Farmacologia clinica
Dalla dermatite atopica all’asma: possibilità di prevenzione farmacologica
FROM ATOPIC DERMATITIS TO ASTHMA: EVALUATION OF EARLY TREATMENT WITH CETIRIZINE
FERNANDO M. DE BENEDICTIS1*, ATTILIO BONER2*, LUISA BUSINCO3*, PAOLO MEGLIO3*, GIOVANNI CAVAGNI4*, ALESSANDRO FIOCCHI5*, MASSIMO MASI6*
1Clinica Pediatrica dell’Università di Perugia,
2Clinica Pediatrica dell’Università di Verona
3Clinica Pediatrica dell’Università di Roma
4Clinica Pediatrica dell’Università di Brescia
5Clinica Pediatrica dell’Università di Milano
6Clinica Pediatrica dell’Università di Bologna
*ETAC Italian Study Group
Settembre 1999 - pagg. 421 -424
Abstract
A multicentre study was carried out to evaluate the efficacy of early treatment with cetirizine
of children affected by atopic dermatitis. 817 patients aged 12 to 24 months and affected
by atopic dermatitis were randomized to receive either cetirizine (0.25 mg/kg twice a
day) or placebo for 18 months. Total and specific IgE levels as well as physical examination
were performed throughout the study period. Sensitivity to house mite and cat but also
to pollen were shown to be highly predictive of the risk of subsequent development of asthma.
There were no significant differences between cetirizine and placebo groups with respect
to the development of asthma but in the subgroup of patients with high baseline IgE
for pollen and house dust mite treatment with cetirizine was associated with lower incidence
of asthma. These results cannot be considered conclusive until the data on longer followup
will be available.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
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3. Witt C, Stuckey MS, Woolcock AJ, Dawkins RL: Positive allergy skin prick test with bronchial histamine responsiveness in unselected population. J Allergy Clin Immunol 77, 698-702, 1986.
4. Peat JK, Salome CM, Sedgwick CS, et al: A prospective study of bronchial hyperresponsiveness and respiratory symptoms in a population of Australian schoolchildren. Clin Exp Allergy 19, 299-306, 1989.
5. Cockcroft DW, Murdock KY, Berscheid BA: Relationship between atopy and bronchial responsiveness to histamine in a random population. Ann Allergy 53, 26-9, 1984.
6. Zimmerman B, Feanny S, Reisman J, et al: Allergy in asthma. I. The dose relationship of allergy to severity of childhood asthma. J Allergy Clin Immunol 81, 63-70, 1988.
7. Gruber W, Eber E, Steinbrugger B, et al: Atopy, lung function and bronchial responsiveness in symptom-free paediatric asthma patients. Eur Respir J 10, 1041-5, 1997.
8. Barker AF, Hirshman CA, D’Silva R, Hanifin JM: Airway responsiveness in atopic dermatitis. J Allergy Clin Immunol 87, 780-3, 1991.
9. Brinkman L, Raaijmakers JAM, Bruijnzeel- Koomen CAFM, et al: Bronchial and skin reactivity in asthmatic patients with and without atopic dermatitis. Eur Respir J 10, 1033-40, 1997.
10. Price JF, Cogswell JJ, Joseph MC, Cochrane GM. Exercise-induced bronchoconstriction, skin sensitivity, and serum IgE in children with eczema. Arch Dis Child 51, 912-7, 1976.
11. Corbo GM, Ferrante E, Macciocchi B, et al: Bronchial hyperresponsiveness in atopic dermatitis. Allergy 44, 595-8, 1989.
12. Salob SP, Laverty A, Atherton DJ: Bronchial hyperresponsiveness in children with atopic dermatitis. Pediatrics 91, 13-6, 1993.
13. Businco L, Ziruolo MG, Ferrara M, et al: Natural history of atopic dermatitis in childhood: an updated review and personal experience of a five-year follow-up. Allergy 44 (suppl 9), 70-8, 1989.
