in alcohol-induced asthma.
BACKGROUND
Alcohol-induced bronchoconstriction is due to high blood concentrations of acetaldehyde, a metabolic product of ethanol, which lead to the release of histamine from basophils and mast cells.


OBJECTIVE
We examined the inhibitory effects of azelastine hydrochloride, which inhibits histamine release and blocks H1 receptors, in alcohol-induced asthma.


METHODS
Subjects were 13 Japanese asthmatic patients. We measured the change in FEV1 after ingestion of 30 g of pure ethanol. Blood ethanol, acetaldehyde, histamine, leukotriene C4 (LTC4), and thromboxane B2 (TXB2) concentrations were also measured. Alcohol challenge test was repeated in responders after administration of azelastine for 1 week at 4 mg/day.


RESULTS
Of 13 asthmatic patients, five (38.5%) tested positive during an ethanol challenge test, represented by a fall more than 20% in FEV1. The responders had a high blood ethanol, and showed a rise in blood acetaldehyde and histamine concentrations, but not in LTC4 or TXB2. After azelastine treatment, there was no significant fall in FEV1 among responders. Neither the rise in blood ethanol nor blood acetaldehyde levels were blunted by treatment with azelastine, but the rise in blood histamine was blunted by this treatment.


CONCLUSIONS
Our results suggest that antihistamine agents may be effective against alcohol-induced asthma by both blocking H1 receptors and inhibiting histamine release.
Takao
A
A
Second Department of Internal Medicine, Nagasaki University, School of Medicine, Japan.
Shimoda
T
T
Matsuse
H
H
Mitsuta
K
K
Obase
Y
Y
Asai
S
S
Kohno
S
S
D000079:Acetaldehyde / Q000097:blood; D000328:Adult; D000368:Aged; D001249:Asthma / Q000139:chemically induced* / Q000378:metabolism*; D016085:Bronchoconstrictor Agents / Q000037:antagonists & inhibitors / Q000494:pharmacology; D001993:Bronchodilator Agents / Q000494:pharmacology; D000431:Ethanol / Q000009:adverse effects* / Q000097:blood; D005260:Female; D006632:Histamine / Q000097:blood; D006801:Humans; D017997:Leukotriene C4 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010793:Phthalazines / Q000494:pharmacology*; D012129:Respiratory Function Tests; D013929:Thromboxane B2 / Q000097:blood
D016085:Bronchoconstrictor Agents; D001993:Bronchodilator Agents; D010793:Phthalazines; D017997:Leukotriene C4; D000431:Ethanol; D013929:Thromboxane B2; D006632:Histamine; D000079:Acetaldehyde; C020976:azelastine