Effects of Loratadine on Red Wine-induced Symptoms and Signs of Rhinitis

Abstract

Objective—Intake of red wine may produce nasal symptoms. Little is known about the pathophysiology and pharmacology of this condition. The aim of this study was to examine whether nasal symptoms produced by red wine are reproducible, associated with mucinous secretion or plasma exudation and affected by antihistamine treatment.

Material and Methods—Twenty-eight subjects with a history of nasal symptoms associated with red wine intake received oral challenges with red wine and raspberry juice in a crossover design. Nasal symptoms and peak inspiratory flow (PIF) were assessed. Nasal lavages were performed and levels of fucose and α₂-macroglobulin were determined as indices of mucinous secretion and plasma exudation, respectively. Twelve responders (according to preset criteria) were re-challenged 1 h after loratadine (10 mg) treatment, in a double-blind, placebo-controlled crossover design. Nasal symptoms and PIF were reassessed. Nasal lavages were performed and levels of fucose were redetermined.

Results—Red wine intake produced nasal symptoms (p < 0.05) and decreased nasal PIF (p < 0.01–0.05). A total of 54% of subjects were categorized as responders, and in this group red wine produced a slight increase in lavage fluid levels of fucose (p < 0.05). In contrast, levels of α₂-macroglobulin were unaffected. A total of 83% of responders developed symptoms at rechallenge. Loratadine reduced post-challenge nasal secretion (p < 0.05). Also, red wine failed to reduce nasal PIF in patients receiving loratadine.

Conclusion—Nasal symptoms associated with red wine intake can be reproduced by oral red wine challenges. This symptomatology may be associated with mucinous secretion, but not with plasma exudation. Loratadine may partially reduce nasal symptoms associated with intake of red wine.

Key words:

• airway
• antihistamine
• fucose
• inflammation
• α2-macroglobulin
• mucinous secretion
• plasma exudation
• rhinitis