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PubMedDate not supplied

Efficacy and safety of nedocromil sodium 2% ophthalmic solution b.i.d. in the treatment of ragweed seasonal allergic conjunctivitis.

The efficacy and safety of twice-daily nedocromil sodium 2% ophthalmic solution and vehicle were compared in the treatment of ragweed seasonal allergic conjunctivitis. Two separate multicenter, randomized, double-masked, placebo-controlled studies were subjected to a combined analysis. Following a one-week baseline period during the beginning of the ragweed pollen season, 189 patients with seasonal allergic conjunctivitis received either nedocromil sodium or vehicle b.i.d. for eight weeks. Efficacy was evaluated by patient diary cards and clinical eye examinations. Safety was assessed by reports of adverse events. Compared with vehicle, nedocromil sodium produced significantly greater decreases in summary symptom score (p = 0.005), itch (p = 0.005), tearing (p = 0.004), overall eye condition (p = 0.001), and clinician-evaluated conjunctival edema (p = 0.018), and significantly better (p = 0.001), and patient (p = 0.001) opinions of treatment effectiveness at the peak pollen period. Additionally, the superiority of nedocromil sodium compared to vehicle approached statistical significance in redness reduction (p = 0.087) and clinician-evaluated conjunctival injection (p = 0.087). There were no serious treatment-related adverse events in either treatment group. In summary, nedocromil sodium 2% ophthalmic solution b.i.d. was found to be effective and to have a favorable safety profile in the treatment of seasonal allergic conjunctivitis.

Adolescent↗
PubMed1997

Characterization of cytokine mRNA transcripts in conjunctival cells in patients with allergic conjunctivitis.

PURPOSE: The host response to allergens appears to be regulated by specific patterns of local cytokine production. More than 20,000 conjunctival superficial cells were collected with a special brush, a smaller version of the Cytobrush used in cervical cytology, from the upper palpebral conjuntiva. METHODS: Samples were obtained by cytology brush from seven patients with allergic conjunctivitis and from seven healthy volunteers. Giemsa staining, immunocytochemistry, and flow cytometric analysis were performed. Cytokine gene expression was assayed by the reverse-transcription-polymerase chain reaction method. RESULTS: Giemsa staining of cytocentrifuged preparations from patients with allergic conjunctivitis showed conjunctival epithelial cells with lymphocytes, mast cells, and eosinophils. In an immunohistochemical study, a few CD3- and CD4-bearing cells, but not CD20- and CD14-bearing cells, were seen in patients. In 82.6 +/- 17% of the samples obtained from allergic patients, HLA-DR was present, but it was present in only 34.2 +/- 17.8% of samples from control subjects (P = 0.0001) using flow cytometric analysis. Steady state transcripts of mRNA for cytokines were analyzed with RT-PCR in conjunctival cell samples, and results showed that samples from allergic conjunctivitis expressed increased transcripts of interleukin 4 and interleukin 13 but virtually no interleukin 2 or interferon-gamma; six samples from seven healthy subjects expressed no interleukin 2, interleukin 4, interleukin 13, or interferon-gamma transcripts. CONCLUSIONS: These results suggest that the clinical features of allergic conjunctivitis in humans are associated with a specific local pattern of proinflammatory cytokine expression.

Adolescent↗
PubMed2000

Experimental allergic conjunctivitis in guinea pigs induced by Japanese cedar pollen.

We report a new experimental allergic conjunctivitis with Japanese cedar pollen as antigen in guinea pigs, and the immunological characteristics of this model were also elucidated. Allergic conjunctivitis was developed by immunization in guinea pigs with a mixture containing Japanese cedar pollen and killed Bordetella pertussis. When local application of Japanese cedar pollen suspension 14 d after systemic immunization was performed every 3d, remarkable conjunctivitis was observed from 20 to 35 d. Increase in vascular permeability and decrease in histamine contents of the conjunctiva were also observed after local application of antigen. Passive cutaneous anaphylactic (PCA) reactions revealed that both IgG- and IgE-rich antibodies were produced in this model. Chlorpheniramine, ketotifen and levocabastine were effective in inhibiting cedar pollen-induced conjunctivitis. Although a high concentration was needed, tranilast and amlexanox also showed significant inhibition of conjunctivitis induced by cedar pollen.

