Skip to main content
Monthly Archives

August 2022

Lack of Clinical Relevance of Bilastine-Food Interaction in Healthy Volunteers: A Wheal and Flare Study

By Articles about Bilastine, Publicaciones sobre Bilastina

Coimbra J, Puntes M, Gich I, Martínez J, Molina P, Antonijoan R, Campo C, Labeaga L

Int Arch Allergy Immunol. 2022 Jun 14:1-10. doi: 10.1159/000524856. Publicación electrónica previa a la edición impresa. PMID: 35700691.

Bilastine is a second-generation antihistamine with good selectivity for H1-receptors, and no brain-penetration. The objective of this study was to compare the pharmacodynamic activity of bilastine administered under fasting and fed conditions in healthy volunteers.

This was a randomized, open-label, two-period, crossover study involving 24 healthy participants who were given 20 mg of once-daily oral bilastine for 4 days under fasting and fed conditions, with a 7-day washout period. The plasma concentrations of bilastine plasma were measured for 24 h after the first and fourth doses in each period. Pharmacodynamic activity was assessed by wheal and flare surface inhibition and subjective assessment of itching, after intradermal injection of histamine.

When administered under fed vs. fasting conditions, the exposure to bilastine 20 mg decreased (mean maximum plasma concentration and area under the curve from time 0 to 24 h decreased by 34.27% and 32.72% [day 1], respectively, and 33.08% and 28.87% [day 4]). Despite this decrease, the antihistaminic effect of bilastine 20 mg did not change with food. On day 1, as measured by wheal and flare surface inhibition,

the maximum effect and duration of action of bilastine did not differ significantly between fasting and fed conditions, with only a short 30-min delay in the onset of wheal inhibition. On day 4, bilastine’s pharmacodynamic effects were not significantly affected under any condition.

In conclusion, the pharmacokinetic interaction of bilastine with food does not mean a significant reduction of its peripheral antihistaminic efficacy.

This document is only available for registered healthcare professionals

Urticaria (angioedema) and COVID- 19 infection

Chronic Urticaria: The Need for Improved Definition

By Artículos seleccionados, Selected articles

Gómez RM, Bernstein JA, Ansotegui I, Maurer M

Front Allergy. 2022 Jun 9;3:905677. doi: 10.3389/falgy.2022.905677. PMID: 35769560; PMCID: PMC9234868.

Chronic urticaria is usually diagnosed after daily or almost daily presence of symptoms for more than 6 weeks. Urticaria symptoms include pruritic wheals or hives, accompanied by angioedema in 40% of cases. Up to 20% of patients have isolated angioedema. Chronic urticaria represents a significant burden which has been extensively reported with numerous validated patient-reported outcome measures that represent a significant impact on several aspects of life ranging from physical discomfort to personal mood changes (anxiety and depression) which frequently interferes with interpersonal relationships, daily activities including work and school. It is not a surprise that management of chronic urticaria is related to substantial

costs to health care systems due to recurrent medical visits and treatments. Consequently, it is crucial to generate awareness among healthcare payors and other stakeholders on the prevalence of chronic urticaria and its impact on quality of life and on the economic burden it has on society. There is no consensus on diagnostic and management criteria for CU, which makes this task more challenging.

In conclusion, the health and economic burden of chronic urticaria is significant and should not be underestimated. The significant impact of this condition requires that physicians and other health care providers understand how to properly identify and manage this condition.

An expert consensus on diagnostic and management criteria for chronic urticaria is needed.

This document is only available for registered healthcare professionals


Compositional alteration of the nasal microbiome and Staphylococcus aureus-characterized dysbiosis in the nasal mucosa of patients with allergic rhinitis

By Artículos seleccionados, Selected articles

Kim HJ, Kim JH, Han S, Kim W

Clin Exp Otorhinolaryngol. 2022 Jun 8. doi: 10.21053/ceo.2021.01928. Epub ahead of print. PMID: 35680131.

Allergic rhinitis (AR) is an IgE and Th2-mediated inflammatory nasal disease. It originates from a sensitized immune response to inhaled allergens, which is thought to result from an imbalance in the Th1-Th2 immune regulation, resulting in increased levels of Th2 cytokines. Nasal ephitelial cells exposed to allergens induce Th2 inflammatory responses that spread to the upper airway mucosa. A commensalism host-microbial can be the basis of the innate immune responses in the nasal mucosa, and the microbial characteristics of the nasal mucus can impact the mechanisms of the initial allergic response. The aim of this study was to evaluate changes in the microbial composition in the nasal mucus of patients with AR and to understand the relationship between dysbiosis of the nasal microbiome and allergic inflammation.

