Summary
Allergic conjunctivitis, unlike several other ocular diseases, is seldom followed by permanent visual impairment; nevertheless, it is important because of both its frequency and its severity. Two major forms, seasonal and perennial, are considered in this review.
To recognise the hallmarks of allergic conjunctivitis, clinicians have need of a thorough knowledge of its pathophysiological aspects and clinical features, enabling them to choose the best and most suitable therapy among the alternatives. The aims of treatment vary according to the symptoms, severity and characteristics of the allergic reactions; in general, treatment is based mainly on environmental control, pharmacotherapy and (sometimes) specific immunotherapy.
Topical vasoconstrictors, decongestant compounds, standard antihistamines or combinations of these drugs have been used for a number of years to treat the acute and/or persistent symptomatology, and in order to prevent the side effects of a prolonged treatment with topical glucocorticosteroids. Nevertheless, the latter represent the most powerful anti-inflammatory drugs, and are particularly recommended in short term treatment (5 to 7 days) in severe acute symptomatology. Orally administered ‘classic’ antihistamines, i.e. histamine H1-receptor antagonists, are effective and very convenient in either short or long term treatment, largely because the new compounds also act on the inflammatory process secondary to the allergic events.
Recently, other topical compounds such as sodium cromoglycate (cromolyn sodium), nedocromil and nonsteroidal anti-inflammatory drugs (NSAIDs) [i.e. piroxicam, aspirin] have become available. Sodium cromoglycate and nedocromil act as prophylactic compounds, able to prevent the allergic reaction; NSAIDs represent a valid and effective alternative to glucocorticosteroids in several situations.
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References
Abelson MB, Allansmith MR, Friedlander MH. Effects of topically applied ocular decongestant and antihistamines. American Journal of Ophthalmology 90: 254, 1980
Abelson MB, Brutus SI, Weston SM. Aspirin therapy in vernal conjunctivitis. American Journal of Ophthalmology 95: 502–505, 1983
Abramson SB, Weissman G. The mechanisms of action of non steroidal antiinflammatory drugs. Arthritis and Rheumatism 32: 1, 1989
Allansmith MR. The eye and immunology, Mosby, St Louis, 1982
Altounyan REC. Review of the clinical activity and modes of action of sodium cromoglycate. In Pepys & Edwards (Eds) The mast cell — its role in health and disease, pp. 199–216, Pitman Medical, London, 1979
Andersson P, Berstrand H. Antigen-induced bronchial anaphylaxis in actively sensitized guinea pigs: effect of long-term treatment with sodium cromoglycate and aminophylline. British Journal of Pharmacology 74: 601–609, 1981
Awouters F, Niemegeers CJE, Janssen PAJ. Oxatomide: the prototype of a chemical series of compounds inhibiting both the release and the effects of allergic mediators. In Temple (Ed.) Drugs affecting the respiratory system, pp. 179–208, American Society Symposium Series, 1980
Barnett A, Iorio LC, Kreutner W, Tozzi S, Ahn HS, et al. Evaluation of the CNS properties of SCH 29851, a potential nonsedating antihistamine. Agentsand Actions 14: 590–597, 1984
Bee P, Berard P, Bonnet M, Cazillas JM, Chagnon A, et al. Cromoglycate de sodium en collyre dans les conjonctives allergiques: étude controlée multicentrique á double insu. Revue de la littérature. Journal Français d’Opthalmologie 5: 727–732, 1982
Bernstein IL, Johnson CL, Tse CST. Therapy with cromolyn sodium. Annals of Internal Medicine 89: 228–233, 1978
Boland N. A double-blind study of astemizole and terfenadine in the treatment of perennial rhinitis. Annals of Allergy 61: 18–24, 1988
Bonini St, Bonini Se, Vecchione A, Naimi DM, Allansmith MR, et al. Inflammatory changes in conjunctival scraping after allergen provocation in humans. Journal of Allergy and Clinical Immunology 82: 462, 1988a
