Kupczyk Maciej, Kupryś Izabela, Bocheńska-Marciniak Małgorzata, Górski Paweł, Kuna Piotr
Department of Pneumonology and Allergology, Medical University of Lodz, Lodz, Poland.
Allergy Asthma Proc. 2007 Nov-Dec;28(6):711-5. doi: 10.2500/aap.2007.28.3064.
H(1)-receptor antagonists are known to suppress reactions in skin-prick tests (SPTs); however, the effect of H(2)-receptor antagonists, which are widely used in our everyday practice, remains unclear. The aim of this study was to determine the influence of ranitidine on wheal, flare, and itching sensation in SPTs. Twenty-one atopic patients (5 women and 16 men) with an average age of 28.04 years (SD, +/-8.24) were tested with histamine, codeine, negative control solution, and standard allergen extracts. Ranitidine (150 mg daily), loratadine (10 mg daily), or placebo were given to the volunteers for 5 days in a double-blind manner with 14 days of washout period. SPTs were applied to the volar surface of a forearm. There was no difference in wheal, flare, and itching between SPTs performed after placebo and washout period. The analysis revealed a statistically significant suppression of wheal and flare by ranitidine and loratadine (p = 0.013 and <0.00001, respectively, for wheals after allergens solutions tests, Wilcoxon rank-sum test). We found a significant suppression of itching induced by ranitidine (reduction of 26.85%; p = 0.005) and loratadine (29.6%; p = 0.005) as compared with placebo (p = 0.068 versus washout). Our data show a suppressive effect of ranitidine on the wheal, flare, and itching sensation in SPT. Because the sensitivity and specificity of skin testing requires withholding medication that could change the skin reactivity, it seems important to take into account the possible influence of H(2)-receptor antagonists on allergy diagnosis and therapy.
已知H(1)受体拮抗剂可抑制皮肤点刺试验（SPT）中的反应；然而，在我们日常实践中广泛使用的H(2)受体拮抗剂的作用仍不清楚。本研究的目的是确定雷尼替丁对SPT中风团、红晕和瘙痒感的影响。对21名平均年龄为28.04岁（标准差，±8.24）的特应性患者（5名女性和16名男性）进行组胺、可待因、阴性对照溶液和标准变应原提取物测试。以双盲方式给志愿者服用雷尼替丁（每日150毫克）、氯雷他定（每日10毫克）或安慰剂，为期5天，洗脱期为14天。将SPT应用于前臂掌侧表面。安慰剂和洗脱期后进行的SPT在风团、红晕和瘙痒方面没有差异。分析显示，雷尼替丁和氯雷他定对风团和红晕有统计学上的显著抑制作用（变应原溶液测试后风团的p值分别为0.013和<0.00001，Wilcoxon秩和检验）。我们发现，与安慰剂相比，雷尼替丁（降低26.85%；p = 0.005）和氯雷他定（降低29.6%；p = 0.005）对瘙痒有显著抑制作用（与洗脱期相比p = 0.068）。我们的数据显示雷尼替丁对SPT中的风团、红晕和瘙痒感有抑制作用。由于皮肤试验的敏感性和特异性要求停用可能改变皮肤反应性的药物，因此考虑H(2)受体拮抗剂对过敏诊断和治疗的可能影响似乎很重要。
