title: Effect of antihistamine eye drops on the conjunctival provocation test with Japanese cedar pollen allergen.
abstract: BACKGROUND
  Approximately 16.2% of the Japanese population suffer from cedar pollinosis, with various manifestations such as ophthalmic, laryngo-pharyngeal and skin symptoms in addition to nasal symptoms. Thus, the annual pollen season is an agonizing period for patients. No study has reported symptoms and their clinical courses after conjunctival provocation with purified cedar pollen allergen Cry j1 as well as suppression of these allergen-induced ocular symptoms by antihistamine eye drops.
  
  
  METHODS
  Nine patients with Japanese cedar pollinosis who had no nasal or ocular symptoms were included in the present study, after obtaining informed consent in writing. 1) Purified cedar pollen allergen Cry j1 was instilled in the left eye and phosphate-buffered saline (PBS) in the right eye as a control. 2) Levocabastine hydrochloride ophthalmic suspension and ketotifen fumarate ophthalmic solution were respectively instilled in the left and right eyes, which were then challenged with the allergen. Ocular symptoms after provocation with the allergen were recorded through the clinical course.
  
  
  RESULTS
  Pollen allergen-induced ocular symptoms were itching and hyperemia of the palpebral conjunctiva, and itching lasted for more than 5 hours. Moreover, preadministration of antihistamine eye drops suppressed the increases in the ocular symptom scores, eliminating itching within 1 hour. Allergen provoked not only ocular symptoms but also nasal symptoms in 77.8% of patients.
  
  
  CONCLUSIONS
  Preadministration of antihistamine eye drops suppressed the symptoms induced by the allergen, which suggests that this is an effective early therapy for Japanese cedar pollinosis, if it is started before the pollen season. However, self-protection by patients using a mask may not be effective enough to suppress nasal symptoms during the pollen season, requiring them to additionally wear glasses to avoid exposure to the allergen.
authors.affiliation: Department of Otolaryngology, Japanese Red Cross Society, Wakayama Medical Center, Wakayama-city, Japan. dakeclinic@zeus.eonet.ne.jp
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Dake
authors.forename: Tadao
authors.initials: T
authors.lastname: Enomoto
authors.forename: Lei
authors.initials: L
authors.lastname: Cheng
authors.forename: Keisuke
authors.initials: K
authors.lastname: Enomoto
authors.forename: Akira
authors.initials: A
authors.lastname: Shibano
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikeda
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yoda
authors.forename: Shinji
authors.initials: S
authors.lastname: Yajin
authors.forename: Takema
authors.initials: T
authors.lastname: Sakota
authors.forename: Emi
authors.initials: E
authors.lastname: Yamanishi
mesh_terms: D000328:Adult; D000485:Allergens / Q000008:administration & dosage; D052179:Antigens, Plant; D003233:Conjunctivitis, Allergic / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D032485:Cryptomeria / Q000276:immunology*; D004306:Dose-Response Relationship, Immunologic; D006634:Histamine H1 Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D039563:Histamine H1 Antagonists, Non-Sedating / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006940:Hyperemia / Q000517:prevention & control; D007564:Japan / Q000453:epidemiology; D007665:Ketotifen / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D010880:Piperidines / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D010940:Plant Proteins / Q000008:administration & dosage; D011058:Pollen / Q000009:adverse effects / Q000276:immunology*; D011292:Premedication; D011537:Pruritus / Q000517:prevention & control; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology / Q000209:etiology; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D052179:Antigens, Plant; C065290:Cry j I protein, Cryptomeria japonica; D006634:Histamine H1 Antagonists; D039563:Histamine H1 Antagonists, Non-Sedating; D009883:Ophthalmic Solutions; D010880:Piperidines; D010940:Plant Proteins; C047340:levocabastine; D007665:Ketotifen