BACKGROUND: Currently there is very limited data in the literature assessing the prevalence of antihistamine prescription, and there is no local prevalence data about the prescription of antihistamine agents among pri...BACKGROUND: Currently there is very limited data in the literature assessing the prevalence of antihistamine prescription, and there is no local prevalence data about the prescription of antihistamine agents among primary practitioner and emergency physicians. The objectives are 1) to report the prevalence of antihistamine prescription for children less than 6 years old with acute upper respiratory infection and 2) to explore the associated factors for the prescription practice.METHODS: This is a cross-sectional study. All consecutive cases of paediatric patients aged 6 or below who presented to the emergency department during a study period of one week from April 1 to July 4, 2009 with diagnosis of acute upper respiratory infection were included. Totally 162 patients were included.RESULTS: Among the 162 cases, 141(87%) patients were prescribed one antihistamine of any group. Sixty(37%) patients were prescribed two or more antihistamines. In multivariate logistic regression model, age was found to be signi? cantly(P<0.001) associated with multiple antihistamine prescription(OR=1.042, 95%CI=1.02 to 1.06). Years of graduation of attending physician for more than 5 years was also a strong predictor of multiple antihistamine prescription(OR=4.654, 95%CI=2.20 to 9.84, P<0.001).CONCLUSION: In the local emergency department, patients' age and the years of graduation from medical school of the attending physician were predictors of multiple antihistamine prescription for acute upper respiratory infections for children aged less than 6.展开更多
COVID-19 is an immune-mediated inflammatory disease caused by SARS-CoV-2 infection,the combination of anti-inflammatory and antiviral therapy is predicted to provide clinical benefits.We recently demonstrated that mas...COVID-19 is an immune-mediated inflammatory disease caused by SARS-CoV-2 infection,the combination of anti-inflammatory and antiviral therapy is predicted to provide clinical benefits.We recently demonstrated that mast cells(MCs)are an essential mediator of SARS-CoV-2-initiated hyperinflammation.We also showed that spike protein-induced MC degranulation initiates alveolar epithelial inflammation for barrier disruption and suggested an off-label use of antihistamines as MC stabilizers to block degranulation and consequently suppress inflammation and prevent lung injury.In this study,we emphasized the essential role of MCs in SARS-CoV-2-induced lung lesions in vivo,and demonstrated the benefits of co-administration of antihistamines and antiviral drug remdesivir in SARS-CoV-2-infected mice.Specifically,SARSCoV-2 spike protein-induced MC degranulation resulted in alveolar-capillary injury,while pretreatment of pulmonary microvascular endothelial cells with antihistamines prevented adhesion junction disruption;predictably,the combination of antiviral drug remdesivir with the antihistamine loratadine,a histamine receptor 1(HR1)antagonist,dampened viral replication and inflammation,thereby greatly reducing lung injury.Our findings emphasize the crucial role of MCs in SARS-CoV-2-induced inflammation and lung injury and provide a feasible combination antiviral and anti-inflammatory therapy for COVID-19 treatment.展开更多