Bonini St, Bonini Se, Todini V, Adriani E, Allansmith MR. Late-phase ocular reaction induced by conjunctival allergen challenge: a dose response study in humans. Journal of Allergy and Clinical Immunology 81: 173, 1988b
Bonnet M, Ducournau D, Lumbroso P, Serpin G. L’acide N-acetyl aspartyl glutamique en collyre dans les conjonctivites de type allergique. Etude dinique comparative en double ensu. Journal Francais d’Ophtalmologie 8: 573–578, 1985
Bousquet J, Lebel B, Chanal I, Morel A, Michel FB, et al. Antiallergic activity of loratadine and terfenadine assessed by nasal challenge. Journal of Allergy and Clinical Immunology 81: 228, 1988
Brandon ML, Weiner M. Clinical investigation of terfenadine, a nonsedating antihistamine. Annals of Allergy 44: 71–75, 1980
Braquet P, Touquil S, Vargraftig BB. Perspective in platelet-activating factor. Research of Farmacology Rev. 39: 97–145, 1987
Brion N, Beaumont D, Adevnier C. Evaluation of the antimuscarinic activity of atropine, terfenadine and mequitazine in healthy volunteers. British Journal of Clinical Pharmacology 25: 27–32, 1988
Brobyn R, Benoit M, Cleaver K. Perennial rhinitis, treated with astemizole. Journal of Allergy and Clinical Immunology 69: 110, 1982
Brogden RN, McTavish D. Acrivastine: a review of its pharmacological properties and therapeutic efficacy in allergic rhinitis, urticaria and related disorders. Drugs 41: 927–940, 1991
Brooks CD, Karl KJ. Hay fever treatment with combined antihistamine and cyclooxygenase-inhibiting drugs. Journal of Allergy and Clinical Immunology 81: 1110–1117, 1988
Bruttmann G, Arendt C, Bernheim J. Double-blind placebo controlled comparison of cetirizine 2HC1 and terfenadine in atopic perennial rhinitis. Acta Therapeutica 15: 99–109, 1989a
Bruttmann G, Charpin D, Germounty J, Horak F, Kunkel G, et al. Evaluation of the efficacy and safety of loratadine in perennial allergic rhinitis. Journal of Allergy and Clinical Immunology 83: 411–416, 1988b
Businco L, Bellioni P, Benincori N, Bruno G, Di Cicco C, et al. Oral ketotifen versus disodium cromoglycate nasal spray for the prophylactic treatment of pollen-induced allergic manifestations. Current Therapeutic Research 35: 239–246, 1984
Callier J, Engelen RF, Ianniello I, Olzem R, Zeisner M, et al. Astemizole (R43512) in the treatment of hay fever: an international double-blind study comparing a weekly treatment (10mg and 25mg) with a placebo. Current Therapeutic Research 29: 24–35, 1981
Campoli-Richards DM, Buckley MM-T, Fitton A. Cetrizine: a review of its pharmacological properties and clinical potential in allergic rhinitis, pollen-induced asthma, and chronic urticaria. Drugs 40: 762–781, 1990
Canonica GW, Ciprandi G. Antiallergic drugs and the immune response: interaction and possible clinical relevance. Allergy 41: 1–5, 1989
Canonica GW, Scordamaglia A, Bagnasco M, Ciprandi G. Drugs and the immune response: perspective in allergology. Annals of Allergy 62: 483–488, 1989
Capron M. Eosinophils in disease: receptors and mediators. In Pichler et al. (Eds) Progress in allergy and clinical immunology, pp. 6–11, Hogrefe H Huber Publications, Toronto, 1989
Carpenter GB, Bunker-Soler AL, Nelson HS. Evaluation of combined H1 - and H2 -receptor blocking agents in seasonal rhinitis. Journal of Allergy and Clinical Immunology 71:412–417, 1983
Cerqueti PM, Saccá S, Preste A, Ciprandi G. Collirio di piroxicam nel trattamento di congiuntiviti allergiche pollinosiche. Bollettino di Oculistica 66: 179–182, 1987
Chin GN. Treatment of vernal keratoconjunctivitis with topical cromolyn sodium. Journal of Pediatric Ophthalmology and Strabismus 15: 326–329, 1978
Chung KF, Minette P, McCusker M, Barnes PJ. Ketotifen inhibits the cutaneous but not the airway responses to platelet-activating factor in man. Journal of Allergy and Clinical Immunology 81: 1192–1198, 1988
Ciprandi G, Buscaglia S, Iudice A, Canonica GW. Protective effects of terfenadine on specific conjunctival provocation test. Clinical and Experimental Allergy 20 (Suppl. 1): 55, 1990a
