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Clinical Trial
. 2001 Nov 1;33(9):1483-8.
doi: 10.1086/322518. Epub 2001 Oct 4.

Variant effect of first- and second-generation antihistamines as clues to their mechanism of action on the sneeze reflex in the common cold

P S Muether  1 , J M Gwaltney Jr
Affiliations
Clinical Trial

Variant effect of first- and second-generation antihistamines as clues to their mechanism of action on the sneeze reflex in the common cold

P S Muether et al. Clin Infect Dis. .

Abstract

Treatment with first-generation antihistamines reduces sneezing, rhinorrhea, nasal mucus weight, and, in some instances, cough in subjects with experimental or natural colds; however, treatment with second-generation antihistamines has not been effective for these complaints in trials in subjects with natural colds. This article reports the negative results of a clinical trial with loratadine, a second-generation antihistamine, in adults in the rhinovirus challenge model. This finding in the highly controlled setting of the challenge model confirms the earlier negative studies with second-generation antihistamines in natural colds. First-generation antihistamines block both histaminic and muscarinic receptors as well as passing the blood-brain barrier. Second-generation antihistamines mainly block histaminic receptors and do not pass the blood-brain barrier. The effectiveness of first-generation antihistamines in blocking sneezing in colds may be due primarily to neuropharmacological manipulation of histaminic and muscarinic receptors in the medulla.

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Figures

Table 1
Table 1
Infection and illness rates in adults with experimental rhinovirus colds given loratadine or placebo.
Figure 2
Figure 2
Geometric mean (±SE) viral titers, mean (±SE) nasal mucus weights, and mean (±SE) symptom scores in adults with experimental rhinovirus colds given loratadine or placebo.
Figure 1
Figure 1
Mean (±SE) sneezing severity scores in adults with experimental rhinovirus colds given loratadine or placebo.
Figure 3
Figure 3
Mean (±SE) nasal fluid ICAM-1 levels in adults with experimental rhinovirus colds given loratadine or placebo.
Figure 4
Figure 4
Pathway of the sneeze reflex
See this image and copyright information in PMC

References

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