Anti-Inflammatory Activity and Clinical Efficacy of a 3-Month Levocetirizine Therapy in Mite-Allergic Children

Francesco      Marcucci; Laura      Giovanna Sensi; Piera      Abate; Giusiana      Allocca; Eleonora      Ugolini; Giuseppe      Di Cara; Cristoforo      Incorvaia

Abstract

The non-sedating third generation antihistamine levocetirizine has ample evidence of efficacy in allergic rhinitis. In vitro studies suggested that levocetirizine has anti-inflammatory properties not simply related to the antihistamine activity but also to regulation of eosinophils. We performed a double-blind placebo-controlled study in 40 children allergic to house dust mites with persistent rhinitis with the primary aim to evaluate the anti-inflammatory efficacy of levocetirizine measuring eosinophil-related parameters and exhaled nitric oxide (eNO). After one month of treatment, a significant improvement in nasal symptom-medication scores was observed in actively but not in placebotreated patients. After 3 months of treatment, a significant effect was detected on eosinophilic cationic protein (ECP) in nasal mucosa and on nasal eNO in active treated patients. This suggests that during treatment of mite-allergic children with levocetirizine the early improvement in nasal symptoms is due to the antihistamine activity, while more time is needed to achieve an effect on allergic inflammation.

Keywords: Antihistamines, levocetirizine, allergic rhinitis, inflammation, exhaled nitric oxide, eosinophilic cationic protein, cell adhesion, cytokine production, allergic inflammation, Levocetirizine dihydrochloride, enantiomer, paediatric populations, dextro-cetirizine, eotaxin, adenosine monophosphate, growth factors, placebo-controlled, allergen specific nasal challenge (ASNC), skin prick tests, blood sampling, IgE, baseline, spirometry, expiratory peak flow meter, immunotherapy, corticosteroids, cromones, antileukotrienes, calcineurin inhibitors, Stallergenes, Antony, monofilament, fluorimetric, calibration curve, Sputum, nebulization, dithiothreitol, cells, chemoluminescence, itching, sneezing, rhinorrhea, conjunctivitis, cough, dyspnoea, Serum eosinophils, sinusitis, otitis, Headache, abdominal pain, allergic patients, monophosphate nasal, nasal scrapings, histamine, eosinophils