Ciprandi G, Cerqueti PM, Saccà S, Cilli P, Canonica GW. Levocabastine versus cromolyn sodium in the treatment of polleninduced conjunctivitis. Annals of Allergy 65: 156–158, 1990b
Ciprandi G, Cerqueti PM, Saccà S, Ciurlo G, Canonica GW. Nonsteroidal treatment of pollinosic conjunctivitis: comparison of different pharmacologic protocols. Allergy 46: 393–395, 1991
Clissold SP, Sorkin EM, Goa KL. Loratadine: a preliminary review of its pharmacodynamic properties and therapeutic efficacy. Drugs 37: 42–57, 1989
Corrado OJ, Gomez E, Baldwin DL, Claque JE, Davies RJ. The effect of nedocromil sodium on nasal provocation with allergen. Journal of Allergy and Clinical Immunology 80: 218–222, 1987
Cox JSG. Disodium cromoglycate, FPL670 (Intal): a specific inhibitor of reaginic antibody/antigen mechanisms. Nature 216: 1328–1329, 1967
Craps LP, Ney UM. Ketotifen: current views on its mechanism of action and their therapeutic implications. Respiration 45: 411–421, 1984
Dahlen SE, Bjorck T, Kumlin M, Sydbom A, Raud J, et al. Dual inhibitory action of nedocromil sodium on antigen-induced inflammation. Drugs 37: 63–68, 1989
Davies BH, Mullins J, Couch HA. Prophylactic treatment of seasonal allergic rhinitis: a comparison of cetirizine (Zirtek) and terfenadine (Triludan). Clinical Trials Journal 26: 100–107, 1989
Dawson JP. Comparative trial of 2% sodium cromoglycate unit dose eye drops in seasonal allergic conjunctivitis. In Pepys & Edwards (Eds) The mast cell — its role in health and disease, pp. 199–216, Pitman Medical, London, 1979
Dechant KL, Goa KL. Levocabastine: a review of its pharmacological properties and therapeutic potential as a topical antihistamine in allergic rhinitis and conjunctivitis. Drugs 41: 202–224, 1991
De Weck AL. Does the clinical experience with non-sedating H1 -antagonists justify a reassessment of antihistamines in allergy treatment? Clinical and Experimental Allergy 20 (Suppl. 2): 51–54, 1990
De Cree J, Horig C, Verhaegen H. Oxatomide in the treatment of various allergic diseases. Current Medical Research and Opinion 6: 380–385, 1980
De Vos C, Joseph M, Leprevost C, Vorng H, Tomassini M, et al. Inhibition of human eosinophils chemotaxis and of the IgE-dependent stimulation of human blood platelets by cetirizine. International Archives of Allergy and Applied Immunology 88: 212–215, 1989
Dockhorn RS, Bergner A, Connell JT, Falliers CJ, Grabiec SV, et al. Safety and efficacy of loratadine (SCH-29851): a new non-sedating antihistamine in seasonal allergic rhinitis. Annals of Allergy 58: 407–411, 1987
Douglas WW. Autacoids. In Gilman et al. (Eds) The pharmacological basis of therapeutics, pp. 608–646, McMillan, New York, 1984
El Hennawi M. Clinical trial with 2% sodium cromoglycate (Opticrom) in vernal keratoconjunctivitis. British Journal of Ophthalmology 64: 483–486, 1980
Fadel R, Herpin-Richard N, Rihoux JP, Henocq E. Inhibitory effect of cetirizine 2HC1 on eosinophil migration in vivo. Clinical Allergy 17: 373–379, 1987
Floyd R, Kalpaxis J, Thayer T, Rangus K. Double-blind comparison of HEPP (IgE pentapeptide) 0.5% ophthalmic solution and sodium cromoglycate ophthalmic solution, USP 4% in patients having allergic conjunctivitis. Investigative Ophthalmology and Visual Science 29: 45, 1988
Fox R, Lockey R, Altman L, Lieberman P, Wasserman S, et al. Cetirizine in the treatment of seasonal rhinitis: a comparison with terfenadine. Journal of Allergy and Clinical Immunology 83: 307, 1989
Frankland AW, Walker RS. A clinical comparison of topical clobethasone butyrate and sodium cromoglycate in allergic conjunctivitis. Clinical Allergy 2: 473–478, 1981
Friedlaender MH. Ocular allergy. In Middleton et al. (Eds) Allergy: principles and practice, 3rd ed., pp. 1469–1480, Mosby, St Louis, 1988
Friedlaender MH. Current concepts in ocular allergy. Annals of Allergy 67: 5–13, 1991
Friedman HM. Loratadine: a potent, non-sedating, and long-acting H1 antagonist. American Journal of Rhinology 4: 95, 1987
Gengo FM, Gabos C. Antihistamines, drowsiness and psychomotor impairment: central nervous system effect of cetirizine. Annals of Allergy 59: 53–57, 1987
