Effects of loratadine on red wine-induced symptoms and signs of rhinitis.
OBJECTIVE
Intake of red wine may produce nasal symptoms. Little is known about the pathophysiology and pharmacology of this condition. The aim of this study was to examine whether nasal symptoms produced by red wine are reproducible, associated with mucinous secretion or plasma exudation and affected by antihistamine treatment.


METHODS
Twenty-eight subjects with a history of nasal symptoms associated with red wine intake received oral challenges with red wine and raspberry juice in a crossover design. Nasal symptoms and peak inspiratory flow (PIF) were assessed. Nasal lavages were performed and levels of fucose and alpha2-macroglobulin were determined as indices of mucinous secretion and plasma exudation, respectively. Twelve responders (according to preset criteria) were re-challenged 1 h after loratadine (10 mg) treatment, in a double-blind, placebo-controlled crossover design. Nasal symptoms and PIF were reassessed. Nasal lavages were performed and levels of fucose were redetermined.


RESULTS
Red wine intake produced nasal symptoms (p < 0.05) and decreased nasal PIF (p < 0.01-0.05). A total of 54% of subjects were categorized as responders, and in this group red wine produced a slight increase in lavage fluid levels of fucose (p < 0.05). In contrast, levels of alpha2-macroglobulin were unaffected. A total of 83% of responders developed symptoms at re-challenge. Loratadine reduced post-challenge nasal secretion (p < 0.05). Also, red wine failed to reduce nasal PIF in patients receiving loratadine.


CONCLUSIONS
Nasal symptoms associated with red wine intake can be reproduced by oral red wine challenges. This symptomatology may be associated with mucinous secretion, but not with plasma exudation. Loratadine may partially reduce nasal symptoms associated with intake of red wine.
Andersson
Morgan
M
Department of Otorhinolaryngology, University Hospital, Lund, Sweden. morgan.andersson@onh.lu.se
Persson
Carl G A
CG
Svensson
Christer
C
Cervin-Hoberg
Charlotte
C
Greiff
Lennart
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005643:Fucose / Q000378:metabolism; D039563:Histamine H1 Antagonists, Non-Sedating / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D017336:Loratadine / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000187:drug effects*; D012220:Rhinitis / Q000188:drug therapy / Q000209:etiology*; D014920:Wine / Q000009:adverse effects*; D000511:alpha-Macroglobulins / Q000378:metabolism
D039563:Histamine H1 Antagonists, Non-Sedating; D000511:alpha-Macroglobulins; D005643:Fucose; D017336:Loratadine