Twentyman O P, Ollier S, Holgate S T
Department of Medicine I, University of Southampton, London, England.
J Allergy Clin Immunol. 1993 Jun;91(6):1169-78. doi: 10.1016/0091-6749(93)90320-f.
Allergen challenge of subjects with asthma produces an early asthmatic response, late asthmatic response, and increases bronchial responsiveness. Histamine partly mediates the early asthmatic response, and may play a role in late-phase responses. Azelastine has antiallergic properties and has been proposed as a treatment for asthma. We therefore investigated the contribution of histamine to late-phase responses with the use of the potent H1-receptor antagonist azelastine.
Ten subjects with atopic asthma were studied in a double-blind, randomized, placebo-controlled trial. Azelastine was administered over 4 days before allergen challenge. Changes in airway caliber were followed with measurements of forced expiratory volume in 1 second, and changes in bronchial responsiveness were followed by methacholine and prostaglandin D2 bronchial provocation tests.
Azelastine significantly inhibited the development of the early asthmatic response. Azelastine had no effect on the late asthmatic response or on the development of allergen-induced increases in bronchial responsiveness. The power of the study was sufficient to have had a high probability of detecting any important differences between placebo and azelastine during the late phase.
Azelastine had no significant effect on the late-phase response model of asthma. This study does not support the hypothesis that histamine is an important mediator of the late asthmatic response or allergen-induced increases in bronchial responsiveness.
对哮喘患者进行变应原激发会引发早期哮喘反应、迟发哮喘反应，并增加支气管反应性。组胺部分介导早期哮喘反应，且可能在迟发反应中起作用。氮卓斯汀具有抗过敏特性，已被提议用于治疗哮喘。因此，我们使用强效H1受体拮抗剂氮卓斯汀研究了组胺在迟发反应中的作用。
在一项双盲、随机、安慰剂对照试验中对10名特应性哮喘患者进行了研究。在变应原激发前4天给予氮卓斯汀。通过测量1秒用力呼气量来跟踪气道管径的变化，通过乙酰甲胆碱和前列腺素D2支气管激发试验来跟踪支气管反应性的变化。
氮卓斯汀显著抑制了早期哮喘反应的发展。氮卓斯汀对迟发哮喘反应或变应原诱导的支气管反应性增加没有影响。该研究的效能足以在后期检测到安慰剂和氮卓斯汀之间的任何重要差异。
氮卓斯汀对哮喘的迟发反应模型没有显著影响。本研究不支持组胺是迟发哮喘反应或变应原诱导的支气管反应性增加的重要介质这一假设。