Gleich GJ. The late-phase of the immunoglobulin E-mediated reaction: a link between anaphylaxis and common allergic disease. Journal of Allergy and Clinical Immunology 70: 160–168, 1982
Gonzalez JP, Brogden RN. Nedocromil sodium: a preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in the treatment of reversible obstructive airways disease. Drugs 34: 560–577, 1987
Goodman LS, Gilman AG, Rall TW, Murad F (Eds) The pharmacological basis of therapeutics, New York, 1990
Grant SM, Goa KL, Fitton A, Sorkin EM. Ketotifen: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in asthma and allergic disorders. Drugs 40: 412–448, 1990
Greenbaum J, Cockcroft D, Hargreave FE, Dolovich J. Sodium cromoglycate in ragweed-allergic conjunctivitis. Journal of Allergy and Clinical Immunology 59: 437–439, 1977
Guill MF, Buckley RH, Rocha Jr W, Kemp JP, Segal AT, et al. Multicenter double-blind placebo-controlled trial of terfenadine suspension in the treatment of fall-allergic rhinitis in children. Journal of Allergy and Clinical Immunology 78: 4–9, 1986
Gutkowski A, Bedard P, DelCarpio J, Hebert J, Prevost M, et al. Comparison of the efficacy and safety of loratadine, terfenadine, and placebo in the treatment of seasonal allergic rhinitis. Journal of Allergy and Clinical Immunology 81: 902–907, 1988
Hechanova Jr MG. A double-blind study comparing sodium cromoglycate eye ointment with placebo in the treatment of chronic allergic conjunctivitis. Clinical Trials Journal 21: 59–66, 1984
Heykants J. Pharmacokinetics and metabolism of astemizole in man. In Astemizole: a new non-sedative, long-acting H1 antagonist, pp. 25-34, Medical Education Services, Oxford, 1984
Hirsch SR, Melamed J, Schwartz RH. Efficacy of nedocromil sodium 2% ophthalmic solution in the treatment of ragweed seasonal allergic conjunctivitis. Journal of Allergy and Clinical Immunology 81: 173, 1988
Howarth PH, Holgate ST. Comparative trial of two non-sedative H1 -antihistamines, terfenadine and astemizole for hay fever. Thorax 39: 668–672, 1984
Inerfield CG, Million R, Singh HS. Cromoglycate eye drops in hay-fever conjunctivitis: a new formulation appears to reduce stinging. Practitioner 228: 543–544, 1984
International New Drug Brochure. Levocabastine (R50547): the first fully specific H1 antagonist, Janssen Pharma, Belgium, 1984
Irander K, Adkvist LM, Ohlander B. Treatment of hay fever with loratadine, a new non-sedating antihistamine. Allergy 45: 86–91, 1990
Juniper EF, Cartier A, Trebicock AL, Frith PA, Dolovich J, et al. Effects of oxatomide compared with chlorpheniramine in allergic rhinoconjunctivitis. Clinical Allergy 11: 61–66, 1981
Juniper EF, White J, Dolovich J. Efficacy of continuous treatment with astemizole (Hismanal) and terfenadine (Seldane) in ragweed pollen-induced rhinoconjunctivitis. Journal of Allergy and Clinical Immunology 82: 670–675, 1988
Kagan G, Dabrowicki E, Huddlestone L, Kapur TR, et al. A double-blind trial of terfenadine and placebo in hay-fever using a substitution technique for non-responders. Journal of International Medical Research 8: 404–407, 1980
Kaiser H, Weisberg S, Morris R, Minneapolis MN, Mansmann H, et al. A comparison of cetirizine and chlorpheniramine vs placebo in the treatment of seasonal allergic rhinitis. Journal of Allergy and Clinical Immunology 93: 306, 1989
Kalpaxis JG, Austin TX. Clinical comparison of IgE pentapeptide (HEPP) and cromolyn (opticrom) in allergic conjunctivitis. Abstract. Annals of Allergy 58: 291, 1987
Kay AB, Varney VA, Gaga M, Aber VR, Durham SR. Usefulness of immunotherapy in patients with summer hay fever uncontrolled by antiallergic drugs. British Medical Journal 302: 265, 1991
Kemp JP, Buckley CE, Gershwin ME, Buchman E, Cascio FL, et al. Multicenter double-blind, placebo-controlled trial of terfenadine in seasonal allergic rhinitis and conjunctivitis. Annals of Allergy 54: 502–509, 1985
Kjellman N-IM, Andersson B. Terfenadine reduces skin and conjunctival reactivity in grass pollen allergic children. Clinical Allergy 16: 441–449, 1986
