The effect of ketotifen on inflammatory markers in allergic conjunctivitis: an open, uncontrolled study

BACKGROUND: The efficacy and safety of ketotifen eye drop treatment in allergic conjunctivitis (AC) management is perfectly known by several studies, but the mechanism of action at the biochemical levels is poorly understood so we decided to perform an open, uncontrolled study in order to investigate the effect of the topical administration of ketotifen fumarate 0.05% on biochemical markers of inflammation on conjunctival cells in patients with AC. METHODS: Nineteen patients with symptoms and signs of AC (itching, discharge, burning, redness, increase in the watery discharge, swelling and follicles) and with a history of allergy were prescribed with two daily instillation of one drop of eyewash ketotifen fumarate 0,05% in both eyes during thirty days. They were studied by measuring clinical and immunologic parameters. RESULTS: Ketotifen fumarate treatment significantly reduced the total symptoms and signs score for each patient as well as each symptoms and signs at all time points compared with day 0 (p < 0.0001 and p < 0.016, respectively). Although the percentage of HLA-DR+ epithelial cells diminished only in 58% of patients, the numbers of CD29+ and eotaxin+ epithelial cells dropped significantly in 68% and 73 % of them (p < 0.0062 and <0.0082, respectively) as a consequence of the treatment. In 9 out of 19 patients a simultaneous decrease in the percentage of epithelial cells positive for CD29 and eotaxin was observed. CONCLUSION: Ketotifen besides the well-known effect in reducing signs and symptoms of AC significantly diminished production of eotaxin and expression of CD29 by epithelial cells in patients with seasonal AC

Clinical Signs and Symptoms are not Enough for the Correct Diagnosis of Allergic Conjunctivitis

Background: Allergic Conjunctivitis (AC) has a high incidence in the general population and sometimes it is difficult to make a correct diagnosis, distinguish among the different subtypes of AC, and therefore, to indicate the suitable therapy. Objective: To determine the best way to carry out an appropriate diagnosis of AC. Methods: Thirty-one patients with clinical manifestations of AC and eleven controls were studied by measuring allergic and immunologic parameters. Only those patients confirmed as having AC were treated with ketotifen fumarate and further evaluated. Results: According to allergic and immunological parameters patients were divided rate two groups. Group I patients had positive prick test toward at least one allergen, 60% exhibited high levels of tear-IgE, and only 36% conjunctival eosinophils. By contrast, patients from Group II had negative prick tests and laboratory findings similar to the control group. In Group I there was a good correlation between levels of tear-IgE and eosinophils (r = 0.55; p = 0.009); key symptoms and signs and prick test (r = 0.52; p = 0.015), and prick test and eosinophils (r = 0.50 p = 0.022). The cardinal signs and symptoms scores dropped significantly in Group I as a consequence of the treatment (p < 0.0001). Conclusion: In order to have a reliable AC diagnosis, allergen-skin prick test. IgE in tears, and conjunctival eosinophils must be studied. Serum IgE is less important.Fil: Martín, A. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas; ArgentinaFil: Gómez Demel, E. Universidad de Buenos Aires. Hospital Privado; ArgentinaFil: Gagliardi, J. Universidad de Buenos Aires. Hospital Privado; ArgentinaFil: Berra, Alejandro. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Mariani, A.L. Universidad Nacional de Misiones; ArgentinaFil: Baena Cagnani, C.E. Hospital Infantil Municipal de Córdoba; ArgentinaFil: Daraio, M.C. Universidad de Buenos Aires. Hospital Privado; ArgentinaFil: Urrets Zavalía, Julio. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Urrets Zavalía, Enrique Alberto. Universidad Católica de Córdoba. Facultad de Ciencias de la Salud; ArgentinaFil: Gallino, N. Universidad de Buenos Aires. Hospital Privado; ArgentinaFil: Serra, Horacio M. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas; Argentin

Integrated care pathways for airway diseases (AIRWAYS-ICPs)

The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life. In the longer term, the incidence of disease may be reduced by innovative prevention strategies. AIRWAYSICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers)