Eotaxin-1 (CCL11) up-regulation in tears during seasonal allergic conjunctivitis.

PURPOSE: To compare in-season eotaxin-1 levels in tears of patients suffering from seasonal allergic conjunctivitis (SAC) with (1) tears of normal subjects and (2) tears of SAC patients out of season. METHODS: Tears of 11 SAC patients and six control volunteers were collected during the pollen season. Tears of five SAC patients showing a strong sensitivity to grass pollen (skin-prick tests and specific serum IgE) were collected both in season and out of season. ELISA measured eotaxin-1 level. RESULTS: Eotaxin-1 concentration in tears of SAC patients [2,100+/-503 (SEM) pg/ml] and normal subjects (1,193+/-176 pg/ml) were significantly different (P=0.0049). Regarding allergic patients, the clinical score (sum of five allergic criteria) was significantly different in season and out of season (P=0.0043) as was also the case with eotaxin-1 concentration (P=0.024). CONCLUSIONS: The eotaxin-1 concentration in tears of patients showing hay fever could confirm a diagnosis of seasonal ocular allergy.

Onset and duration of action of ketotifen 0.025% and emedastine 0.05% in seasonal allergic conjunctivitis : efficacy after repeated pollen challenges in the vienna challenge chamber.

OBJECTIVE: To compare the efficacy, onset and duration of action, and the safety of ketotifen fumarate 0.025% ophthalmic solution and emedastine difumarate 0.05% ophthalmic solution in subjects with seasonal allergic conjunctivitis (SAC) induced by allergen exposure, using the Vienna Challenge Chamber model. DESIGN AND SETTING: This was a double-masked, randomised, comparative, crossover study conducted at an allergy outpatient clinic in Austria. STUDY PARTICIPANTS: Subjects with an allergy to grass pollen were exposed to the allergen in a pollen chamber for 4 hours, followed by a 3-hour break and then a second exposure for 3 hours. INTERVENTIONS: Study participants were randomised to a treatment sequence (ketotifen followed by emedastine or emedastine followed by ketotifen), receiving 1 drop per eye of ketotifen or emedastine 2 hours after the initial allergen exposure in the pollen chamber. OUTCOMES: Individual and composite ocular, individual and composite nasal, and total (ocular + nasal) symptom complex scores were determined by repeated exposure to allergen 0-2 hours and 5-8 hours after dosing. Onset of action was defined as the time to the first observation of a 20% reduction from baseline in the composite ocular symptom score. RESULTS: All 37 subjects enrolled completed the study. The median time to onset of action was 15 minutes for ketotifen and 30 minutes for emedastine. This difference was significant using the generalised linear model (p = 0.048), but not for the log-rank test analysis. In the initial 2 hours post dose, ketotifen provided significantly greater relief of both composite ocular symptoms (p = 0.026) and total symptom complex (p = 0.014). Both medications were effective in reducing symptoms 5 to 8 hours after dosing. No adverse events were reported for either treatment. CONCLUSIONS: In the Vienna Challenge Chamber model, ketotifen and emedastine both effectively alleviated ocular symptoms of SAC after single-dose administration. Ketotifen had a faster onset of action and provided better symptom relief than emedastine during the first 2 hours after dosing. The rapid onset of action and symptom control make ketotifen a valuable treatment for SAC.

Fomivirsen.

Cytomegalovirus (CMV) retinitis can rapidly lead to blindness in patients with acquired immune deficiency syndrome (AIDS). Fomivirsen is a novel antisense drug with a 21-nucleotide sequence complementary to the immediate early region 2 of CMV messenger ribonucleic acid. In clinical trials, fomivirsen was shown to provide effective treatment for newly diagnosed, peripheral CMV retinitis in patients with AIDS and in those with relapsed CMV retinitis that is unresponsive to conventional therapy. These trials also demonstrated that local treatment with fomivirsen does not result in measurable systemic absorption of fomivirsen or its metabolites. Thus, there is minimal risk of systemic exposure to fomivirsen or its metabolites with intravitreal dosing at either 165 mcg or 330 mcg. The only clinically relevant adverse events are mild to moderate local ocular effects that are transient and manageable with topical medications. (c) 2001 Prous Science. All rights reserved.