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

DAVID P. HUSTON, M.D.; ROBERT B. BRESSLER, M.D.; MICHAEL KALINER, M.D.; LAURA K. SOWELL, R.N.; and MARJORIE W. BAYLOR, R.N.
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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.

Presented in part at the national meeting of the American Federation for Clinical Research, Washington, D.C., 1985.

▸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.


Houston, Texas; and Bethesda, Maryland


©1986 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1986;104(4):507-510. doi:10.7326/0003-4819-104-4-507
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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.

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