The investigators analyzed the microbiota of 104 samples (n=42 participants with AR vs. n=30 healthy participants), in a total of 364,923 high-quality bacterial 16S ribosomal RNA-encoding gene sequence reads. The nasal mucus of healthy participants had mainly Proteobacteria (Ralstonia genus) and Actinobacteria (Propionibacterium genus) phyla, whereas the Firmicutes (Staphylococcus genus) phylum was significantly abundant in the nasal mucus of participants with AR. More sequencing data from 32 participants (healthy participants: n=15, AR patients: n=17) shown a greater abundance of Staphylococcus epidermidis, Corynebacterium

accolens, and Nocardia coeliaca, in 41.55% of mapped sequences in the nasal mucus of healthy participants. Patients with AR had a more pronounced dysbiosis of nasal microbiome and Staphylococcus aureus exhibited the greatest abundance (37.69%).

In conclusion, this study demonstrated that the nasal mucus of patients with AR have S. aureus–dominant dysbiosis, which suggests a role of host–microbial commensalism in allergic inflammation.

This document is only available for registered healthcare professionals


Autoimmune chronic spontaneous urticaria

By Artículos seleccionados, Selected articles

Kolkhir P, Muñoz M, Asero R, Ferrer M, Kocatürk E, Metz M, Xiang YK, Maurer M

J Allergy Clin Immunol. 2022 Jun;149(6):1819-1831. doi: 10.1016/j.jaci.2022.04.010. PMID: 35667749.

Chronic spontaneous urticaria (CSU) symptoms include the recurrent spontaneous appearance of wheals and intense itch that may last from hours to days and occur for several years. Some patients develop localized and self-limiting angioedema. These manifestations result from a temporary increase in vascular permeability. Almost 13% of patients with CSU experience angioedema and do not develop wheals.

There are 2 main autoimmune mechanisms for CSU: type I autoimmune (autoallergic) CSU, which is associated with with IgE antibodies against autoantigens; and type IIb autoimmune CSU, which is mediated by autoantibodies that activate mast cells via IgE and FceRI. Type IIb autoimmune CSU is present in almost 10% of patients and is characterized by higher disease severity, concomitant autoimmune diseases, low levels of total IgE, elevated levels of IgG-anti–thyroid peroxidase, basopenia, eosinopenia, poor response to antihistamines and to omalizumab, and a good response to cyclosporine. Some new targeted therapies are under development, such as the anti-IgE, ligelizumab, and the Bruton’s tyrosine kinase inhibitors, fenebrutinib and remibrutinib, and an anti-IL-4Ra, dupilumab.

There are missing some studies on the overlap between autoallergic and type IIb autoimmune CSU and on the optimal management of both types of autoimmune CSU, with easy-to-perform, noninvasive and inexpensive markers to assess the treatment response.

This document is only available for registered healthcare professionals


Comorbid allergic rhinitis and asthma: important clinical considerations

By Artículos seleccionados, Selected articles

Nappi E, Paoletti G, Malvezzi L, Ferri S, Racca F, Messina MR, Puggioni F, Heffler E, Canonica GW

Expert Rev Clin Immunol. 2022 Jun 19:1-12. doi: 10.1080/1744666X.2022.2089654. Epub ahead of print. PMID: 35695326.

There are several links between asthma and allergic rhinitis in the same patient, although these conditions are frequently underdiagnosed with suboptimal clinical outcomes. The two conditions coexist and share clinical, pathogenic, and pathophysiological mechanisms.

The aim of this article was to review the major links between the mechanisms of allergic rhinitis and asthma, as well as their treatment according to existing guidelines, focusing on treatment of allergic rhinitis in patients with comorbid asthma.

The authors concluded there are some unmet needs for patients with asthma and allergic rhinitis. Not all allergic rhinitis patients are screened for asthma. This screening should be conducted with a multidisciplinary approach to characterize the journey of patients with respiratory allergies to subsequently refer adequately to Allergy/Asthma centers. There may be advantages in treatment with allergen immunotherapy and/or biosimilars, which might represent encouraging advances in the management of both conditions.

This document is only available for registered healthcare professionals

Close Menu

La información que está a punto de visualizar está dirigida únicamente a los profesionales sanitarios aptos para prescribir o dispensar medicamentos. La correcta utilización de su contenido requiere de formación como profesional sanitario.

Debe hacer clic en Aceptar para confirmar que es usted profesional de la salud y continuar con la navegación.