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Background: The main objective of this randomized, double-blind, parallel-group, comparative study was to assess the efficacy and safety of rupatadine 10 mg (R10) and 20 mg (R20) administered once-daily for two weeks compared with those of loratadine 10 mg (L10) in the treatment of seasonal allergic rhinitis (SAR)., Methods: A total of 339 SAR patients were randomized to receive R20 (111 patients), R10 (112 patients) or L10 (116 patients). The main efficacy variable was the mean total daily symptom score (mTDSS) based on the daily subjective assessment of the severity of rhinitis symptoms--rhinorrhea, sneezing, nasal itching, nasal obstruction, conjunctival itching, tearing and pharyngeal itching--recorded by patients., Results: The mTDSS was significantly lower in the groups treated with R20 (0.80 +/- 0.46) and R10 (0.85 +/- 0.52) than in the group treated with L10 (0.92 +/- 0.51) by protocol analysis (p = 0.03) but not by intention-to-treat analysis. The secondary variables used to assess efficacy (mDSS, DSSmax, CSS and TCSS) also showed significantly milder symptoms in patients treated with R20 and R10, particularly in sneezing and nasal itching. All treatments were well tolerated and no serious adverse events were recorded. Headache was the most frequent non-serious adverse event, and these did not show significant differences between treatments at similar dose levels. Somnolence was more frequent in R20 than in the other two groups., Conclusions: The present results suggest that rupatadine 10 mg a day may be a valuable and safe alternative for the symptomatic treatment of seasonal allergic rhinitis.

The non-standardized Cupressus sempervirens allergen extract currently available for the diagnosis of cypress allergy has a low level of activity. The search for an active material consisted of in vitro and in vivo comparison of three Cupressaceae pollen extracts: Cupressus sempervirens (Cs), Cupressus arizonica (Ca) and Juniperus ashei (Ja) (synonyms: Juniperus sabinoides and Mountain Cedar). These 3 trees belong to the same botanical family of Cupressaceae. While Cs and Ca are commonly encountered in Mediterranean regions, Ja is only present in Europe in the Balkans, but is a major cause of allergy in the USA. In vitro, with a similar protein content, the allergenic properties of Ja extract are 20-Fold higher than those of Cs and 11-fold higher than those of Ca. IgE immunoblotting revealed 14, 42 and 70 kDa allergens common to all 3 extracts. The inhibition curves of the 3 extracts were more than 88% parallel. A significant correlation was observed between serum specific IgE titres for Ja and Cs in 23 patients (r = 0.916; p < 0.001). In vivo, in 23 patients with cypress allergy, the mean diameter of the prick test papule at 1/20 W/V of Ja (8.3 mm) was greater than that of the Cs papule (6.3 mm) (p = 0.001) and the Ca papule (6.7 mm) (p < 0.001). Correlations between cutaneous responses to Cs and Ja (r = 0.629; p = 0.002), and to Cs and Ca (r = 0.75; p = 0.001) were significant. These results demonstrate the intense cross-reactivity between Cs, Ca and Ja. The allergenic potency of the Ja extract is superior to that of Cs and Ca extracts, both in vitro and in vivo. This superiority is correlated with a high concentration of the major allergen, Jun a 1. The non-standardized The now standardized extract of in vitro ashei pollen therefore represents an effective and documented solution for identification, and probably for treatment, of Cupressaceae pollen allergy.

A study of the genealogy of a 53 year old lady (A.M...) suffering from diffuse interstitial pulmonary fibrosis (FID) has revealed several cases of FID in her forbears and relations. Two brothers of A.M... died of histologically proven FID; FID was also discovered in one of their daughters. A sister died young of some unclassified respiratory problem. Two cousins died likewise at a young age of acute FID proven histologically. The level of spontaneous pneumothorax was particularly elevated in this family which represented a clinical peculiarity when compared to sporadic FID. The most probable mode of transmission of familial FID is autosomal dominant with variable penetrance. The HLA group seen in A.M... showed the A2 and B12 alleles. The B12 allele was also present in the niece of A.M...