Adjunct therapy with probiotics for chronic urticaria in children: randomised placebo-controlled trial

Backgrounds Chronic urticaria is a common disorder of the skin, characterised by recurrent skin wheals and angioedema. Recent reports have shown that altered diversity and composition of the gut microbiota may lead to imbalances in immune regulation, a causal factor in the occurrence of chronic urticaria. Objective This study aimed to evaluate the efficacy of the Yimingjia® probiotic formula in the adjuvant treatment of chronic urticaria in children. Methods We enrolled 206 children with confirmed diagnoses of chronic urticaria and randomly assigned them to the treatment (n = 104) or placebo group (n = 102). The children in each group were treated with desloratadine dry suspension, and those in the treatment group also received Yimingjia®. Clinical efficacy was evaluated at 1, 2 and 4 weeks. Results Clinical symptom scores did not differ significantly at weeks 1 and 2 (p > 0.05), but at 4 weeks, wheal size and attack frequency were significantly reduced in the treatment group (p = 0.049 and 0.03, respectively). The overall response rate (significant improvement + complete response) significantly differed between the treatment (80.8%) and placebo groups (62.5%) (χ2 = 4.20, p = 0.04). Conclusion Adjunct therapy with Yimingjia® was safe and effective at 4 weeks in the treatment of chronic urticaria in children. The study was registered under trial number NCT03328897.

Oxatomide in Food Allergies. Comparative Study versus Disodium Chromoglycate

A randomized, controlled, single blind study was carried out to compare the efficacy and safety of oxatomide and disodium chromoglycate in the treatment of adverse reactions to food. Twenty-three patients (16F and 7M) with urticaria (16 patients), respiratory (5 patients), intestinal (15 patients) and/or neurological symptoms (3 patients) were treated for 60 days: 14 (9F and 5M; mean ± SD age 36.3 ± 13.8 years) with oxatomide, 60 mg every evening and 9 (7F and 2M; 31.5 ± 15.1 years) with disodium chromoglycate, 500 mg three times a day. Both therapies lasted two months. On admission and after 15,30 and 60 days skin (wheals, itching, vesicular blisters, scratching lesions), respiratory (rhinorrhea, sneezing, coughing, wheezing), intestinal (constipation, diarrhea, bloating, abdominal pain and/or cramps) and neurological (headache, irritability) symptoms were assessed. Wheals decreased in number and size in both groups (p<0.005). Itching became less severe in the two groups (p<0.05), although the improvement in the oxatomide group was faster. Vesicular blisters, present in one patient in the oxatomide group at baseline, disappeared by days 15 and 30, reappearing in a mild form at the end of the study. The frequency of scratching lesions decreased. Sneezing and wheezing disappeared in both groups. Digestive system symptoms also improved. Both treatments were effective as regards cutaneous, intestinal and respiratory symptoms, with a significant reduction of itching, wheals and vesicular blisters and the complete relies of intestinal disorders. The drugs were well tolerated.

SIDEROCALGIPHYLACTIC SENSITIZATION TO MASTOCYTE DISCHARGERS

Experiments on rats indicate that, following so-called siderocalciphylactic sensitization with dihydrotachysterol (DHT) and ferric dextran (Fe-Dex), the subcutaneous injection of minute amounts of various mastocyte depleters produces local calcified skin wheals. The possible role of the mastocyte in the production of physiologic and pathologic calcium depositions is briefly discussed.

SIDEROCALGIPHYLACTIC SENSITIZATION TO MASTOCYTE DISCHARGERS

Experiments on rats indicate that, following so-called siderocalciphylactic sensitization with dihydrotachysterol (DHT) and ferric dextran (Fe-Dex), the subcutaneous injection of minute amounts of various mastocyte depleters produces local calcified skin wheals. The possible role of the mastocyte in the production of physiologic and pathologic calcium depositions is briefly discussed.