Enhancement of clara cell 10-kD protein (CC10) production from nasal epithelial cells by fexofenadine hydrochloride.

BACKGROUND: Clara cell 10-kD protein (CC10) is well known to be an immuno-suppressive protein secreted from airway epithelial cells after inflammatory stimulation and is involved in the development of allergic disorders. Although histamine H1 receptor antagonists are used for the treatment of allergic disorders, the influence of the agents on CC10 production is not well understood. In the present study, we examined the influence of a histamine H1 receptor antagonist, fexofenadine hydrochloride (FEX) on CC10 production in vitro and in vivo. METHODS: Nasal epithelial cells (5 x 10(6) cells/ml) were stimulated with 20 ng/ml TNF-alpha in the presence of various concentrations of FEX for 24 hours. CC10 levels in culture supernatants were examined by ELISA. Patients with Japanese cedar pollinosis were treated orally with FEX twice a day at a single dose of 60 mg for two weeks during Japanese cedar pollen season (February 2011 to April 2011). CC10 levels in nasal secretions were also examined by ELISA. RESULTS: The addition of FEX into cell cultures caused increase in CC10 production induced by TNF-alpha stimulation, and the minimum concentration that caused significant increase was 200 ng/ml. Oral administration of FEX also increased CC10 levels in nasal secretions from pollinosis patients along with attenuation of clinical symptoms. CONCLUSION: The ability of FEX to enhance CC10 production may account, at least in part, for the clinical efficacy of the agent in allergic disorders, including allergic rhinitis.

Examination, diagnosis and classification for Japanese allergic rhinitis: Japanese guideline.

Many countries throughout the world have experienced an increase in the prevalence of allergic rhinitis (AR), which has come to be a major cause of morbidity in developed countries. The pathology underlying AR is regarded as IgE-mediated type I allergy characterized by mucosal inflammation that occurs in response to allergen exposure. In Japan, AR caused by Japanese cedar pollen, the most common allergic disease, has become a salient public health challenge. Almost all primary care physicians and otorhinolaryngologists have been consulted by AR patients between February and April. Although most such patients have received treatment, numerous patients with AR have not received proper examinations for AR. Clinical guidelines are systematically developed statements that are designed to help practitioners make decisions about appropriate and effective health care. Guidelines in many countries including Japan have been published for AR. Unfortunately, those guidelines have remained untested. Moreover, they might be difficult for non-specialists to use. In this review, we specifically examine the present standard examination for diagnosis of AR and optimal classification for AR in Japan. We hope that this review would be used not only for the support of daily practice but also for selection of AR patients for clinical trials.

Mechanism of salivary secretion enhancement by Byakkokaninjinto.

Byakkokaninjinto (BN) is a Kampo preparation used for the treatment of xerostomia induced by drug, ageing, Sjogren syndrome, etc. The mechanism for BN to induce salivary secretion has not been made clear. In this study, various rat thirst models were prepared using muscarinic receptor blockers, such as 4-diphenylacetoxy-N-methylpiperidine (4-DAMP) and atropine, or adrenoceptor blockers, such as phentolamine and propranolol, in order to investigate the efficiency of BN. When BN was orally administered to the rats in the dose range of 100 to 300 mg/kg, the salivary secretion increased in a dose-dependent manner. The suppression of salivary secretion induced by phentolamine, atropine, and 4-DAMP was recovered by the additional treatment of BN. Interestingly, BN treatment increased the expression of aquaporin 5 in rats, which is known to regulate salivary secretion from the submandibular gland. These results suggested that BN increased the expression of aquaporin 5 through activation of muscarinic M3 receptor and enhanced salivary secretion.

[Combination steroid and hyperbaric oxygenation therapy for sudden idiopathic sensorineural hearing loss].

We retrospectively evaluated the efficacy of combination therapy with steroid and hyperbaric oxygenation for sudden idiopathic sensorineural hearing loss (SISNHL). Patients (n: 109; 111 ears) visited our clinic within 14 days from onset before receiving treatment between January 1999 and March 2003. Hearing loss was assessed based on criteria prepared by the Ministry of Health and Welfare Acute Severe Hearing Loss Study Group. Patients were distributed into Group I-95 patients who started treatment within 7 days from onset-, and Group II-14 patients who started treatment within 8-14 days from onset. We evaluated the outcome of therapy using grading established by The Research Committee on Acute Profound Deafness, Ministry of Health and Welfare, Japan. The complete recovery of hearing was worse in patients with severe hearing loss. It was 4.8% in grade 4a, 18.2% in grade 3a, 25% in grade 2a, 20.0% in grade 4b, 38.5% in grade 3b, and 66.7% in grade 2b. We studied the relationship between type of hearing loss and recovery after treatment. The complete recovery of hearing was most favorable in patients with low tone hearing loss, followed by those with middle tone hearing loss and those with horizontal hearing loss. These findings indicate that the type of hearing loss was the most significant determinant of SISNHL prognosis and course. Twenty patients with acute stage SISNHL had diabetes mellitus. The recovery of hearing was almost the same in those with and without diabetes mellitus. Recovery was complete in 32.4%, Niarked in 32.4%, and slight in 21.6%. In 13.5%, no change was observed. Our results and data from previous reports, involving more than 70 Japanese patients treated with steroids alone, suggest that combination therapy with steroid and hyperbaric oxygenation is effective for SISNHL.