Objective: To investigate the antihistamine-releasing effect of a peptide isolated from wasp venom of Vespa orientalis.Methods: This peptide was separated from crude venom by chromatography methods and mass spectromet...Objective: To investigate the antihistamine-releasing effect of a peptide isolated from wasp venom of Vespa orientalis.Methods: This peptide was separated from crude venom by chromatography methods and mass spectrometry. Then various concentrations(2, 4, 8, 16, 32, 64, 128 and256 mmol/L) of the peptide were incubated with mast cells and lactate dehydrogenase assay was performed.Results: No significant effect was observed in lactate dehydrogenase absorbance under128 mmol/L concentration. This implied that the peptide did not cause cell death in mast cells and consequently, histamine release did not happen. Moreover, the results showed the IC50 of mast cells degranulation at 126 mmol/L, which was approximately high implying that this peptide had high selectivity for normal cells and did not cause histamine release from these cells.Conclusions: This would be a great aim in new drug development, in which an agent acts potentially on its target tissue without activating the immune system.展开更多
Objective:To evaluate the efficacy and safety of Peitu Shengjin prescription versus H1 antihistamine in the treatment of allergic rhinitis.Methods:Electronic searching"China Knowledge Network","Wanfang ...Objective:To evaluate the efficacy and safety of Peitu Shengjin prescription versus H1 antihistamine in the treatment of allergic rhinitis.Methods:Electronic searching"China Knowledge Network","Wanfang Database","Vip Database","Chinese Biomedical Literature Database",PubMed,Embase,The Cochrane Library,all published on the prescription of Peitu Shengjin prescription comparison H1 antihistamine In randomized controlled trials(RCTs)of drug treatment of allergic rhinitis,two researchers screened the literature according to the inclusion and exclusion criteria,and conducted Meta-analysis using RevMan5.3 software.Results:A total of 22 studies were involved,involving a total of 1463 subjects,including 822 in the treatment group and 641 in the control group.Meta-analysis results show that compared with oral H1 antihistamines,Peitu Shengjin prescription can improve the total effective rate of allergic rhinitis(RR=1.19,95%CI[1.14,1.24],P<0.00001);reduce recurrence Rate(RR=0.46,95%CI[0.23,0.90],P=0.02);reduce serum IL-6(MD=-17.33,95%CI[-21.96,-12.70],P<0.00001)and serum IL-8(MD=-100.35,95%CI[-175.18,-25.52],P=0.009);reduce the patient’s total score of symptoms and signs(SMD=-1.21,95%CI[-1.82,-0.61],P<0.0001)And TCM symptom scores(SMD=-0.98,95%CI[-1.28,-0.68],P<0.00001);superior to the control group in improving patients'nasal congestion,nasal itching,and turbinate/nasal mucosa enlargement,in improving runny nose There is no obvious advantage compared with the control group in terms of sneezing symptoms;in terms of safety,there are fewer mild adverse reactions in the treatment group(RD=-0.05,95%CI[-0.09,-0.00],P=0.04).Conclusion:Compared with H1 antihistamine,Peitu Shengjin prescription can improve clinical efficacy,improve patients'symptoms and signs and TCM symptoms,regulate immune function,and is not easy to relapse and has good safety.展开更多
目的:本研究通过对前期多中心随机对照试验数据进行二次分析,评估针刺作为非药物疗法在减少慢性自发性荨麻疹(Chronic Spontaneous Urticaria,CSU)患者对应急使用抗组胺药依赖方面的潜力,为CSU的多元化管理提供新的证据。方法:患者随机...目的:本研究通过对前期多中心随机对照试验数据进行二次分析,评估针刺作为非药物疗法在减少慢性自发性荨麻疹(Chronic Spontaneous Urticaria,CSU)患者对应急使用抗组胺药依赖方面的潜力,为CSU的多元化管理提供新的证据。方法:患者随机分配到针刺组、假针刺组和等待治疗组,并记录了4周治疗期及4周随访期内应急使用抗组胺药的情况。本研究主要评估指标为应急使用抗组胺药的平均天数,通过单因素方差分析(ANOVA)及Tukey HSD多重比较探讨不同时期组间应急使用抗组胺药的平均天数差异。对于组内比较,采用Welch的t检验评估不同时期的差异。非参数Mann-Whitney-U检验进一步验证了组间差异的稳健性。卡方检验和Fisher精确检验用于分析治疗组间用药人数的统计学差异。结果:共分析了296名患者的数据。与针刺组相比,等待治疗组在治疗期(0.30,95%CI0.08 to 0.53,P=0.005)和随访期(0.31,95%CI0.12 to 0.50,P<0.001)应急使用抗组胺药的频率增加。组内分析表明,尽管3组应急使用抗组胺药的平均天数有所下降,但这些变化无统计学意义(P>0.05)。此外,与等待治疗组相比,治疗和随访期间接受针刺治疗的患者中应急用药的人数较少(P<0.05)。结论:针刺治疗显示了减轻CSU患者依赖应急用药的潜力,为减少药物负担提供了一个有效的非药物治疗选择。展开更多
