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J Clin Med. 2019 Aug 29;8(9). doi: 10.3390/jcm8091338.

Platelet-Activating Factor (PAF) in Allergic Rhinitis: Clinical and Therapeutic Implications.

Journal of clinical medicine

Rosa M Muñoz-Cano, Rocio Casas-Saucedo, Antonio Valero Santiago, Irina Bobolea, Paula Ribó, Joaquim Mullol

Affiliations

  1. Allergy Section, Pheumology & Allergy Department, Hospital Clinic, Barcelona, 08036 Catalonia, Spain. [email protected].
  2. Clinical & Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, 08036 Catalonia, Spain. [email protected].
  3. ARADyAL, Instituto de Salud Carlos III, 28029 Madrid, Spain. [email protected].
  4. Allergy Section, Pheumology & Allergy Department, Hospital Clinic, Barcelona, 08036 Catalonia, Spain.
  5. Clinical & Experimental Respiratory Immunoallergy, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, 08036 Catalonia, Spain.
  6. ARADyAL, Instituto de Salud Carlos III, 28029 Madrid, Spain.
  7. CIBER of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain.
  8. Rhinology Unit & Smell Clinic, ENT Department, Hospital Clinic, Barcelona, 08036 Catalonia, Spain.

PMID: 31470575 PMCID: PMC6780525 DOI: 10.3390/jcm8091338

Abstract

Platelet-activating factor (PAF) is a lipid mediator involved in several allergic reactions. It is released from multiple cells of the immune system, such as eosinophils, neutrophils, and mast cells, and also exerts its effect on most of them upon specific binding to its receptor, becoming a pleiotropic mediator. PAF is considered a potential relevant mediator in allergic rhinitis, with a key role in nasal congestion and rhinorrhoea due to its effect on vascular permeability. Interestingly, despite its potential relevance as a therapeutic target, no specific PAF inhibitors have been studied in humans. However, rupatadine, a second-generation antihistamine with dual antihistamine and anti-PAF effects has shown promising results by both blocking nasal symptoms and inhibiting mast cell activation induced by PAF, in comparison to antihistamine receptor drugs. In conclusion, the inhibition of PAF may be an interesting approach in the treatment of allergic rhinitis as part of a global strategy directed at blocking as many relevant inflammatory mediators as possible.

Keywords: PAF antagonist; allergic rhinitis; anaphylaxis; asthma; epinastine; ketotifen; nasal congestion; platelet-activating factor; rupatadine

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