Animals↗
PubMed2000

Epidemiological study of 134 subjects with allergic conjunctivitis.

At times it is difficult to distinguish among the subtypes of chronic allergic conjunctivitis. A prospective study with 134 patients was carried out. Patients were diagnosed with vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis (AKC) or perennial allergic conjunctivitis (PAC). Demographic information was also collected including, age at symptom onset, sex, history of non-ocular allergy, and history of family allergy. Forty-six percent were diagnosed with VKC, 40% with AKC, 8% with PAC, and 6% were not specifically diagnosed. This distribution information as well as the demographic information collected demonstrates that there are patterns within each subgroup of chronic ocular allergy sufferers. These findings will be helpful in the diagnosing and proper classification of ocular allergic conditions.

Brazil↗
PubMed2000

Role of histamine in allergic conjunctivitis.

Histamine remains the main mediator released by both specific allergic and non-specific mast cell activation. Histamine is the classic mediator of itching, flare and redness. The effects of histamine in allergic conjunctivitis are mediated by H1-receptor activation on blood vessels and nociceptive nerves. Histamine effects may be prolonged and exaggerated since a defect in the histaminase enzymes has been recently demonstrated in VKC. The effects of histamine on conjunctival tissues may be more complex than those manifested by the simple symptom of itching. In fact, proinflammatory effects of histamine on conjunctival epithelial cells and fibroblasts have been demonstrated. Preliminary results showed that the H1 antagonist, emedastine, reduces significantly cytokine production from histamine-stimulated fibroblasts.

Conjunctivitis, Allergic↗
PubMedDate not supplied

[Allergic conjunctivitis. Treatment and course].

A group of 74 patients with allergic conjunctivitis from the out patient service of allergy of the Hospital Pediátrico Provincial Docente José Luis Miranda, in Santa Clara, were studied. In this study are stressed the importance of the search for etiologic agents influencing the disease and the used diagnostic methods. Finally, the used treatments are pointed out. The most frequent were the strepto-staphylo-gamma vaccines, preventive measures, antibiotic drops, environmental measures and sodium cromoglycate drops. Treatment was dynamic, individual and associated with the ophthalmology and pediatric allergy specialties.

Child↗
PubMed1992

New trends in the treatment of allergic conjunctivitis.

Histamine is the key mediator producing itching, redness and chemosis in allergic conjunctivitis. Histamine levels in tears are increased ten-fold in patients with this allergic condition. Levocabastine is a newly synthesized histamine H1 antagonist which has been formulated as both eye drops and nasal spray. In well established assays of antihistamine activity, levocabastine was found to be the most potent antihistamine compound available, being 15,000 times more potent than chlorpheniramine. Ocular provocation studies in man have shown that levocabastine protects against the symptoms of allergen-induced conjunctivitis. Ophthalmological examinations, including slit lamp and ophthalmoscopy showed no adverse effects. Data from therapeutic studies are available for more than 1700 patients with allergic conjunctivitis treated for 2-16 weeks. One drop of levocabastine (0.5 mg/ml) per eye given two to four times daily provided significantly better symptom control than placebo, with good to excellent results in 71% of patients on levocabastine compared to 55% on placebo (p < 0.001). Levocabastine has a fast onset of action. In one study 94% of patients experienced symptom relief within 15 minutes after the first instillation. The effects observed with levocabastine were at least as good as those with ocular cromoglycate or oral terfenadine. The incidence of adverse experiences was not different from placebo. Levocabastine promises to be a valuable treatment for patients with allergic conjunctivitis.

Animals↗
PubMed1994

Lodoxamide treatment of allergic conjunctivitis.