BACKGROUND Immunochemotherapy involving the combination of programmed cell death 1/programmed cell death ligand 1 inhibitors with chemotherapy has advanced the treatment of locally advanced esophageal squamous cell ca...BACKGROUND Immunochemotherapy involving the combination of programmed cell death 1/programmed cell death ligand 1 inhibitors with chemotherapy has advanced the treatment of locally advanced esophageal squamous cell carcinoma(ESCC).The use of corticosteroids as pretreatment might reduce immunotherapy efficacy.AIM To investigate the impact of baseline corticosteroid use on neoadjuvant immunochemotherapy(nIC)outcomes in locally advanced ESCC patients.METHODS Patients with locally advanced ESCC who received nIC at Sun Yat-sen University Cancer Center and the Third Affiliated Hospital of Sun Yat-sen University were included.Patients were divided into dexamethasone and antihistamine groups on the basis of the administered pretreatment.Antiallergic efficacy and safety were evaluated,as well as its impact on short-term efficacy[complete pathological response(pCR),major pathological response(MPR)]and long-term efficacy[overall survival(OS),progression-free survival(PFS)]of nIC.RESULTS From September 2019 to September 2023,142 patients were analyzed.No severe treatment-related adverse events or deaths were observed.Allergy occurrence was greater in the antihistamine group(P=0.014).Short-term efficacy was not significantly different:The pCR rates were 29.9%and 40.0%,and the MPR rates were 57.9%and 65.7%in the dexamethasone and antihistamine groups,respectively.The long-term efficacy was not significantly different:The 2 years OS rates were 95.2%and 93.5%,and the 2 years PFS rates were 90.3%and 87.8%.Subgroup analysis revealed no difference in OS between the 20 mg dexamethasone group and the<20 mg dexamethasone group,but PFS was significantly greater in the 20 mg dexamethasone group(93.9%vs 56.4%,P=0.001).CONCLUSION Dexamethasone or antihistamines can be used before nIC in locally advanced ESCC without affecting short-or long-term efficacy.Administering 20 mg dexamethasone before nIC may improve PFS in ESCC.展开更多
文摘BACKGROUND: Currently there is very limited data in the literature assessing the prevalence of antihistamine prescription, and there is no local prevalence data about the prescription of antihistamine agents among primary practitioner and emergency physicians. The objectives are 1) to report the prevalence of antihistamine prescription for children less than 6 years old with acute upper respiratory infection and 2) to explore the associated factors for the prescription practice.METHODS: This is a cross-sectional study. All consecutive cases of paediatric patients aged 6 or below who presented to the emergency department during a study period of one week from April 1 to July 4, 2009 with diagnosis of acute upper respiratory infection were included. Totally 162 patients were included.RESULTS: Among the 162 cases, 141(87%) patients were prescribed one antihistamine of any group. Sixty(37%) patients were prescribed two or more antihistamines. In multivariate logistic regression model, age was found to be signi? cantly(P<0.001) associated with multiple antihistamine prescription(OR=1.042, 95%CI=1.02 to 1.06). Years of graduation of attending physician for more than 5 years was also a strong predictor of multiple antihistamine prescription(OR=4.654, 95%CI=2.20 to 9.84, P<0.001).CONCLUSION: In the local emergency department, patients' age and the years of graduation from medical school of the attending physician were predictors of multiple antihistamine prescription for acute upper respiratory infections for children aged less than 6.
