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Pathophysiology of nasal obstruction and meta-analysis of early and late effects of levocetirizine.

Abstract
Nasal obstruction, also referred to as congestion, blockage or stuffiness, is a crucial symptom in allergic rhinitis (AR) and may affect sleep as well as quality of life. Early- and late-phase-allergic reactions both contribute to nasal obstruction, although it primarily represents a major symptom in the chronic allergic reaction. A complex network of inflammatory and neurogenic phenomena relates to chronic nasal obstruction, including the subepithelial accumulation of inflammatory cells, particularly mast cells and eosinophils, and the release of neuropeptides. Nasal obstruction is a difficult-to-treat symptom. Vasoconstrictors (decongestants) and intranasal corticosteroids, due to their anti-inflammatory properties, have mainly been used for relieving the nasal passages from the congested mucosa. However, there is accumulating evidence recently that the latest-generation potent antihistamines have decongestant properties in AR. This paper aims to review the pathophysiologic background of nasal obstruction and the evidence for an antihistamine, levocetirizine, in relieving nasal congestion. A meta-analysis on the early and late effects of levocetirizine on nasal obstruction under artificial and natural allergen exposure conditions is presented, demonstrating convincingly that levocetirizine shows a consistent effect on nasal obstruction as early as over the first 2 h and sustained over 6 weeks.
AuthorsJ Patou, H De Smedt, P van Cauwenberge, C Bachert
JournalClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology (Clin Exp Allergy) Vol. 36 Issue 8 Pg. 972-81 (Aug 2006) ISSN: 0954-7894 [Print] England
PMID16911353 (Publication Type: Journal Article, Meta-Analysis)
Chemical References
  • Histamine H1 Antagonists, Non-Sedating
  • Neuropeptides
  • Piperazines
  • levocetirizine
  • Cetirizine
Topics
  • Cetirizine (therapeutic use)
  • Eosinophils (immunology)
  • Histamine H1 Antagonists, Non-Sedating (therapeutic use)
  • Humans
  • Mast Cells (immunology)
  • Nasal Obstruction (drug therapy, immunology, physiopathology)
  • Neuropeptides (physiology)
  • Piperazines (therapeutic use)
  • Rhinitis, Allergic, Perennial (drug therapy, immunology, physiopathology)
  • Time Factors
  • Treatment Outcome

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