Prevention of Mast-Cell Degranulation by Ketotifen in Patients with Physical Urticarias

  1. DAVID P. HUSTON, M.D.;
  2. ROBERT B. BRESSLER, M.D.;
  3. MICHAEL KALINER, M.D.;
  4. LAURA K. SOWELL, R.N.; and
  5. MARJORIE W. BAYLOR, R.N.
  1. Houston, Texas; and Bethesda, Maryland

    Abstract

    The capacity for ketotifen to prevent mast-cell degranulation in vivo was studied in patients with physical urticarias. Patients were exposed to the appropriate stimulus to elicit their physical urticaria before and during ketotifen therapy. Histamine concentrations in plasma samples, obtained before and serially after the physical provocation, were determined by radioenzymatic thin-layer chromatography. Ketotifen therapy was associated with marked reductions in plasma histamine levels after stimulation and in clinical evidence of urticaria in each patient. A direct correlation of ketotifen therapy and a reduction in histamine release was confirmed in a patient with a cold-induced urticaria who was studied again after discontinuation and again after reinstitution of therapy. Although the mechanism of action is unknown, this report shows that ketotifen is capable of inhibiting cutaneous mast-cell degranulation and its accompanying symptoms. These findings suggest important therapeutic alternatives for patients with mast-cell-mediated diseases.

    Article and Author Information

    • ▸From the Immunology Sections, Departments of Medicine and of Microbiology and Immunology, Baylor College of Medicine and The Methodist Hospital, Houston, Texas; and the Allergic Diseases Section, Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

    • Grant support: in part by grant AI00519 from the National Institute of Allergy and Infectious Diseases, and grant RR-00350 from the National Institutes of Health to the General Clinical Research Center at the Methodist Hospital and Baylor College of Medicine. Dr. Huston is the recipient of a Clinical Investigator Award from the National Institute of Allergy and Infectious Diseases.

    • ▸Requests for reprints should be addressed to David P. Huston, M.D.; The Methodist Hospital, 6565 Fannin Street, M.S. F-501; Houston, TX 77030.

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    1. Ann Intern Med April 1, 1986 vol. 104 no. 4 507-510
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