Variant Effect of First- and Second-Generation Antihistamines as Clues to Their Mechanism of Action on the Sneeze Reflex in the Common Cold

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 wi...

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Bibliographic Details
Published in:Clinical Infectious Diseases 2001-11, Vol.33 (9), p.1483-1488
Main Authors: Muether, Philipp S., Gwaltney, Jack M.
Format: Article
Language:English
Subjects:
Adult
Allergies
Biological and medical sciences
Common Cold - drug therapy
Common Cold - metabolism
Common Cold - physiopathology
Common Cold - virology
Histamine and antagonists. Allergy
Histamine H1 antagonists
Histamine H1 Antagonists - therapeutic use
Histamines
Human experimentation
Humans
Infections
Intercellular Adhesion Molecule-1 - metabolism
Loratadine - therapeutic use
Major
Major Articles
Medical sciences
Mucus
Pharmacology. Drug treatments
Placebos
Rhinovirus
Rhinovirus - drug effects
Rhinovirus - metabolism
Secretion
Sneezing
Sneezing - drug effects
Treatment Outcome
Viral Load
Viruses
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Summary: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.
ISSN:1058-4838
1537-6591
DOI:10.1086/322518