14. Salob SP, Atherton DJ: Prevalence of respiratory symptoms in children with atopic dermatitis attending pediatric dermatology clinics. Pediatrics 91, 8-12, 1993.
15. Queille-Roussel C, Raynaud F, Saurat J-H: A prospective computerized study of 500 cases of atopic dermatitis in childhood. Acta Derm Venereol (Stockh), Suppl. 114, 87-92, 1985.
16. Bergmann RL, Edenharter G, Bergmann KE, et al: Atopic dermatitis in early infancy predicts allergic airway disease at 5 years. Clin Exp Allergy 28, 965-70, 1998.
17. Schauer U, Trube M, Jager R, et al: Blood eosinophils, eosinophil-derived proteins, and leukotriene C4 generation in relation to bronchial hyperreactivity in children with atopic dermatitis. Allergy 50, 126-32, 1995.
18. Bergmann RL, Edenharter G, Bergmann KE, et al: Predictability of early atopy by cord blood IgE and parental history. Clin Exp Allergy 27, 752-60, 1997.
19. Whan U, Bergmann R, Kulig M, et al: The natural course of sensitization and atopic disease in infancy and childhood. Pediatr Allergy Immunol 8 (suppl 10), 16-20, 1997.
20. Morgan WJ, Martinez FD: Risk factors for developing wheezing and asthma in childhood. Pediatr Clin North Am 39, 1185, 1992.
21. Peat JK, Li J: Reversing the trend: reducing the prevalence of asthma. J Allergy Clin Immunol 103, 1-10, 1999.
22. Gern JE, Lemanske RF: Pediatric allergy. Can it be prevented? Pediatr Clin North Am 19, 233-52, 1999.
23. Zeiger RS: Secondary prevention of allergic disease: an adjunct to primary prevention. Pediatr Allergy Immunol 6, 127-38, 1995.
24. Iikura Y, Naspitz CK, Mikawa H, et al: Prevention of asthma by ketotifen in infants with atopic dermatitis. Ann Allergy 68, 233-6, 1992.
25. Bustos GJ, Bustos D, Bustos GJ, Romero O: Prevention of asthma with ketotifen in preasthmatic children: a three-year follow-up study. Clin Exp Allergy 25, 568-73, 1995.
26. Campoli-Richards DM, Buckley MM, Fitton A: Cetirizine. A review of its pharmacological properties and clinical potential in allergic rhinitis, pollen-induced asthma and chronic urticaria. Drugs 40 (5), 726-81, 1990.
27. Ciprandi G, Buscaglia S, Pesce G, et al: Cetirizine reduces inflammatory cell recruitment and ICAM-1 (or CD54) expression on conjunctival epithelium in both early and latephase reactions after allergen-specific challenge. J Allergy Clin Immunol 95, 612-21, 1995.
28. Redier H, Chanez P, De Vos C, et al: Inhibitory effect of cetirizine on the bronchial eosinophil recruitment induced by allergen inhalation challenge in allergic patients with asthma. J Allergy Clin Immunol 90, 215-24, 1992.
29. ETAC Study Group: Determinants of total and specific IgE in infants with atopic dermatitis. Pediatr Allergy Immunol 8, 177-84, 1998.
30. Kaur B, Anderson HR, Austin J, et al: Prevalence of asthma symptoms, diagnosis and treatment in 12-14 year old children across Great Britain (International Study of Asthma and Allergies in Childhood, UK). BMJ 316, 118-24, 1998.
31. Holt PG: A potential vaccine strategy for asthma and allied atopic diseases. Lancet 344, 456-8, 1994.
32. Lindfors ATB, Danielsson L, Enocksson E, et al: Allergic symptoms up to 4-6 years of age in children given cow milk neonatally. Allergy 47, 207-11, 1992.
33. Saarinen UM, Kajosaari M: Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years. Lancet 346, 1065-9, 1995.
34. ETAC Study Group: Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomized, placebo-controlled trial: First result of ETAC. Pediatr Allergy Immunol 9, 116- 24, 1998.