Kniest FM, Vos H, Young E, de Maart-Blecker F, Koers W, et al. Reduction of rhinitis complaints by acaricidal plus treatment of living environment with salified benzylbenzoate: a triple blind placebo controlled clinical trial. Journal of Allergy and Clinical Immunology 1989
Kreutner W, Chapman RW, Gulbenkian A, Siegel MI. Antiallergic activity of loratadine, a non-sedating antihistamine. Allergy 42: 57–63, 1987
Lanier Q, Tremblan N, Smith JP, De Faller JM. A double masked comparison of ocular decongestants as therapy for allergic conjunctivitis. Annals of Allergy 50: 174–177, 1983
Laduron PM, Janssen PFM, Gommeren W, Leysen JE. In vitro and in vivo binding characteristics of a new long-acting histamine H1 antagonist, astemizole. Molecular Pharmacology 21: 294–300, 1982
Lavin N, Rachelefsky MD, Kaplan SA. An action of disodium cromoglycate: inhibition of cyclic 3′,5′-AMP phosphodiesterase. Journal of Allergy and Clinical Immunology 57: 80–88, 1976
Leclercq-Foucart J, Fernere A, Vanden Bussche G. A double-blind trial comparing astemizole and ketotifen in the suppression of hay fever symptoms. Current Therapeutic Research 39: 875–883, 1986
Leino M, Carlson C, Jaanio E, Koivunen T, Lavikkala H, et al. Double-blind group comparative study of 2% nedocromil sodium eye drops with placebo eye drops in the treatment of seasonal allergic conjunctivitis. Annals of Allergy 64: 398–402, 1990
Leino M, Jaanio E, Koivunen T, Carlson C, Takalo E. A multicenter double-blind group comparative study of 2% nedocromil sodium eye drops (Tilavist) with placebo eye drops in the treatment of seasonal allergic conjunctivitis. Allergologie 19 (Suppl.): 128–129, 1980
Lemanske Jr RF, Kalmer MA. Late-phase allergic reactions. In Middleton et al. (Eds) Allergy: principles and practice, 3rd ed., pp. 224–246, Mosby, St Louis, 1988
Leprevost C, Capron M, De Vos C, Tomassini M, Capron A. Inhibition of eosinophil chemotaxis by a new antiallergic compound (cetirizine). International Archives of Allergy and Applied Immunology 87: 9–13, 1988
Lichtenstein LM, Fauci AS (Eds). Current therapy in allergy, immunology and rheumatology, B.C. Decker Inc., Toronto, 1988
Lindsay-Miller ACM. Group comparative trial of 2% sodium cromoglycate (Opticrom) with placebo in the treatment of seasonal allergic conjunctivitis. Clinical Allergy 9: 271–275, 1979
Maclay WP, Crowder D. Post-marketing surveillance of ketotifen (Zaditen): an interim report. Research and Clinical Forums 4: 51–64, 1982
Mailing H-J (Ed) Immunotherapy position paper. Allergy 43 (Suppl. 6): 1–33, 1988
Malmberg H, Holopainen E, Grahne B, Binder E, Savolainen S, et al. Astemizole in the treatment of hay fever. Allergy 38: 227–231, 1983
Maniatakou GP, Paleologos GK, Kontou-Fili KH. Lack of tachyphylaxis during chronic administration of cetirizine 2HC1, an antagonist of peripheral H1 receptors. Abstract. Clinical and Experimental Allergy 20 (Suppl. 1): 97, 1990
Marlin SD, Staunton DE, Springer TA, Stratowa C, Sommergruber W, et al. A soluble form of intercellular adhesion molecule-1 inhibits rhinovirus infection. Nature 344: 70–72, 1990
Mazurek N, Berger G, Pecht I. A binding site on mast cells and basophils for the anti-allergic drug cromolyn. Nature 286: 722–723, 1980
McTavish D, Goa LK, Ferrell M. Terfenadine: an updated review of its pharmacological properties and therapeutic efficacy. Drugs 39: 552–574, 1990
McTavish D, Sorkin EM. Azelastine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential. Drugs 38: 778–800, 1989
Metzger WJ, Zavala D, Richerson HB, Moseley P, Iwamoto P, et al. Local allergen challenge and bronchoalveolar lavage of allergic asthmatic lungs. American Review Respiratory Diseases 135: 433, 1987
Michel L, De Vos C, Rihoux JP, Burtin C, Benveniste J, et al. Inhibitory effect of oral cetirizine on in vivo antigen-induced histamine and PAF-acether release and eosinophil recruitment in human skin. Journal of Allergy and Clinical Immunology 82: 101–109, 1988
Moller C, Bjorksten B. Oxatomide in seasonal rhinoconjunctivitis. Allergy 35: 319–322, 1980
