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British Journal of Hospital Medicine... Feb 2022Allergic rhinitis affects 20% of the population of the UK. It confers a significant health burden upon the individual as it affects the patient's quality of life and is... (Review)
Review
Allergic rhinitis affects 20% of the population of the UK. It confers a significant health burden upon the individual as it affects the patient's quality of life and is associated with serious comorbidities including asthma, sinusitis and conjunctivitis. Owing to its prevalence, it has a significant economic impact through its effects on education, productivity and use of healthcare resources. This review focuses on the management of allergic rhinitis and potential future treatments, because of the lack of clear national guidelines and because this illness is often misdiagnosed and mismanaged. The article provides a comprehensive overview of allergic rhinitis and illustrates the assessment criteria for various subcategories.
Topics: Asthma; Humans; Quality of Life; Rhinitis, Allergic; Rhinitis, Allergic, Perennial; Rhinitis, Allergic, Seasonal
PubMed: 35243888
DOI: 10.12968/hmed.2021.0570 -
Asian Pacific Journal of Allergy and... Dec 2014Rhinitis can be divided into allergic and non-allergic rhinitis. Rhinitis, particularly allergic rhinitis, has been shown to be associated with obstructive sleep apnea;... (Review)
Review
Rhinitis can be divided into allergic and non-allergic rhinitis. Rhinitis, particularly allergic rhinitis, has been shown to be associated with obstructive sleep apnea; a condition characterized by repetitive upper airway obstruction during sleep. Allergic rhinitis increases the risk of developing obstructive sleep apnea by two major mechanisms: 1) increase in airway resistance due to higher nasal resistance and 2) reduction in pharyngeal diameter from mouth breathing that moves the mandible inferiorly. Other inflammatory mediators including histamine, CysLTs, IL 1β and IL-4 found in high levels in allergic rhinitis, have also been shown to worsen sleep quality in obstructive sleep apnea. Prior studies have shown that treatment of allergic rhinitis, particularly when intranasal steroid are used, improved obstructive sleep apnea. Leukotriene receptor antagonists were also associated with positive results on obstructive sleep apnea in adult patients with concomitant allergic rhinitis but current data are limited in the case of children.
Topics: Humans; Rhinitis, Allergic; Sleep Apnea, Obstructive
PubMed: 25543037
DOI: No ID Found -
Allergology International : Official... Jul 2020Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes... (Review)
Review
Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 8th edition was published in 2016, and is widely used today. To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2016. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline.
Topics: Disease Management; Disease Susceptibility; Humans; Japan; Rhinitis, Allergic
PubMed: 32473790
DOI: 10.1016/j.alit.2020.04.001 -
Clinical and Experimental Allergy :... Sep 2016Rhinitis is a heterogeneous condition that has been associated with inflammatory responses as in allergic rhinitis but can also occur in the absence of inflammation such... (Review)
Review
Rhinitis is a heterogeneous condition that has been associated with inflammatory responses as in allergic rhinitis but can also occur in the absence of inflammation such as in so-called idiopathic (previously 'vasomotor') rhinitis. Allergic rhinitis affects approximately one in four of the population of westernized countries and is characterized by typical symptoms of nasal itching, sneezing, watery discharge and congestion. The intention of this review is to illustrate key concepts of the pathogenesis of rhinitis. Imbalance in innate and adaptive immunity together with environmental factors is likely to play major roles. In allergic rhinitis, initial allergen exposure and sensitization involves antigen-presenting cells, T and B lymphocytes and results in the generation of allergen-specific T cells and allergen-specific IgE antibodies. On re-exposure to relevant allergens, cross-linking of IgE on mast cells results in the release of mediators of hypersensitivity such as histamine and immediate nasal symptoms. Within hours, there is an infiltration by inflammatory cells, particularly Th2 T lymphocytes, eosinophils and basophils into nasal mucosal tissue that results in the late-phase allergic response. Evidence for nasal priming and whether or not remodelling may be a feature of allergic rhinitis will be reviewed. The occurrence of so-called local allergic rhinitis in the absence of systemic IgE will be discussed. Non-allergic (non-IgE-mediated) rhinitis will be considered in the context of inflammatory and non-inflammatory disorders.
Topics: Airway Remodeling; Allergens; Biomarkers; Diagnosis, Differential; Humans; Immunoglobulin E; Phenotype; Respiratory Mucosa; Rhinitis; Rhinitis, Allergic
PubMed: 27434218
DOI: 10.1111/cea.12780 -
The New England Journal of Medicine Jan 2015A 35-year-old woman has a history of nasal congestion on most days of the year, dating back to her late teens. She has chronic nasal drainage, which is clear and thick.... (Review)
Review
A 35-year-old woman has a history of nasal congestion on most days of the year, dating back to her late teens. She has chronic nasal drainage, which is clear and thick. Her congestion is worst in the late summer and early fall and again in the early spring; at these times, she also has sneezing, nasal itching, and cough. Five years ago, she had an episode of shortness of breath with wheezing on a day when her nasal symptoms were severe, but this episode resolved spontaneously and has not recurred. Her eyes do not bother her. Over-the-counter oral antihistamines help her symptoms a little, as do nasal decongestants, which she uses occasionally. Her 6-year-old son has similar symptoms. How should this case be managed?
