Persi L, Demoly P, Harris A G, Tisserand B, Michel F B, Bousquet J
Hôpital Arnaud de Villeneuve, Montpellier, France.
J Allergy Clin Immunol. 1999 Apr;103(4):591-4. doi: 10.1016/s0091-6749(99)70229-0.
The effect of H1-blockers may differ depending on the target organ.
A double-blind, placebo-controlled study was carried out to compare the effect of a 7-day treatment with loratadine (10 mg daily) or cetirizine (10 mg daily) on nasal challenge with grass pollen grains and skin tests with allergen or histamine.
Twenty-four patients were enrolled, but the analysis was carried out on 23. Nasal challenge was carried out by using 5-fold increasing numbers of pollen grains. Skin prick tests were done with serial concentrations of allergens and 1 concentration of histamine. Patients were tested in a cross-over design, with each treatment being administered for the previous 7 days and with a 2-week washout period.
By comparison with placebo, loratadine and cetirizine increased significantly the threshold number of pollen grains required to induce a positive nasal challenge (P <.001). There was no difference between loratadine and cetirizine. Skin test responses to allergen were significantly reduced by loratadine and cetirizine by comparison with placebo. Skin test responses to histamine were significantly decreased by the 2 H1-blockers, but they were more profoundly decreased by cetirizine than by loratadine.
Both H1-blockers reduced similarly allergen-induced skin test and nasal challenge responses. Cetirizine was more effective on histamine skin test responses.
H1受体阻滞剂的效果可能因靶器官不同而有所差异。
开展一项双盲、安慰剂对照研究，以比较氯雷他定（每日10毫克）或西替利嗪（每日10毫克）进行7天治疗对草花粉颗粒鼻腔激发试验以及变应原或组胺皮肤试验的影响。
招募了24名患者，但分析是基于23名患者进行的。通过使用数量呈5倍递增的花粉颗粒进行鼻腔激发试验。采用变应原系列浓度和1种组胺浓度进行皮肤点刺试验。患者采用交叉设计进行检测，每种治疗给药7天，并有2周的洗脱期。
与安慰剂相比，氯雷他定和西替利嗪显著提高了诱发鼻腔激发试验阳性所需的花粉颗粒阈值数量（P<.001）。氯雷他定和西替利嗪之间无差异。与安慰剂相比，氯雷他定和西替利嗪显著降低了对变应原的皮肤试验反应。两种H1受体阻滞剂均使对组胺的皮肤试验反应显著降低，但西替利嗪比氯雷他定降低得更明显。
两种H1受体阻滞剂对变应原诱导的皮肤试验和鼻腔激发试验反应的降低作用相似。西替利嗪对组胺皮肤试验反应更有效。