Monroe EW, Cohen SH, Kalbfleisch J, Schulz CI. Combined H1 and H2 antihistamine therapy in chronic urticaria. Archives of Dermatology 117: 404–407, 1987
Montgomery JS. Epidemiology and natural history of asthma, allergic rhinitis and atopic dermatitis. In Middleton et al. (Eds) Allergy: principles and practice, 3rd ed., Vol. 1, pp. 891–929, Mosby, St Louis, 1988
Moqbel R, Walsh GM, MacDonald AJ, Kay AB. The effects of nedocromil sodium on the activation of human eosinophils, neutrophils and histamine release from mast cells. Allergy 43: 268–276, 1988
Mygind N, Nuchel Petersen B, Nuchel Petersen L, Winl JA. Astemizole in the treatment of perennial non-allergic rhinitis. In Astemizole: a new non-sedative, long-acting H1 antagonist, pp. 87–94, Medical Education Services, Oxford, 1984
Nabe M, Agrawal DK, Sarmiento EU, Townley RG. Inhibitory effect of terfenadine on mediator release from human blood basophils and eosinophils. Clinical and Experimental Allergy 19: 515–520, 1989
Naclerio RM, Proud D, Kagey-Sobotka A, Friedhoff L, Norman PS, et al. The effect of cetirizine on early allergic response. Laryngoscope 99: 596–599, 1989
Nathan RA, Segall N, Schocket AL. A comparison of the actions of H1 and H2 antihistamines on histamine-induced bronchoconstriction and cutaneous wheal response in asthmatic patients. Journal of Allergy and Clinical Immunology 67: 171–177, 1981
Nizami RM. Treatment of ragweed allergic conjunctivitis with 2% cromolyn solution in unit doses. Annals of Allergy 47: 5–7, 1981
Norman PS. Newer antihistaminic agents. Journal of Allergy and Clinical Immunology 76: 366, 1985
Oei HD, Verheij E, Schwab D, Lherminier M, Bruynzeel PLB. A comparative study of the efficacy of loratadine (L) and astemizole (A). Journal of Allergy and Clinical Immunology 79: 190, 1987
Okuda M. Clinical investigation of ketotifen in perennial allergic rhinitis: a double-blind comparative study of ketotifen and clemastine fumarate. Rhinology 22: 171–182, 1984
Okuda M. Prophylactic effect of ketotifen on pollinosis. In Wuthrich & Jager (Eds) The prophylaxis of allergic rhinitis, pp. 28–35, Excerpta Medica, Amsterdam, 1986
Panayotopoulos SM, Panayotopoulou ES. Efficacy of cetirizine in the treatment of seasonal allergic rhinoconjunctivitis. Annals of Allergy 65: 146–148, 1990
Parodi MN, Gao Jing, Villaggio B, Bagnasco M, Canonica GW. The cell adhesion molecules on epithelial cell surfaces. Schweizerische Medizinische Wochenschrift, in press, 1992
Pearlman DS. Antihistamine: pharmacology and clinical use. Drugs 12: 258–273, 1973
Pecoud AR, Huguenot C, Lantin JP. Comparison of one versus two daily doses of terfenadine: effects on skin tests. Journal of Allergy and Clinical Immunology 81: 213, 1988
Pecoud AR, Zuber P, Kolly M. Effect of a new H1 receptor antagonist (levocabastine) in a nasal and conjunctival provocation test. International Archives of Allergy and Applied Immunology 82: 541, 1987
Pipkorn U, Bende M, Hedner J, Hedner T. A double-blind evaluation of topical levocabastine, a new specific H1 antagonist, in patients with allergic conjunctivitis. Allergy 40: 491, 1985
Polansky JR, Wienreb RN. Antiinflammatory agents: steroids as antiinflammatory agents. In Sears (Ed.) Pharmacology of the eye, Handbook of Experimental Pharmacology 89: 459–538, Springer-Verlag, Berlin, 1984
Portellinha W, Belfort Jr R, Molinari H, Paula Silva VL, De Paiva ER. Cromoglicato disodico e corticoide topico nas conjunctivites atopicas cronicas e primaveris. Arquivos Brasileiros Of-talmologia 41: 105–108, 1978
Prowse K. Ketotifen in adult asthma. British Medical Journal 280: 646, 1980
Rackham A, Brown CA, Chandra RK, Ho P, Hoogerwerf PE, et al. A Canadian multicenter study with Zaditen (ketotifen) in the treatment of bronchial asthma in children aged 5 to 17 years. Journal of Allergy and Clinical Immunology 84: 286–296, 1989
Rafferty P, Holgate ST. Terfenadine (Seldane) is a potent and selective histamine H1 receptor antagonist in asthmatic airways. American Review of Respiratory Disease 135: 181–184, 1987
