Ciprandi Giorgio, Tosca Maria Angela, Cosentino Cristina, Riccio Anna Maria, Passalacqua Giovanni, Canonica Giorgio Walter
Allergy and Respiratory Diseases, Department of Internal Medicine, University of Genoa, Genoa, Italy.
J Allergy Clin Immunol. 2003 Oct;112(4 Suppl):S78-82. doi: 10.1016/s0091-6749(03)01880-3.
Intercellular adhesion molecules (ICAMs), in particular ICAM-1, appear to play a crucial role in the recruitment and migration of inflammatory cells to the site of an allergic reaction. Glucocorticoids and allergen-specific immunotherapy have been shown to exert effects on selected components of this system, both in vitro and in vivo, but further research is required to better understand the effects of these therapies. Nasal and conjunctival challenge models (including natural and experimental allergen exposure) represent useful and safe tools for studying the activity of antiallergy drugs in vivo. These tests allow the investigation of a wide variety of parameters including inflammatory infiltrate, ICAM-1 expression, and changes in the concentration of soluble inflammatory mediators. With these tools, anti-inflammatory activity related to the modulation of epithelial cell adhesion molecules has been demonstrated in vivo for several H(1)-receptor antagonists (azelastine, cetirizine, loratadine, levocabastine, oxatomide, and terfenadine). Fexofenadine is a nonsedating, long-acting antihistamine with highly selective H(1)-receptor antagonist activity and a particularly favorable safety profile. In addition, fexofenadine has proven anti-inflammatory activity and has been shown to inhibit a number of mediators at clinically relevant concentrations, including in vitro inhibition of ICAM-1 expression on conjunctival and nasal epithelial cells.
细胞间黏附分子（ICAMs），尤其是ICAM - 1，似乎在炎症细胞募集和迁移至过敏反应部位的过程中发挥着关键作用。糖皮质激素和变应原特异性免疫疗法已被证明在体外和体内对该系统的特定成分均有作用，但仍需进一步研究以更好地理解这些疗法的效果。鼻和结膜激发模型（包括自然和实验性变应原暴露）是研究体内抗过敏药物活性的有用且安全的工具。这些测试允许对多种参数进行研究，包括炎症浸润、ICAM - 1表达以及可溶性炎症介质浓度的变化。借助这些工具，已在体内证明几种H(1)受体拮抗剂（氮卓斯汀、西替利嗪、氯雷他定、左卡巴斯汀、奥沙米特和特非那定）具有与上皮细胞黏附分子调节相关的抗炎活性。非索非那定是一种无镇静作用的长效抗组胺药，具有高度选择性的H(1)受体拮抗剂活性，且安全性特别良好。此外，非索非那定已被证明具有抗炎活性，并已显示在临床相关浓度下能抑制多种介质，包括在体外抑制结膜和鼻上皮细胞上的ICAM - 1表达。