基金supported by the National Natural Science Foundation of China(82172242,81873965)State Key Laboratory of Respiratory Disease,Guangzhou,China(SKLRD-OP-202207)+2 种基金National Key R&D Program of China(2020YFC0842000)Natural Science Foundation of Guangdong(2022A1515012053)Key Project from the Chinese Academy of Sciences(QYZDB-SSWSMC059)。
文摘COVID-19 is an immune-mediated inflammatory disease caused by SARS-CoV-2 infection,the combination of anti-inflammatory and antiviral therapy is predicted to provide clinical benefits.We recently demonstrated that mast cells(MCs)are an essential mediator of SARS-CoV-2-initiated hyperinflammation.We also showed that spike protein-induced MC degranulation initiates alveolar epithelial inflammation for barrier disruption and suggested an off-label use of antihistamines as MC stabilizers to block degranulation and consequently suppress inflammation and prevent lung injury.In this study,we emphasized the essential role of MCs in SARS-CoV-2-induced lung lesions in vivo,and demonstrated the benefits of co-administration of antihistamines and antiviral drug remdesivir in SARS-CoV-2-infected mice.Specifically,SARSCoV-2 spike protein-induced MC degranulation resulted in alveolar-capillary injury,while pretreatment of pulmonary microvascular endothelial cells with antihistamines prevented adhesion junction disruption;predictably,the combination of antiviral drug remdesivir with the antihistamine loratadine,a histamine receptor 1(HR1)antagonist,dampened viral replication and inflammation,thereby greatly reducing lung injury.Our findings emphasize the crucial role of MCs in SARS-CoV-2-induced inflammation and lung injury and provide a feasible combination antiviral and anti-inflammatory therapy for COVID-19 treatment.
基金financially supported by Natural Antimicrobial Centre of Excellence of Shiraz University
文摘Objective: To investigate the antihistamine-releasing effect of a peptide isolated from wasp venom of Vespa orientalis.Methods: This peptide was separated from crude venom by chromatography methods and mass spectrometry. Then various concentrations(2, 4, 8, 16, 32, 64, 128 and256 mmol/L) of the peptide were incubated with mast cells and lactate dehydrogenase assay was performed.Results: No significant effect was observed in lactate dehydrogenase absorbance under128 mmol/L concentration. This implied that the peptide did not cause cell death in mast cells and consequently, histamine release did not happen. Moreover, the results showed the IC50 of mast cells degranulation at 126 mmol/L, which was approximately high implying that this peptide had high selectivity for normal cells and did not cause histamine release from these cells.Conclusions: This would be a great aim in new drug development, in which an agent acts potentially on its target tissue without activating the immune system.
基金Research and Development project of"Ten Diseases and ten Drugs"of Beijing Municipal Commission of Science and Technology(No.Z141100002214018)。
文摘Objective:To evaluate the efficacy and safety of Peitu Shengjin prescription versus H1 antihistamine in the treatment of allergic rhinitis.Methods:Electronic searching"China Knowledge Network","Wanfang Database","Vip Database","Chinese Biomedical Literature Database",PubMed,Embase,The Cochrane Library,all published on the prescription of Peitu Shengjin prescription comparison H1 antihistamine In randomized controlled trials(RCTs)of drug treatment of allergic rhinitis,two researchers screened the literature according to the inclusion and exclusion criteria,and conducted Meta-analysis using RevMan5.3 software.Results:A total of 22 studies were involved,involving a total of 1463 subjects,including 822 in the treatment group and 641 in the control group.Meta-analysis results show that compared with oral H1 antihistamines,Peitu Shengjin prescription can improve the total effective rate of allergic rhinitis(RR=1.19,95%CI[1.14,1.24],P<0.00001);reduce recurrence Rate(RR=0.46,95%CI[0.23,0.90],P=0.02);reduce serum IL-6(MD=-17.33,95%CI[-21.96,-12.70],P<0.00001)and serum IL-8(MD=-100.35,95%CI[-175.18,-25.52],P=0.009);reduce the patient’s total score of symptoms and signs(SMD=-1.21,95%CI[-1.82,-0.61],P<0.0001)And TCM symptom scores(SMD=-0.98,95%CI[-1.28,-0.68],P<0.00001);superior to the control group in improving patients'nasal congestion,nasal itching,and turbinate/nasal mucosa enlargement,in improving runny nose There is no obvious advantage compared with the control group in terms of sneezing symptoms;in terms of safety,there are fewer mild adverse reactions in the treatment group(RD=-0.05,95%CI[-0.09,-0.00],P=0.04).Conclusion:Compared with H1 antihistamine,Peitu Shengjin prescription can improve clinical efficacy,improve patients'symptoms and signs and TCM symptoms,regulate immune function,and is not easy to relapse and has good safety.