Rak S, Hakanson L, Venge P. Immunotherapy abrogates the generation of eosinophil and neutrophil chemotactic activity during pollen season. Journal of Allergy and Clinical Immunology 86: 706–713, 1990
Richards DM, Brogden RN, Heel RC, Speight TM, Avery GJ. Astemizole: a review of its pharmacodynamic properties and therapeutic efficacy. Drugs 28: 38–61, 1984a
Richards DM, Brogden RN, Heel RC, Speight TM, Avery GJ. Oxatomide: a review of its pharmacodynamic properties and therapeutic efficacy. Drugs 27: 210–231, 1984b
Rimas M, Kjellman NJ, Blychert LO, Bjorksten B. Topical levocabastine protects better than sodium cromoglycate and placebo in conjunctival provocation tests. Allergy 45: 18–21, 1990
Ring J, Behrendt H. H1 and H2 antagonists in allergic and pseudoallergic diseases. Clinical and Experimental Allergy 20 (Suppl. 2): 43–49, 1990
Robinson AC, Cherry JR, Daly S. Double-blind cross-over trial comparing beclomethasone dipropionate and terfenadine in perennial rhinitis. Clinical and Experimental Allergy 19: 569–573, 1989
Roth T, Roehrs T, Koshorek G, Sicklesteel J, Zorick F. Sedative effects of antihistamines. Journal of Allergy and Clinical Immunology 80: 94–98, 1987
Ruggieri ML, Scorcia G. Double-blind group comparative trial of sodium cromoglycate eye treatment and placebo in the treatment of allergic eye diseases. Annals of Allergy 58: 105–112, 1987
Saccà S, Cerqueti PM, Rolando M, Ciprandi G, Ciurlo G. L’impiego per via topica di aspirina nelle congiuntiviti allergiche. Bollettino di Oculistica 67: 193–197, 1988
Saito Y, Baba S, Furuuchi I, Shimizu T. Double blind comparative study of terfenadine vs ketotifen on perennial allergic rhinitis. Oto-rhino-laryngology 31 (Suppl. 7): 963–964, 1988
Schmeisser KJ, Arendt C, Bernheim J. Double-blind comparison of two effective treatments of perennial rhinoconjunctivitis. Acta Therapeutica 15: 87–98, 1989
Schoeneich M, Pecoud AR. Effect of cetirizine in a conjunctival provocation test with allergens. Clinical and Experimental Allergy 20: 171–174, 1990
Secchi AG, Fregona IA, DeCarli M. Allergic conjunctivitis. In Falagiani (Ed.) Pollinosis, pp. 107–114, CRC Press, Florida, 1990
Secher C, Kirkegaard J, Borum P, Maansson A, Osterhammel P, et al. Significance of H1 and H2 receptors in the human nose: rationale for topical use of combined antihistamine preparations. Journal of Allergy and Clinical Immunology 70: 211–218, 1982
Seidel WF, Cohen S, Bliwise NG, Dement WC. Cetirizine effects on objective measures of daytime sleepiness and performance. Annals of Allergy 59: 58–62, 1987
Seppala T, Savolainen K. Effect of astemizole on human psychomotor performance. Current Therapeutic Research 31: 638–644, 1982
Settipane GA. Aspirin and allergic disease: a review. American Journal of Medicine 74(6A): 102, 1983
Settipane GA, Klein OE, Boyd GK. Adverse reactions to cromolyn. Journal of the American Medical Association 241: 811, 1979
Shall L, Newcombe RG, Marks R. Assessment of the duration of action of terfenadine on histamine induced weals. British Journal of Dermatology 119: 525–531, 1988
Siegel SC. Overview of corticosteroids therapy. Journal of Allergy and Clinical Immunology 76: 312–320, 1985
Simons FER, Watson WTA, Simons KJ. Lack of subsensitivity to terfenadine during long-term terfenadine treatment. Journal of Allergy and Clinical Immunology 82: 1068–1075, 1988
Skassa-Brociek W, Bousquet J, Montes F, Verdier M, Schwab D, et al. Double-blind placebo-controlled study of loratadine, me-quitazine, and placebo in the symptomatic treatment of seasonal allergic rhinitis. Journal of Allergy and Clinical Immunology 81: 725–730, 1988
Snyder SH, Snowman AM. Receptor effect of cetirizine. Annals of Allergy 59: 4–8, 1987
Sorkin EM, Heel RC. Terfenadine: a review of its pharmacodynamic properties and therapeutic efficacy. Drugs 29: 34–56, 1985
Sorkin EM, Ward A. Ocular sodium cromoglycate: an overview of its therapeutic efficacy in allergic eye disease. Drugs 31: 131–148, 1986
Springer T. Adhesion receptors of the immune system. Nature 346: 425–433, 1990
