Continuous antihistamine treatment controls allergic inflammation and reduces respiratory morbidity in children with mite allergy

Allergy. 1999 Apr;54(4):358-65. doi: 10.1034/j.1398-9995.1999.00920.x.


Background: Allergic reaction is characterized by a complex inflammatory process. Some of the new antihistamines have antiallergic effects and can affect the inflammatory cell recruitment via adhesion molecule downregulation. We aimed to assess in a 12-month study whether continuous treatment with an antihistamine (terfenadine) can reduce respiratory symptoms and local inflammation in children with mite allergy.

Methods: The study was double-blind and placebo-controlled: it involved two parallel groups of children suffering from rhinoconjunctivitis and/or mild intermittent asthma due to mite allergy. They received either terfenadine (1 mg/kg per body weight per day) or placebo for 1 year. Nasal, conjunctival, and bronchial symptoms were recorded by diary cards; at each of the programmed control visits, a nasal scraping for inflammatory cells and ICAM-1 was performed. Some additional clinical parameters were also recorded: days of school absence, extra visits for acute respiratory symptoms, and days of hospital admission.

Results: Only children treated with terfenadine achieved significant control of symptoms (P<0.05 in 8 out of 12 months) and allergic inflammation, as shown by inflammatory cell infiltrate and ICAM-1 expression at nasal level (P<0.001), and had significantly fewer extra visits and school absences than the placebo group (P<0.03). No side-effects were reported in either group.

Conclusions: The present study demonstrates that continuous terfenadine treatment (1 mg/kg body weight per day) could decrease respiratory symptoms and allergic inflammation, and it had an additional antiallergic effect in reducing ICAM-1 expression on nasal epithelial cells. Therefore, the present results confirm the efficacy of a long-term therapeutic strategy in controlling allergic inflammation.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Animals
  • Antigens, Dermatophagoides
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Dust
  • Glycoproteins / analysis*
  • Histamine H1 Antagonists / therapeutic use*
  • Humans
  • Immunohistochemistry
  • Inflammation Mediators / blood
  • Intercellular Adhesion Molecule-1 / metabolism
  • Mites / immunology*
  • Nasal Mucosa / cytology
  • Nasal Mucosa / immunology
  • Respiratory Hypersensitivity / immunology
  • Respiratory Hypersensitivity / pathology
  • Respiratory Hypersensitivity / therapy*
  • Terfenadine / therapeutic use*
  • Treatment Outcome


  • Antigens, Dermatophagoides
  • Dust
  • Glycoproteins
  • Histamine H1 Antagonists
  • Inflammation Mediators
  • Intercellular Adhesion Molecule-1
  • Terfenadine