文摘目的:本研究通过对前期多中心随机对照试验数据进行二次分析,评估针刺作为非药物疗法在减少慢性自发性荨麻疹(Chronic Spontaneous Urticaria,CSU)患者对应急使用抗组胺药依赖方面的潜力,为CSU的多元化管理提供新的证据。方法:患者随机分配到针刺组、假针刺组和等待治疗组,并记录了4周治疗期及4周随访期内应急使用抗组胺药的情况。本研究主要评估指标为应急使用抗组胺药的平均天数,通过单因素方差分析(ANOVA)及Tukey HSD多重比较探讨不同时期组间应急使用抗组胺药的平均天数差异。对于组内比较,采用Welch的t检验评估不同时期的差异。非参数Mann-Whitney-U检验进一步验证了组间差异的稳健性。卡方检验和Fisher精确检验用于分析治疗组间用药人数的统计学差异。结果:共分析了296名患者的数据。与针刺组相比,等待治疗组在治疗期(0.30,95%CI0.08 to 0.53,P=0.005)和随访期(0.31,95%CI0.12 to 0.50,P<0.001)应急使用抗组胺药的频率增加。组内分析表明,尽管3组应急使用抗组胺药的平均天数有所下降,但这些变化无统计学意义(P>0.05)。此外,与等待治疗组相比,治疗和随访期间接受针刺治疗的患者中应急用药的人数较少(P<0.05)。结论:针刺治疗显示了减轻CSU患者依赖应急用药的潜力,为减少药物负担提供了一个有效的非药物治疗选择。
文摘BACKGROUND Immunochemotherapy involving the combination of programmed cell death 1/programmed cell death ligand 1 inhibitors with chemotherapy has advanced the treatment of locally advanced esophageal squamous cell carcinoma(ESCC).The use of corticosteroids as pretreatment might reduce immunotherapy efficacy.AIM To investigate the impact of baseline corticosteroid use on neoadjuvant immunochemotherapy(nIC)outcomes in locally advanced ESCC patients.METHODS Patients with locally advanced ESCC who received nIC at Sun Yat-sen University Cancer Center and the Third Affiliated Hospital of Sun Yat-sen University were included.Patients were divided into dexamethasone and antihistamine groups on the basis of the administered pretreatment.Antiallergic efficacy and safety were evaluated,as well as its impact on short-term efficacy[complete pathological response(pCR),major pathological response(MPR)]and long-term efficacy[overall survival(OS),progression-free survival(PFS)]of nIC.RESULTS From September 2019 to September 2023,142 patients were analyzed.No severe treatment-related adverse events or deaths were observed.Allergy occurrence was greater in the antihistamine group(P=0.014).Short-term efficacy was not significantly different:The pCR rates were 29.9%and 40.0%,and the MPR rates were 57.9%and 65.7%in the dexamethasone and antihistamine groups,respectively.The long-term efficacy was not significantly different:The 2 years OS rates were 95.2%and 93.5%,and the 2 years PFS rates were 90.3%and 87.8%.Subgroup analysis revealed no difference in OS between the 20 mg dexamethasone group and the<20 mg dexamethasone group,but PFS was significantly greater in the 20 mg dexamethasone group(93.9%vs 56.4%,P=0.001).CONCLUSION Dexamethasone or antihistamines can be used before nIC in locally advanced ESCC without affecting short-or long-term efficacy.Administering 20 mg dexamethasone before nIC may improve PFS in ESCC.