Topics: Administration, Intranasal; Adult; Anti-Allergic Agents; Asthma; Desensitization, Immunologic; Female; Glucocorticoids; Histamine Antagonists; Humans; Practice Guidelines as Topic; Rhinitis, Allergic; Sublingual Immunotherapy
PubMed: 25629743
DOI: 10.1056/NEJMcp1412282 -
Italian Journal of Pediatrics Mar 2013Ocular allergy represents one of the most common conditions encountered by allergists and ophthalmologists. Allergic conjunctivitis is often underdiagnosed and... (Review)
Review
Ocular allergy represents one of the most common conditions encountered by allergists and ophthalmologists. Allergic conjunctivitis is often underdiagnosed and consequently undertreated. Basic and clinical research has provided a better understanding of the cells, mediators, and immunologic events, which occur in ocular allergy. New pharmacological agents have improved the efficacy and safety of ocular allergy treatment. An understanding of the immunologic mechanisms, clinical features, differential diagnosis, and treatment of ocular allergy may be useful to all specialists who deal with these patients. The purpose of this review is to systematically review literature underlining all the forms classified as ocular allergy: seasonal allergic conjunctivitis, perennial allergic conjunctivitis, vernal keratoconjunctivitis, atopic keratocongiuntivitis, contact allergy, and giant papillary conjunctivitis.
Topics: Anti-Allergic Agents; Anti-Inflammatory Agents; Conjunctivitis, Allergic; Diagnosis, Differential; Histamine Antagonists; Humans; Keratoconjunctivitis; Treatment Outcome
PubMed: 23497516
DOI: 10.1186/1824-7288-39-18 -
Biomedicine & Pharmacotherapy =... Sep 2021Allergic rhinitis (AR) is a common chronic respiratory disease. Asarum heterotropoides (AH) is predicted to be a treatment for allergic diseases, but its therapeutic...
Allergic rhinitis (AR) is a common chronic respiratory disease. Asarum heterotropoides (AH) is predicted to be a treatment for allergic diseases, but its therapeutic effect is unclear. We aimed to determine the anti-allergic effects of AH in mice with ovalbumin (OVA)-induced AR. OVA-induced AR mouse model was constructed, and AH was orally administered for a week; next, nasal clinical symptoms were evaluated. The levels of serum histamine, OVA-specific IgE, and IL-13 were measured by ELISA. Inflammatory cells, including leukocytes, neutrophils, eosinophils, and macrophages were counted in the nasal lavage fluid (NALF). Histopathological examinations of the nasal tissues were performed using H&E, Giemsa, and PAS staining. The production of periostin and eotaxin-3 from AH-treated human nasal epithelial cells (HNEpCs) in vitro, was measured using ELISA. Oral administration of AH alleviated allergic symptoms in mice with AR; significantly decreased levels of allergic mediators, such as serum histamine and OVA-specific IgE. The decrease in allergic symptoms positively correlated with the decrease in serum allergic mediators. The NALF of AH-treated AR mice demonstrated lower number of eosinophils. AH demonstrated a capacity to reduce the infiltration of mast cells, eosinophils, and goblet cells, thereby resulting in thinner nasal tissues. Moreover, treatment of HNEpCs with AH demonstrated suppressed production of periostin and eotaxin-3. AH exerts a therapeutic effect in modulating AR through multi-target and multi-function influence on regulating B cells, mast cells, eosinophils, goblet cells, and epithelial cells.
Topics: Animals; Anti-Allergic Agents; Asarum; Disease Models, Animal; Female; Humans; Mice; Mice, Inbred BALB C; Ovalbumin; Plant Extracts; Rhinitis, Allergic
PubMed: 34328098
DOI: 10.1016/j.biopha.2021.111944 -
Asian Pacific Journal of Allergy and... Dec 2014
Topics: Animals; Asthma; Cytokines; Humans; Rhinitis, Allergic
PubMed: 25543036
DOI: No ID Found -
Romanian Journal of Ophthalmology 2022Allergic rhinitis and allergic conjunctivitis are so frequently associated that the need to coin a new name to describe the simultaneous manifestations generated the... (Review)
Review
Allergic rhinitis and allergic conjunctivitis are so frequently associated that the need to coin a new name to describe the simultaneous manifestations generated the term allergic rhinoconjunctivitis. The significant impact of rhinoconjunctivitis on the quality of life and the wellbeing of the patients is the reason why the medical community shows a great interest to this disease. Another aspect is the financial burden that is not negligible. The anatomical connection between the organs involved facilitates the propagation of the disease. The allergic pathophysiological mechanisms implicated in allergic rhinitis and conjunctivitis also share common features. The diagnosis of rhinoconjunctivitis is based on the concordance between the symptoms, the clinical examination, and the diagnostic tests that should reveal the existence of an allergen specific IgE in vivo or in vitro. Whilst the nasal smear for eosinophils is considered a reliable diagnostic test for allergic rhinitis, the occurrence of eosinophils in the conjunctive is not a trustworthy indicator of allergy. The therapy of allergic rhinoconjunctivitis is based on patient education, pharmacotherapy, and allergen-specific immunotherapy. The local treatment for the allergic rhinitis is primarily based on topical corticosteroids that also manage the ocular symptoms. The first line of treatment of the ocular manifestations is represented by topical antihistamines and mast-cell stabilizers or double action drugs.
Topics: Allergens; Conjunctivitis; Conjunctivitis, Allergic; Humans; Quality of Life; Rhinitis, Allergic
PubMed: 35531453
DOI: 10.22336/rjo.2022.3 -
Brazilian Journal of Otorhinolaryngology 2019
Review
Topics: Autoantibodies; Chronic Disease; Diagnosis, Differential; Dysphonia; Humans; Laryngitis; Rhinitis, Allergic, Seasonal
PubMed: 30898484
DOI: 10.1016/j.bjorl.2019.02.001