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Allergic Diseases of the Eye
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
For patients presenting with acute symptoms, it is usual to prescribe a moderately potent topical steroid with low ocular penetration, such as fluorometholone or loteprednol, three or four times a day for around two weeks. Along with this a mast cell stabilizer or a dual action drug is started as a preventive medication, intended for long term instillation (Mantelli et al. 2007). Prophylactic treatment is usually continued through the expected period of allergen exposure. As drugs such as olopatadine and alcaftadine are available as once-a-day preparations for this purpose, compliance is usually good.
Cell Adhesion Molecules in Mast Cell Adhesion and Migration
Published in Bruce S. Bochner, Adhesion Molecules in Allergic Disease, 2020
Harissios Vliagoftis, Dean D. Metcalfe
Perfusion of the rat mesentery with compound 48/80, a mast cell degranulating agent, leads to a dose-dependent rise in the number of rolling and adherent cells in the local vasculature (67). These effects are significantly reduced by the mast cell stabilizers ketotifen and cromolyn; and by chronic treatment with compound 48/80, which depletes mast cell mediators. Mast cell degranulation, in this study, induced P-selectin-dependent leukocyte rolling and CD18-dependent leukocyte adhesion to the endothelium via histamine and PAF, respectively (67).
Osteoarthritis
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
David Musnick, Richard D. Batson
Of interest is that chondroitin sulfate has been shown to have an action as a mast cell stabilizer. There are patients that have worsening pain when they are having concurrent allergies. In this population CS is an excellent supplement to use. There are some studies documenting increased mast cells in osteoarthritic joints that would make a trial of CS worthwhile (de Lange-Brokaar et al., 2016).
Topical tacrolimus for the treatment of external eye inflammation in children
Published in Expert Review of Ophthalmology, 2022
Bernales Andrea, Berger Osvaldo, Hamada Samer
In one of our patients, tacrolimus was not effective in reducing clinical signs. However, it was effective in decreasing the dependence on topical steroidal treatment. Some patients with eye allergies can also not respond to tacrolimus and require steroidal treatment. This can be related to the thymic stromal lymphopoietin (TSLP), an alternative pathway of inflammation in allergic conjunctivitis, which has shown poor response to tacrolimus and cyclosporine but suppression with steroids [65]. There are some reports of recurrence after stopping treatment [30] and long-term follow-up without side effects reported [56,66]. For that reason, the decision to stop tacrolimus in a stable patient must be taken with caution. Al-Amri et al. suggest the use of mast cell stabilizers and tacrolimus at the same time in the initial phase and withdrawal of tacrolimus when patients remain asymptomatic for at least a few months. Any relapse after discontinuation may be again treated with tacrolimus [22].
Anti-allergic actions of a Chinese patent medicine, huoxiangzhengqi oral liquid, in RBL-2H3 cells and in mice
Published in Pharmaceutical Biology, 2021
Jianbin Sun, Sixing Huang, Yao Qin, Ping Zhang, Ziwei Li, Li Zhang, Xin Wang, Ruijun Wu, Shaorong Qin, Jiayong Huo, Kunquan Xiao, Weizao Luo
Thus far, there are no therapies that can cure allergic diseases completely. The treatment of allergic diseases includes clinically-prescribed mast cell stabilizers (e.g., disodium cromoglycate, tranilast and ketotifen fumarate), H1 receptors antagonists (e.g., cetirizine, diphenhydramine and loratadine) and immune suppressors (e.g., adrenal cortical hormones, dexamethasone and hydrocortisone) which have side effects such as drowsiness, dizziness, dry mouth and skin atrophy (Oppenheimer and Casale 2002; Schoepe et al. 2006). As such, there is inspiring research using herbal medicines that have multi-component, multi-target and multi-mechanism anti-allergic characteristics with few side effects (Wang et al. 2015). In addition, since herbal medicines are widely available and inexpensive, they could be valuable approaches for the treatment of allergic diseases (Man et al. 2018).
Recent advances in our understanding of mast cell activation – or should it be mast cell mediator disorders?
Published in Expert Review of Clinical Immunology, 2019
Theoharis C. Theoharides, Irene Tsilioni, Huali Ren
Despite the common use of the term ‘mast cell stabilizers’ [226], there are no such clinically effective drugs. Disodium cromoglycate (cromolyn sodium), known as a ‘mast cell stabilizer,’ reduces mostly GI symptoms, such as abdominal bloating and pain. Cromolyn is administered orally and is divided into doses [117]. Cromolyn causes tachyphylaxis [227], making it necessary to increase the dose from 100 mg tid to 400 mg tid over the course of a year. However, cromolyn is difficult to dissolve, poorly (less than 5%) is absorbed orall, and can cause severe diarrhea in about 15% of patients. Cromolyn can also cause alopecia in about 10% of patients. Recent data have even cast some doubt on the ability of cromolyn to stabilize human mast cells [228], and its beneficial effect on pruritus might be mediated by inhibition of C-fiber peripheral sensory nerves, instead [229].