Lodoxamide is an antiallergic compound. The present study evaluated the efficacy on clinical and cytological parameters and safety of topical lodoxamide compared to placebo in the treatment of allergic conjunctivitis. The trial, designed as double-blind, randomized, placebo-controlled and parallel group treatment, was carried out in 30 patients, suffering from seasonal allergic conjunctivitis due to grass pollen, during the pollen season. Patients received lodoxamide tromethamine 0.1% eye drops or placebo eye drops, one drop in each eye t.i.d. for 4 weeks. The clinical and cytological evidence was investigated by clinicians on admission and after 4 weeks' treatment. At the end of the trial, only the lodoxamide-treated group showed a significant clinical improvement, associated with a reduction of inflammatory cells. No serious side effects were observed. The results show the clinical efficacy of lodoxamide in the treatment of pollen-induced allergic conjunctivitis. In addition, lodoxamide exerts its antiallergic activity by reducing inflammatory infiltrate (mainly eosinophils).

Adult↗
PubMed2000

Evaluation of the onset and duration of effect of azelastine eye drops (0.05%) versus placebo in patients with allergic conjunctivitis using an allergen challenge model.

OBJECTIVE: The trial evaluated the effectiveness of the investigational antihistaminic and antiallergic compound Azelastine Eye Drops (AZE) in the treatment of allergic conjunctivitis using an allergen challenge model. DESIGN: Randomized, double-blind, placebo-controlled, paired-eye study. PARTICIPANTS: Adults with a history of allergic conjunctivitis (>/=2 years) who were asymptomatic throughout the trial, had a positive skin test (cat dander, grass, or ragweed pollen within the last year), and had a positive conjunctival reaction (score 2+ or more for itching and redness in both eyes on a 0-4 scale) during two separate conjunctival provocation tests (CPT) before randomization. METHODS: Eighty patients underwent a 2-week screening period (visits 1 and 2) that included a CPT during visit 1 to establish the allergen threshold dose and a second confirmatory CPT performed at visit 2. Eye symptom assessments for itching (evaluated by patient) and conjunctival redness (evaluated by physician) were performed 5 and 10 minutes after CPT using a 5-point scale (from 0 = none to 4+ = severe). Qualified patients were randomized to receive one drop of AZE (0.015 mg of azelastine hydrochloride) in one eye and one drop of placebo in the other eye 20 minutes before CPT at visit 3 (onset) and 8 or 10 hours before CPT at visit 4 (duration). MAIN OUTCOME MEASURES: Individual severity scores for itching (evaluated by patient) and conjunctival redness (evaluated by physician) for each eye at 3, 5, and 10 minutes after CPT at visits 3 and 4 using a 5-point scale (0 = none to 4+ = very severe). RESULTS: Each of the 80 randomized patients completed the trial. Mean itching and conjunctival redness scores at visit 3 (onset) were significantly lower (P: < 0.001) in the AZE-treated eyes than in the placebo-treated eyes. At visit 4 (duration), mean itching and conjunctival redness scores (P: </= 0.003) for the 8-hour group and mean itching scores (P: </= 0.001) for the 10-hour group were significantly lower in the AZE-treated eyes than in the placebo-treated eyes. Significant differences in mean tearing and chemosis severity scores were also seen at visit 3 (onset) and visit 4 (duration) in the AZE-treated eyes when compared with the placebo-treated eyes. Treatment with AZE was well tolerated. CONCLUSIONS: Therapy of experimentally induced allergic conjunctivitis with AZE was highly effective, with an onset of action seen within 3 minutes and a duration of effect of at least 8 to 10 hours.

Adolescent↗
PubMed2002

The role of histamine H(1) receptors in late-phase reaction of allergic conjunctivitis.

