De Weck A L, Derer T, Bähre M
Institute for Clinical Immunology, Inselspital, University of Bern, Switzerland.
Clin Exp Allergy. 2000 Feb;30(2):283-7. doi: 10.1046/j.1365-2222.2000.00724.x.
Due to the interest in azelastine's diverse modes of action, this study investigated its effects on immediate and late-phase cutaneous allergic reactions using visual methods and telethermography.
The aim of the study was to investigate the effect of azelastine on the immediate and late-phase skin reactions using both planimetric evaluation of weal and erythema and a telethermographic technique.
The study was a double-blind crossover study; medication consisted of one tablet per day for 7 days of either placebo or azelastine 4 mg. Eight allergic patients were assessed on five occasions: prior to treatment, at the end of the first 7-day treatment, after a 21-day washout period, following the second 7-day treatment period and finally following a 2-6 week washout period. Skin prick tests with timothy grass and intradermal tests with Alternaria allergens were performed on the patients' back. In addition, patients were tested with intradermal histamine as a positive control. Surfaces of weal, erythema and infiltration were calculated using computerized planimetry at 0, 20, 40 and 60 min, and 3, 6 and 8 h. Thermographic images were recorded and the thermographic area and the increase in average temperature (DeltaT) were calculated.
The coefficient of variation within baseline reactions ranged from 3 to 32% for weal and erythema and from 5 to 25% for thermographically recorded reactions. The stronger the reaction, the more constant the baseline was. Treatment with azelastine (4 mg/os once daily) inhibited immediate reactions to allergens by 65% (range 55-74) and to histamine by 68% (range 47-82). The late-phase reactions to allergens were less well defined and showed larger individual differences in the degree of inhibition caused by azelastine, they were inhibited by 49% (range 32-67). Late-phase reactions to histamine were less intense and could only be detected with thermography; only thermographic units showed a decrease (26%) in response to azelastine.
This study has confirmed azelastine's histamine-blocking activity. In addition, the late-phase results suggest that azelastine has anti-inflammatory activity. The reproducibility and sensitivity of the thermographic results confirm the usefulness of this technique in immunopharmacology.
由于对氮卓斯汀多种作用方式的关注，本研究使用视觉方法和远红外热成像技术研究了其对速发和迟发性皮肤过敏反应的影响。
本研究旨在通过对风团和红斑进行平面测量评估以及远红外热成像技术，研究氮卓斯汀对速发和迟发性皮肤反应的影响。
本研究为双盲交叉研究；用药方案为每天服用一片，持续7天，药物为安慰剂或4毫克氮卓斯汀。8名过敏患者接受了5次评估：治疗前、第一个7天治疗结束时、21天洗脱期后、第二个7天治疗期后以及最后2 - 6周洗脱期后。在患者背部进行了梯牧草皮肤点刺试验和链格孢属变应原皮内试验。此外，对患者进行皮内组胺试验作为阳性对照。在0、20、40和60分钟以及3、6和8小时使用计算机平面测量法计算风团、红斑和浸润的面积。记录热成像图像并计算热成像面积和平均温度升高值（ΔT）。
风团和红斑的基线反应变异系数在3%至32%之间，热成像记录反应的变异系数在5%至25%之间。反应越强，基线越稳定。氮卓斯汀（4毫克/口服，每日一次）治疗可使对变应原的速发反应抑制65%（范围为55% - 74%），对组胺的速发反应抑制68%（范围为47% - 82%）。对变应原的迟发反应定义不太明确，氮卓斯汀引起的抑制程度个体差异较大，被抑制了49%（范围为32% - 67%）。对组胺的迟发反应不太强烈，只能通过热成像检测到；只有热成像单位显示对氮卓斯汀有反应下降（26%）。
本研究证实了氮卓斯汀的组胺阻断活性。此外，迟发反应结果表明氮卓斯汀具有抗炎活性。热成像结果的可重复性和敏感性证实了该技术在免疫药理学中的实用性。
