Variant effect of first- and second-generation antihistamines as clues to their mechanism of action on the sneeze reflex in the common cold.
Treatment with first-generation antihistamines reduces sneezing, rhinorrhea, nasal mucus weight, and, in some instances, cough in subjects with experimental or natural colds; however, treatment with second-generation antihistamines has not been effective for these complaints in trials in subjects with natural colds. This article reports the negative results of a clinical trial with loratadine, a second-generation antihistamine, in adults in the rhinovirus challenge model. This finding in the highly controlled setting of the challenge model confirms the earlier negative studies with second-generation antihistamines in natural colds. First-generation antihistamines block both histaminic and muscarinic receptors as well as passing the blood-brain barrier. Second-generation antihistamines mainly block histaminic receptors and do not pass the blood-brain barrier. The effectiveness of first-generation antihistamines in blocking sneezing in colds may be due primarily to neuropharmacological manipulation of histaminic and muscarinic receptors in the medulla.
Muether
P S
PS
Aachen Medical School, Aachen, Germany.
Gwaltney
J M
JM
D000328:Adult; D003139:Common Cold / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology / Q000821:virology; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D017336:Loratadine / Q000627:therapeutic use*; D009093:Mucus; D012229:Rhinovirus / Q000187:drug effects* / Q000378:metabolism; D012912:Sneezing / Q000187:drug effects*; D016896:Treatment Outcome; D019562:Viral Load
D006634:Histamine H1 Antagonists; D018799:Intercellular Adhesion Molecule-1; D017336:Loratadine