The role of histamine H(1) receptors in the late-phase reaction of allergic conjunctivitis was studied using histamine H(1) receptor-deficient mice. To clarify the eosinophil infiltration, which is a reliable indicator of late-phase reaction, eosinophil peroxidase activity in the conjunctiva was measured. Mice were actively immunized with ovalbumin, and conjunctivitis was induced by topical instillation of ovalbumin. A significantly high eosinophil peroxidase level in the conjunctiva was observed in sensitized wild-type mice, whereas sensitized histamine H(1) receptor-deficient mice showed no significant increase in the conjunctival eosinophil peroxidase level. In addition, the elevation of eosinophil peroxidase level observed in sensitized wild-type mice was significantly antagonized by pretreatment with anti-P-selectin antibody. From these findings, it was concluded that eosinophil infiltration into the conjunctival tissue in late-phase reaction of allergic conjunctivitis is mediated by P-selectin stored in endothelial cells via histamine H(1) receptors.

Animals↗
PubMedDate not supplied

[Azelastine in the treatment of allergic conjunctivitis].

The efficiency of azelastin (eye drops) in allergic conjunctivitis was evaluated. Ophthalmological, specific allergological, bacteriological, and cytological studies were carried out in 3 groups of patients. Group 1 was treated with claritin (orally), group 2 with azelastin (eye drops), and group 3 with both. The treatment was effective in all 3 groups. Regression of the clinical symptoms started earlier in groups 2 and 3 and was observed throughout the entire period of observation.

Administration, Oral↗
PubMed2002

[Effects of iodine on experimental allergic conjunctivitis].

PURPOSE: To evaluate the anti-allergic effect of iodine in an allergic conjunctivities model. METHODS: Guinea pigs (n = 107) were administered iodine at three different concentrations in feed. Twenty Guinea pigs were passively sensitized by serum containing ovalbumin (OA) antibody, and eighteen Guinea pigs were actively sensitized by OA intraperitoneal injection. OA was dropped into the eye and the degree of chemosis was determined 15 minutes after challenge. Six hours later, eosinophils infiltrating the conjunctiva were counted, and iodine, histamine and triiodothyronine concentrations in blood were measured. In addition, platelet activating factor (PAF) was dropped into the eye of sixty non-sensitized Guinea pigs. Eosinophils infiltrating the conjunctiva were counted at 30 min, and 1, 2, and 4 hours later. Mast cells in the conjunctiva of nine other non-sensitized Guinea pigs were observed under an electron microscope to determine the effect of iodine on mast cells. RESULTS: As the iodine concentration in blood increased, there was less chemosis, fewer eosinophils, and a lower histamine concentration in the blood. Eosinophilic infiltration induced by PAF was not inhibited. Granules showing a low-density area in mast cells were increased. CONCLUSION: Iodine exerted an anti-allergic effect, thought to be mediated through mast cells rather than PAF.

Animals↗
PubMed1993

[Effect of tranilast ophthalmic solution on allergic conjunctivitis in guinea pigs].

The effect of the ophthalmic solution of tranilast, an anti-allergic agent, on allergic conjunctivitis was studied in passively sensitized guinea pigs. We determined the content of uranine dye and histamine in tears and histopathologically examined palpebral conjunctiva. After instillation of antigen into the conjunctival sac, inflammation of the palpebral conjunctiva, an increase in leaked dye and the release of histamine were found. In the histopathological study, tranilast (1.0%) suppressed the appearance of edema and infiltration of inflammatory cells. Tranilast suppressed the leakage of uranine in a dose-dependent manner. A 0.5% solution of diphenhydramine also showed the inhibitory effect on the leakage of uranine. The inhibitory effect of 0.5% tranilast on antigen-induced dye leakage and histamine release lasted for 6 hr. These results suggest that topically applied tranilast is effective for allergic conjunctivitis.

Animals↗
PubMed2000

The role of IL-12 in the induction of late-phase cellular infiltration in a murine model of allergic conjunctivitis.