35. Nickel R, Kulig M, Forster J, et al: Sensitization to hen’s egg at the age of 12 months is predictive for allergic sensitization to common indoor and outdoor allergens at the age of three years. J Allergy Clin Immunol 99, 613-7, 1997.
36. Marks GB, Tovey ER, Green W, et al:. The effect of change in house dust mite allergen exposure on the severity of asthma. Clin Exp Allergy 25, 114-8, 1995.
37. Quirce S, Dimich-Ward H, Chan H, et al: Major cat allergen (Fel d I) levels in the homes of patients with asthma and their relationship to sensitization to cat dander. Ann Allergy Asthma Immunol 75, 325-30, 1995.
2. Van Asperen PP, Kemp AS, Mukhi A: Atopy in infancy predicts severity of bronchial hyperresponsiveness in later childhood. J Allergy Clin Immunol 85, 790-5, 1990.
3. Witt C, Stuckey MS, Woolcock AJ, Dawkins RL: Positive allergy skin prick test with bronchial histamine responsiveness in unselected population. J Allergy Clin Immunol 77, 698-702, 1986.
4. Peat JK, Salome CM, Sedgwick CS, et al: A prospective study of bronchial hyperresponsiveness and respiratory symptoms in a population of Australian schoolchildren. Clin Exp Allergy 19, 299-306, 1989.
5. Cockcroft DW, Murdock KY, Berscheid BA: Relationship between atopy and bronchial responsiveness to histamine in a random population. Ann Allergy 53, 26-9, 1984.
6. Zimmerman B, Feanny S, Reisman J, et al: Allergy in asthma. I. The dose relationship of allergy to severity of childhood asthma. J Allergy Clin Immunol 81, 63-70, 1988.
7. Gruber W, Eber E, Steinbrugger B, et al: Atopy, lung function and bronchial responsiveness in symptom-free paediatric asthma patients. Eur Respir J 10, 1041-5, 1997.
8. Barker AF, Hirshman CA, D’Silva R, Hanifin JM: Airway responsiveness in atopic dermatitis. J Allergy Clin Immunol 87, 780-3, 1991.
9. Brinkman L, Raaijmakers JAM, Bruijnzeel- Koomen CAFM, et al: Bronchial and skin reactivity in asthmatic patients with and without atopic dermatitis. Eur Respir J 10, 1033-40, 1997.
10. Price JF, Cogswell JJ, Joseph MC, Cochrane GM. Exercise-induced bronchoconstriction, skin sensitivity, and serum IgE in children with eczema. Arch Dis Child 51, 912-7, 1976.
11. Corbo GM, Ferrante E, Macciocchi B, et al: Bronchial hyperresponsiveness in atopic dermatitis. Allergy 44, 595-8, 1989.
12. Salob SP, Laverty A, Atherton DJ: Bronchial hyperresponsiveness in children with atopic dermatitis. Pediatrics 91, 13-6, 1993.
13. Businco L, Ziruolo MG, Ferrara M, et al: Natural history of atopic dermatitis in childhood: an updated review and personal experience of a five-year follow-up. Allergy 44 (suppl 9), 70-8, 1989.
14. Salob SP, Atherton DJ: Prevalence of respiratory symptoms in children with atopic dermatitis attending pediatric dermatology clinics. Pediatrics 91, 8-12, 1993.
15. Queille-Roussel C, Raynaud F, Saurat J-H: A prospective computerized study of 500 cases of atopic dermatitis in childhood. Acta Derm Venereol (Stockh), Suppl. 114, 87-92, 1985.
16. Bergmann RL, Edenharter G, Bergmann KE, et al: Atopic dermatitis in early infancy predicts allergic airway disease at 5 years. Clin Exp Allergy 28, 965-70, 1998.
17. Schauer U, Trube M, Jager R, et al: Blood eosinophils, eosinophil-derived proteins, and leukotriene C4 generation in relation to bronchial hyperreactivity in children with atopic dermatitis. Allergy 50, 126-32, 1995.
