The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Mar 1992
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialThe effect of inhaled gallopamil, a potent calcium channel blocker, on the late-phase response in subjects with allergic asthma.
The effect of gallopamil on the late-phase response to inhaled allergen was evaluated in six young adults with allergic asthma in a crossover manner. During 2 study days, subjects received 20 mg of inhaled gallopamil or placebo 30 minutes before challenge with the same dose of allergen. In addition, a histamine challenge was performed 1 1/2 hours before and 24 hours after allergen challenge. ⋯ Airway reactivity to histamine 24 hours after allergen challenge could not be measured in three subjects after gallopamil administration and in one subject after placebo administration because of persistent bronchospasm. In contrast, basal responsiveness to histamine in the absence of allergen was modestly decreased by gallopamil. Since gallopamil is one of the most potent calcium channel blockers when it is administered by the inhaled route, it is unlikely that this group of drugs will be clinically useful for allergic asthma.
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J. Allergy Clin. Immunol. · Dec 1990
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialUrticaria: clinical efficacy of cetirizine in comparison with hydroxyzine and placebo.
Chronic urticaria is a problem for both physician and patient. In an effort to avoid the risks associated with corticosteroid treatment, many first-generation H1-receptor antagonists have been tried and found to induce undesirable levels of sedation when given in amounts sufficient to control urticaria. Cetirizine, a pharmacologically active oxidized metabolite of hydroxyzine, was developed to provide selective H1-receptor inhibition without depression of the central nervous system. ⋯ The incidence of somnolence in the cetirizine group was not significantly different from that of the placebo group. However, in the hydroxyzine group, the incidence of somnolence was significantly higher than that in the placebo group (p = 0.001). The results of this study demonstrate that cetirizine has a greater safety margin over the older parent drug hydroxyzine.
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J. Allergy Clin. Immunol. · Sep 1990
Randomized Controlled Trial Clinical TrialRepeated exposure of asthmatic airways to inhaled adenosine 5'-monophosphate attenuates bronchoconstriction provoked by exercise.
Inhaled adenosine 5'-monophosphate (AMP) induces bronchoconstriction in subjects with asthma, probably caused by histamine release from airway mast cells, and repeated AMP bronchial challenge leads to attenuation of the bronchoconstrictor response. Since exercise-induced bronchoconstriction may be mediated by hypertonic mast cell degranulation, we postulated that repeated AMP bronchial challenge should reduce the response to subsequent exercise challenge. Eight atopic subjects with asthma took part in an unblinded, randomized trial. ⋯ On the AMP study day, the geometric mean PC20 was 15.3 (7.9 to 29.5) mg/ml for the first test, and 28.2 (10.7 to 77.4) mg/ml for the third test (not significant). On the control study day, the mean maximum percentage fall in FEV1 after exercise was 28.0% +/- 2.7%, whereas on the AMP study day, it was reduced to 13.0% +/- 4.3% (p less than 0.01). A significant correlation was found between the change in responsiveness to AMP induced by repeated challenge and the attenuation of the subsequent exercise response (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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J. Allergy Clin. Immunol. · Nov 1988
Randomized Controlled Trial Clinical TrialThe effect on airway function of inspired air conditions after isocapnic hyperventilation with dry air.
The magnitude of postexercise or posthyperventilation bronchoconstriction in patients with asthma is related to the temperature and the water content of the inspired air during the exercise or hyperventilation period. Recent studies have suggested that the inspired air conditions during recovery from exercise may also be important in determining the magnitude of postexercise airway narrowing. In the present study, normal subjects (n = 8) and patients with asthma (n = 12) were studied on separate days. ⋯ There was no significant bronchoconstriction in the normal subjects, irrespective of the inspired air conditions during recovery. The patients with asthma showed greater bronchoconstriction during recovery in warm, humid air (maximal decrease in FEV1 31% +/- 17%) than in dry air (maximal decrease in FEV1 19% +/- 20%; p less than 0.05). These results suggest that the inspired air condition during recovery from isocapnic hyperventilation of dry air is also a determinant of the magnitude of the bronchoconstrictor response.
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J. Allergy Clin. Immunol. · Jan 1986
Randomized Controlled Trial Comparative Study Clinical TrialBlinded comparison of maxillary sinus radiography and ultrasound for diagnosis of sinusitis.
The correlation of Waters view radiographs and A-mode ultrasound for diagnosing sinusitis was evaluated in 75 subjects with allergic rhinitis who presented with signs and symptoms suggesting sinus disease. All patients had Waters view radiographs, which were read by a radiologist (E. G.) who was not provided with historical information. ⋯ Middle ear abnormalities on examination and tympanometry were more common in those with abnormal radiographs, p less than 0.05 and p less than 0.01, respectively. If the radiograph is considered to be a "gold standard," sensitivity of ultrasound varied from 44% to 58% and specificity from 55% to 61%, dependent on which criteria are applied to the radiograph to consider it normal. A-mode ultrasound is not sufficiently comparable to radiography to be used as its substitute for diagnosing sinus disease.