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Second-generation antihistamines in asthma therapy: is there a protective effect?
1Department of Medicine & Therapeutics, University of Aberdeen Medical School, IMS Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK. g.m.walsh@abdn.ac.uk
Summary
Second-generation antihistamines offer benefits for allergic diseases, including asthma and allergic rhinitis. Novel antihistamines and combination therapies show promise for managing asthma symptoms and exacerbations.
Area of Science:
- Pharmacology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Second-generation H1 receptor antagonists are widely used for allergic diseases.
- Histamine is a key mediator in asthma pathogenesis, causing bronchoconstriction and inflammation.
- Allergic rhinitis is increasingly recognized as a risk factor for asthma development.
Purpose of the Study:
- To review the role and efficacy of second-generation antihistamines in managing allergic diseases, particularly asthma.
- To explore the potential of novel antihistamines and combination therapies in asthma treatment.
- To highlight the anti-inflammatory properties of antihistamines and their impact on asthma exacerbations.
Main Methods:
- Review of existing literature on second-generation antihistamines and their effects on allergic conditions.
- Analysis of studies investigating antihistamines as monotherapy and adjunct therapy for asthma.
- Examination of evidence for novel antihistamines (e.g., desloratadine) and combination therapies (e.g., with antileukotrienes).
Main Results:
- Antihistamines provide protection against histamine-induced bronchoconstriction and can benefit patients with co-existing allergic asthma and rhinitis.
- Novel antihistamines like desloratadine show potential for symptomatic relief in some asthma types.
- Anti-inflammatory effects, such as ICAM-1 inhibition, suggest a role in managing virus-induced asthma exacerbations.
- Combination therapy with antihistamines and antileukotrienes may be comparable to corticosteroids for allergic asthma and rhinitis.
Conclusions:
- Second-generation antihistamines are valuable in managing allergic diseases and can be beneficial as adjunct therapy in allergic asthma.
- Emerging evidence supports the use of novel antihistamines and combination therapies for improved asthma control.
- The anti-inflammatory actions of antihistamines offer a potential new strategy for asthma management, including exacerbations.
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