Stockwell A, Easty D. Double blind group comparative trial of 2% nedocromil sodium eye drops in the treatment of seasonal allergy conjunctivitis. Investigative Ophthalmology and Visual Science 29: 229, 1988
Theoharides TC, Sieghart W, Greengard P, Douglas WW. Antiallergic drug cromolyn may inhibit histamine secretion by regulating phosphorylation of a mast cell protein. Science 207: 80–82, 1980
Truneh A, White JR, Pearce FL. Effects of ketotifen and oxatomide on histamine secretion from mast cells. Agents and Actions 12: 206, 1982
Trzecrakowski JP, Mendelsohn N, Levi R. Antihistamines. In Middleton et al. (Eds) Allergy: principles and practice, 3rd ed., Vol. I, pp. 715–738, Mosby, St Louis, 1988
Van Bever HP, Stevens WJ. Evolution of the late asthmatic reaction during immunotherapy and after stopping immunotherapy. Journal of Allergy and Clinical Immunology 86: 141–146, 1990
Van Bijsterveld OP, Aalders-Deenstra V. Klinische Erprobung von N-acetyl-aspartyl-glutaminasäure Augentropfen bei subakuter und chronischer atopischer konjunktivitis. Klinische Monatsblatter fur Augenheil Kunde 188: 625–627, 1988
Vane J. The evaluation of non steroidal antiinflammatory drugs and their mechanisms of action. Drugs 33 (Suppl. 1): 18, 1987
Van Epps DE, Kutvirt SG, Potter JW. In vitro effects of cetirizine and histamine on human neutrophil function. Annals of Allergy 59: 13–19, 1987
Van Metre Jr TE, Adkinson Jr VF. Immunotherapy for aeroallergen disease. In Middleton et al. (Eds) Allergy: principles and practice, 3rd ed., pp. 1327–1343, Mosby, St Louis, 1988
Vannieuwenhuys E, Degreef F, De Proost W, Callier J. Oxatomide in the treatment of chronic allergic rhinitis. Annals of Otology, Rhinology and Laryngology 91: 175–178, 1982
Verhaegen H, De Cree J. Treatment of idiopathic chronic urticaria with oxatomide: a placebo-controlled study. Allergologie 3: 30–33, 1980
Warner JO, Goldsworthy SJ. Comparative trial of ketotifen and clemastine in childhood seasonal allergic rhinitis and asthma. Research and Clinical Forums 4: 85–95, 1982
Weeke ER. Epidemiology of hay fever and perennial allergic rhinitis. Monographs in Allergy 21: 1–20, 1987
Wegner CD, Gundel RH, Reilly P, Haynes N, Letts LG, et al. Intercellular adhesion molecules-1 (ICAM-1) in the pathogenesis of asthma. Science 257: 456–459, 1990
Welsh PW, Yuninger JW, Tani DG, Toussaint Jr NF, Larson LA, et al. Topical ocular administration of cromolyn sodium for treatment in seasonal ragweed conjunctivitis. Journal of Allergy and Clinical Immunology 64: 209–215, 1979
Wheatley D. Ketotifen in hay fever and allergic rhinitis. Practitioner 228: 685–686, 1984
Wiech NL, Martin JS. Absence of an effect of terfenadine on guinea pig brain histamine H1 -receptors in vivo determined by receptor binding techniques. Arzneimittel-Forschung 32: 1167–1170, 1982
Wilson JD, Hillas JL. Astemizole: a new long-acting antihistamine in the treatment of seasonal allergic rhinitis. Clinical Allergy 13: 131–140, 1983
Wood S. Oxatomide: a new approach to the treatment of allergic rhinitis. Drugs of Today 18: 341–349, 1982
Wood S. Astemizole in maintenance therapy of hay-fever: a comparison with a long-acting formulation of pheniramine maleate. In Astemizole: a new non-sedative, long-acting H1 antagonist, pp. 63–68, Medical Education Services, Oxford, 1984
Wood SG, John BA, Chasseaud LF, Yeh J, Chung M, The metabolism and pharmacokinetics of 14 C-cetirizine in humans. Annals of Allergy 59 (Part II): 31–34, 1987
Younghaiyud P, Lee TB. Effects of nedocromil sodium on the immediate response to allergen challenge in asthmatic patients. Clinical Allergy 16: 129, 1986
Zuber P, Pecoud A. Effect of levocabastine, a new H1 antagonist, in a conjunctival provocation test with allergen. Journal of Allergy and Clinical Immunology 82: 590–595, 1988
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Ciprandi, G., Buscaglia, S., Cerqueti, P.M. et al. Drug Treatment of Allergic Conjunctivitis. Drugs 43, 154–176 (1992). https://doi.org/10.2165/00003495-199243020-00003
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DOI: https://doi.org/10.2165/00003495-199243020-00003