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<p>This narrative review focuses on the relationship between histamine H2 receptor antagonists (H2RAs) and allergic diseases. In this review we have analysed the evidence from previous clinical trials and epidemiological studies and tried to highlight how H2RAs, which are primarily used for gastric acid suppression, increase histamine availability for H1-mediated pathways and disrupt anti-inflammatory cAMP/PKA signalling, Previous clinical trials had documented worsened nasal allergic responses in cimetidine-pretreated volunteers, increased anti-allergic medication use following H2RA therapy, and increased IgE levels and anaphylaxis severity in H2RA users. We suggest a competitive reallocation hypothesis, which proposes that H2 blockade may aggravate allergic responses by redirecting histamine to H1 receptors. In our review we have found that long term H2 blockade might worsen allergic response in allergy-prone patients.</p>

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Exploring the Association Between Long-Term H₂ Blocker Use and Allergic Disease: The Competitive Reallocation Hypothesis

  • 期刊论文

  • 发表日期：

    2026年7月3日

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  • Sudipto Chatterjee,
  • Pritama Paul

摘要

This narrative review focuses on the relationship between histamine H2 receptor antagonists (H2RAs) and allergic diseases. In this review we have analysed the evidence from previous clinical trials and epidemiological studies and tried to highlight how H2RAs, which are primarily used for gastric acid suppression, increase histamine availability for H1-mediated pathways and disrupt anti-inflammatory cAMP/PKA signalling, Previous clinical trials had documented worsened nasal allergic responses in cimetidine-pretreated volunteers, increased anti-allergic medication use following H2RA therapy, and increased IgE levels and anaphylaxis severity in H2RA users. We suggest a competitive reallocation hypothesis, which proposes that H2 blockade may aggravate allergic responses by redirecting histamine to H1 receptors. In our review we have found that long term H2 blockade might worsen allergic response in allergy-prone patients.