Rapid anti-inflammatory action of azelastine eyedrops for ongoing allergic reactions.
BACKGROUND
Some second-generation antihistamines have anti-inflammatory activities, but the clinical relevance of this property is still unclear.


OBJECTIVE
The aim of our study was to investigate the effects of azelastine when administered during the early-phase reaction.


METHODS
This investigation was designed as a randomized, placebo-controlled, double-blind, parallel-group study. Clinical and inflammatory events were evaluated after a single dose of azelastine eyedrops or placebo was administered 30 minutes after an allergen-specific conjunctival challenge. Twenty outpatients with allergic rhinoconjunctivitis attributable to Parietaria judaica were enrolled in the study outside the pollen season. Patients were evaluated at baseline, after allergen challenge (at 30 minutes), and after administration of azelastine (at 30 minutes and at 6 hours). The following variables were evaluated: hyperemia, lacrimation, itching, eyelid swelling, number of inflammatory cells (neutrophils, eosinophils, monocytes, and lymphocytes), and intercellular adhesion molecule-1 expression on conjunctival epithelial cells.


RESULTS
Azelastine, in comparison to placebo, significantly reduced symptom scores, number of inflammatory cells, and intercellular adhesion molecule-1 expression during the early- and late-phase reaction.


CONCLUSIONS
The ability of azelastine to reduce symptoms and inflammation during an ongoing allergic reaction can be considered concrete and convincing proof of a clinically relevant anti-inflammatory activity.
Allergy and Immunology Clinic, Department of Internal Medicine, Genoa University, Genoa, Italy. giocip@unige.it
Giorgio
G
Ciprandi
Cristina
C
Cosentino
Manlio
M
Milanese
Maria Angela
MA
Tosca
D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000009:adverse effects; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D002452:Cell Count; D002634:Chemotaxis, Leukocyte / Q000187:drug effects; D003228:Conjunctiva / Q000378:metabolism / Q000473:pathology; D003233:Conjunctivitis, Allergic / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000096:biosynthesis / Q000235:genetics; D008297:Male; D008875:Middle Aged; D016328:NF-kappa B / Q000378:metabolism; D009883:Ophthalmic Solutions; D032403:Parietaria; D010793:Phthalazines / Q000008:administration & dosage / Q000627:therapeutic use*; D011058:Pollen / Q000009:adverse effects; D011852:Radioallergosorbent Test; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications; D012882:Skin Tests; D016896:Treatment Outcome
D000485:Allergens; D018926:Anti-Allergic Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016328:NF-kappa B; D009883:Ophthalmic Solutions; D010793:Phthalazines; D018799:Intercellular Adhesion Molecule-1; C020976:azelastine