Document Detail


Nedocromil sodium and levocabastine reduce the symptoms of conjunctival allergen challenge by different mechanisms.
MedLine Citation:
PMID:  11544467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Nedocromil sodium and levocabastine are widely used for the treatment of ocular allergy, but their mechanisms of action are unclear. OBJECTIVE: We sought to compare the efficacy and mechanisms of action of nedocromil sodium and levocabastine in reducing conjunctival symptoms after ocular allergen challenge. METHODS: We performed a double-blind, placebo-controlled study in which 48 subjects were randomized to 3 groups to receive nedocromil sodium (2%), levocabastine (0.05%), or placebo eye drops twice daily for 2 weeks before ocular challenge with 10 microL of ryegrass extract. Symptoms and tear histamine and PGD(2) concentrations were determined before challenge and at 10, 20, 30, 60, 180, and 360 minutes after challenge. Bulbar biopsy specimens were taken at 6 and 24 hours after challenge to assess conjunctival inflammatory cell numbers, adhesion molecule expression, and mast cell-associated IL-4, IL-5, IL-6, IL-13, and TNF-alpha levels. RESULTS: Both drugs significantly reduced total symptom scores (P <.05) at all times after challenge compared with placebo. Itching, hyperemia, and lacrimation were most affected. Nedocromil sodium treatment reduced tear concentrations of histamine (by 77%) and PGD(2) (by 70%) at 30 minutes after challenge (both P <.05). In biopsy specimens nedocromil sodium reduced the number of 3H4-positive mast cells (purportedly the secreted form of IL-4) by 49% at 6 hours and 59% at 24 hours (both P <.05). Levocabastine reduced intercellular adhesion molecule 1 expression by 52% at 6 hours and 45% at 24 hours (both P <.05). CONCLUSION: Nedocromil sodium and levocabastine both reduced the conjunctival symptoms after ocular allergen challenge but appeared to work by different mechanisms. Nedocromil sodium reduced mast cell function, whereas levocabastine appeared to have primarily antihistaminic actions, although it also reduced the expression of intercellular adhesion molecule 1.
Authors:
P Ahluwalia; D F Anderson; S J Wilson; J I McGill; M K Church
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  108     ISSN:  0091-6749     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-06     Completed Date:  2001-10-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  449-54     Citation Subset:  AIM; IM    
Affiliation:
Allergy and Inflammation Sciences, Southampton University Medical School, Southampton, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Allergic Agents / therapeutic use*
Conjunctiva / chemistry
Conjunctivitis, Allergic / drug therapy*
E-Selectin / analysis
Female
Histamine / analysis
Histamine H1 Antagonists / therapeutic use*
Humans
Intercellular Adhesion Molecule-1 / analysis
Lolium / adverse effects*
Male
Middle Aged
Nedocromil / therapeutic use*
Piperidines / therapeutic use*
Prostaglandin D2 / analysis
Tears / chemistry
Vascular Cell Adhesion Molecule-1 / analysis
Chemical
Reg. No./Substance:
0/Anti-Allergic Agents; 0/E-Selectin; 0/Histamine H1 Antagonists; 0/Piperidines; 0/Vascular Cell Adhesion Molecule-1; 126547-89-5/Intercellular Adhesion Molecule-1; 41598-07-6/Prostaglandin D2; 51-45-6/Histamine; 69049-73-6/Nedocromil; 79516-68-0/levocabastine
Comments/Corrections
Summary for patients in:
Curr Allergy Asthma Rep. 2002 Jul;2(4):319   [PMID:  12044267 ]

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