18. Bergmann RL, Edenharter G, Bergmann KE, et al: Predictability of early atopy by cord blood IgE and parental history. Clin Exp Allergy 27, 752-60, 1997.
19. Whan U, Bergmann R, Kulig M, et al: The natural course of sensitization and atopic disease in infancy and childhood. Pediatr Allergy Immunol 8 (suppl 10), 16-20, 1997.
20. Morgan WJ, Martinez FD: Risk factors for developing wheezing and asthma in childhood. Pediatr Clin North Am 39, 1185, 1992.
21. Peat JK, Li J: Reversing the trend: reducing the prevalence of asthma. J Allergy Clin Immunol 103, 1-10, 1999.
22. Gern JE, Lemanske RF: Pediatric allergy. Can it be prevented? Pediatr Clin North Am 19, 233-52, 1999.
23. Zeiger RS: Secondary prevention of allergic disease: an adjunct to primary prevention. Pediatr Allergy Immunol 6, 127-38, 1995.
24. Iikura Y, Naspitz CK, Mikawa H, et al: Prevention of asthma by ketotifen in infants with atopic dermatitis. Ann Allergy 68, 233-6, 1992.
25. Bustos GJ, Bustos D, Bustos GJ, Romero O: Prevention of asthma with ketotifen in preasthmatic children: a three-year follow-up study. Clin Exp Allergy 25, 568-73, 1995.
26. Campoli-Richards DM, Buckley MM, Fitton A: Cetirizine. A review of its pharmacological properties and clinical potential in allergic rhinitis, pollen-induced asthma and chronic urticaria. Drugs 40 (5), 726-81, 1990.
27. Ciprandi G, Buscaglia S, Pesce G, et al: Cetirizine reduces inflammatory cell recruitment and ICAM-1 (or CD54) expression on conjunctival epithelium in both early and latephase reactions after allergen-specific challenge. J Allergy Clin Immunol 95, 612-21, 1995.
28. Redier H, Chanez P, De Vos C, et al: Inhibitory effect of cetirizine on the bronchial eosinophil recruitment induced by allergen inhalation challenge in allergic patients with asthma. J Allergy Clin Immunol 90, 215-24, 1992.
29. ETAC Study Group: Determinants of total and specific IgE in infants with atopic dermatitis. Pediatr Allergy Immunol 8, 177-84, 1998.
30. Kaur B, Anderson HR, Austin J, et al: Prevalence of asthma symptoms, diagnosis and treatment in 12-14 year old children across Great Britain (International Study of Asthma and Allergies in Childhood, UK). BMJ 316, 118-24, 1998.
31. Holt PG: A potential vaccine strategy for asthma and allied atopic diseases. Lancet 344, 456-8, 1994.
32. Lindfors ATB, Danielsson L, Enocksson E, et al: Allergic symptoms up to 4-6 years of age in children given cow milk neonatally. Allergy 47, 207-11, 1992.
33. Saarinen UM, Kajosaari M: Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years. Lancet 346, 1065-9, 1995.
34. ETAC Study Group: Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomized, placebo-controlled trial: First result of ETAC. Pediatr Allergy Immunol 9, 116- 24, 1998.
35. Nickel R, Kulig M, Forster J, et al: Sensitization to hen’s egg at the age of 12 months is predictive for allergic sensitization to common indoor and outdoor allergens at the age of three years. J Allergy Clin Immunol 99, 613-7, 1997.
36. Marks GB, Tovey ER, Green W, et al:. The effect of change in house dust mite allergen exposure on the severity of asthma. Clin Exp Allergy 25, 114-8, 1995.
37. Quirce S, Dimich-Ward H, Chan H, et al: Major cat allergen (Fel d I) levels in the homes of patients with asthma and their relationship to sensitization to cat dander. Ann Allergy Asthma Immunol 75, 325-30, 1995.