BACKGROUND: The applied murine model of allergic conjunctivitis mimics human disease, and an immediate hypersensitivity reaction (IHR) and a late-phase cellular reaction typically develop in sensitized mice after topical challenge with the allergen. OBJECTIVE: We investigated the role of IL-4, IFN-gamma, and IL-12 in the early and late phases of ocular allergy with use of cytokine knockout (KO) mice and neutralizing antibodies. METHODS: Ragweed-sensitized wild-type or IL-4KO, IL-12KO, IFN-gamma KO, anti-IL-12 mAb-treated, recombinant murine IL-12-treated, and anti-IFN-gamma mAb-treated mice were challenged with the allergen 10 days after the immunization. IHR, cellular infiltration, lymphoproliferative response, and cytokine production from draining lymph nodes were recorded and compared among groups. RESULTS: We show that IL-12KO mice and anti-IL-12 antibody-treated wild-type animals failed to have a cellular infiltration into the conjunctiva. Treatment with recombinant murine IL-12 also reduced the number of infiltrating PMNs but increased the percentage of mononuclear cells in the conjunctiva compared with controls. IFN-gamma KO mice had a significantly stronger IHR and prolonged infiltration into the conjunctiva after challenge with ragweed than controls. CONCLUSION: Our data suggest that the presence of IL-12, although better known as a T(H)1-inducing cytokine, is important for the development and the regulation of the late-phase pathologic features in ocular allergy. Furthermore, IFN-gamma is a limiting factor in the late phase of allergy and thus may be important in preventing chronic allergic disease.

Animals↗
PubMed1984

Diagnosis of allergic conjunctivitis.

Itching was cited as a major symptom of their ocular disease by 49 (80%) of the 61 patients with allergic conjunctivitis. Conjunctival scrapings from 51 patients (84%) demonstrated intact eosinophils or eosinophil granules. Eosinophil granules were a useful and recognizable cytologic feature of allergic conjunctivitis even in the absence of intact eosinophils. We believe that a history of itching and the presence of eosinophils or eosinophil granules in conjunctival scrapings are helpful in diagnosing allergic conjunctivitis.

Conjunctiva↗
PubMed2001

[Conjunctival provocation test with Dermatophagoides pteronyssinus in the diagnosis of allergic conjunctivitis from house mites].

INTRODUCTION: Perennial conjunctivitis due to house dust mites is the most frequent form of allergic conjunctivitis in urban environments. However, its diagnosis remains difficult for ophthalmologists. In this study, we evaluated a conjunctival provocation test (CPT) using standardized extracts of Dermatophagoides pteronyssinus (Dpt) and compared it to the diagnostic methods commonly performed in allergology: prick tests with dust and house dust mites and specific and IgE assay. MATERIALS AND METHODS: We performed a CPT on 60 volunteer patients, between the ages of 8 and 64 years, corresponding to 30 patients sensitized to house dust mites with the presence of specific IgE and chronic conjunctivitis, 21 patients not sensitized to house dust mites but presenting features of chronic conjunctivitis, and 9 asymptomatic patients. A house dust mite desensitizing treatment was not an exclusion criterion for a number of allergic patients. CPTs were prepared from Dpt allergenic extracts (Laboratoires Stallergènes, Antony, France) with 5 progressive concentrations by dilution in a nonphenolic physiological solution: 1.2 RI, 3.7 RI, 11 RI, 33 RI, and 100 RI. CPTs were performed in only one eye and asymmetry of the ocular response was evaluated by the cumulative clinical score of Abelson Chambers and Smith. The correlation between the 2 diagnostic tests was established by calculating the Cohen correlation coefficient or kappa. We also evaluated the sensitivity and diagnostic specificity for each test. RESULTS: The statistical correlation between specific IgE and the other allergological tests in for allergic conjunctivitis to house dust mites was 0.93 for the CPT, 0.46 for the prick test to Dpt, and 0.33 for the prick test to dust. The diagnostic sensitivities and specificities for each test were 90% and 100% for the CPT, 60% and 70% for the prick test to dust, 70% and 76% for prick test to Dpt, respectively. Beyond an antigenic cut-off value of 11 RI, we also observed greater hypersensitivity reactions for patients with lacrimal IgE or elevated specific IgE levels. CONCLUSION: The results obtained with the CPT confirm its high antigenic quality. It is a particularly useful, rapid, and perfectly safe clinical test. It is the only test able to establish a relationship between ocular manifestations and specific I(8)E.

Adolescent↗