Allergic rhinitis

2020 ◽  
pp. 4059-4066
Author(s):  
Stephen R. Durham ◽  
Hesham A. Saleh
Keyword(s):  
Allergic Rhinitis ◽  
Work Performance ◽  
Occupational Exposures ◽  
Specific Ige ◽  
Nasal Discharge ◽  
School Work ◽  
Tissue Eosinophilia ◽  
Skin Prick Tests

Allergic rhinitis affects more than 20% of the population of Westernized countries and has a significant impact on quality of life and school/work performance. Important environmental factors include tree and grass pollens (seasonal allergic rhinitis); house dust mite and domestic pets, most often cats (perennial allergic rhinitis); and a variety of occupational exposures (occupational rhinitis). Pathogenesis involves activation of type 2 (Th2) lymphocytes resulting in IgE antibody production and tissue eosinophilia. Immediate symptoms (itching, sneezing, and watery nasal discharge) result from allergen cross-linking adjacent IgE molecules on the surface of mast cells in the nasal mucosa, resulting in the release of histamine and tryptase, and generation of bradykinin. Diagnosis is usually straightforward and based on the history, examination, and (when indicated) the results of skin prick tests and/or serum allergen-specific IgE levels.

Allergic rhinitis

2010 ◽  
pp. 3277-3282
Author(s):  
Stephen R. Durham ◽  
Hesham Saleh
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Mast Cells ◽  
Environmental Factors ◽  
Work Performance ◽  
Occupational Exposures ◽  
Cross Linking ◽  
Nasal Discharge ◽  
School Work

Allergic rhinitis affects more than 20% of the population of Westernized countries and has a significant impact on quality of life and school/work performance. Aetiology and clinical features—important environmental factors include tree and grass pollens (seasonal allergic rhinitis); house dust mite and domestic pets, most often cats (perennial allergic rhinitis); and a variety of occupational exposures (occupational rhinitis). Many genetic loci confer susceptibility. Immediate symptoms (itching, sneezing, and watery nasal discharge) occur as a consequence of allergen cross-linking adjacent IgE molecules on the surface of mast cells in the nasal mucosa, resulting in the release of histamine and tryptase, and the generation of bradykinin....

Quality of life in allergic rhinitis

2011 ◽  
Vol 6 (1) ◽  
pp. 25-39 ◽  
Author(s):  
Tunis Ozdoganoglu ◽  
Murat Songu ◽  
Hasan Mete Inancli
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
School Performance ◽  
Work Performance ◽  
Upper Respiratory Tract ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Allergic rhinitis is a global health problem that causes major illness and disability worldwide. Although nasal and nonnasal symptoms are directly attributable to inflammation in the upper respiratory tract, individuals also experience generalized symptoms that include fatigue, mood changes, depression, anxiety and impairments of work and school performance, and cognitive function. Health-related quality of life focuses on patients’ perceptions of their disease and measures impairments that have a significant impact on the patient. The burden of disease, as the patient perceives it, forms the basic motivation to seek medical aid or to undergo therapy. Adherence to therapy requires changes in health, perceived by patients as relevant and outweighing eventual disadvantages of intervention. Because so many factors are involved in health-related quality of life, there are multiple ways in which it can be measured. A variety of validated and standardized questionnaires have been developed including assessments of school performance, work performance, productivity, and other parameters that quantify the impact of allergic rhinitis and its treatment on quality of life. The aim of this review is to highlight the impact of allergic rhinitis on the quality of life and to analyze the most commonly used health-related quality of life instruments.

scholarly journals Correlation of Serumβ-Endorphin and the Quality of Life in Allergic Rhinitis

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Jichao Sha ◽  
Cuida Meng ◽  
Lin Li ◽  
Na Cui ◽  
Qian Xiu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Significant Negative Correlation ◽  
Specific Ige ◽  
Symptom Duration ◽  
Life Questionnaire ◽  
Immunoblot Assay ◽  
Total Ige ◽  
Quality Of Life Questionnaire

Background.Allergic rhinitis (AR) significantly impairs the quality of life of the patients; however, a questionnaire alone is an insufficient and subjective measure of this condition. Obtaining an objective clinical assessment of the level of impairment will be valuable for its treatment.β-Endorphin is one of the most important mediators of both mental state and specific immunity. Thus, we investigated the possibility of usingβ-endorphin as a biomarker for evaluating the impairment level in AR.Methods.This study included 48 patients with AR and 32 healthy volunteers. The serumβ-endorphin level was determined by enzyme immunoassay, and the serum-specific IgE and total IgE levels were determined by immunoblot assay. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used to assess the impairment level in the symptom duration.Results.Theβ-endorphin concentration was significantly decreased in AR patients compared to the healthy controls (p=0.000,p<0.05). There was significant negative correlation between the impairment level and serumβ-endorphin level (correlation coefficient:-0.468;p=0.001;p<0.05), but there was no association between the serumβ-endorphin and total IgE levels (p=0.947,p>0.05).Conclusion.β-Endorphin is a systemic biomarker that has the potential to assess the impairment level in AR and may therefore be a novel therapeutic target for the treatment of AR.

Evaluation of Dermatophagoides pteronyssinus (Trouessart) and D. farinae Hughes (Acari: Pyroglyphidae) sensitivity in patients with allergic rhinitis: a comparative study

2018 ◽  
Vol 23 (2) ◽  
pp. 206
Author(s):  
Erhan ZEYTUN ◽  
Salih DOĞAN ◽  
Edhem Ünver ◽  
Fatih ÖZÇÜÇEK
Keyword(s):  
Allergic Rhinitis ◽  
Comparative Study ◽  
Clinical Assessment ◽  
Serum Levels ◽  
Specific Ige ◽  
Dermatophagoides Pteronyssinus ◽  
Total Ige ◽  
Serologic Tests ◽  
Stereo Microscope ◽  
Skin Prick Tests

This study was conducted to determine the sensitivity to Dermatophagoides pteronyssinus (Trouessart) and D. farinae Hughes with skin prick tests (SPT) and serologic tests in patients with allergic rhinitis (AR), and to specifically search for those mites in homes of patients. A total of 51 participants, (23 patients and 28 controls) were utilized. Skin-prick tests with D. pteronyssinus and D. farinae allergens were performed on all participants, and serum levels of allergen-specific lgE and total IgE were also measured. Dust samples were collected from homes of all participants and examined under a stereo microscope. 977 D. pteronyssinus (mean 44.4/g) and 24 D. farinae (mean 4.0/g) were isolated from the homes of patients, whereas 35 D. pteronyssinus (mean 4.4/g), and four D. farinae (mean 2.0/g) were isolated from the homes of the controls. Patients with D. pteronyssinus in their homes had 95.5% sensitivity to the species according to SPT and 27.3 according to IgE. Patients with D. farinae in their homes had 83.3% sensitivity to the species according to SPT, and 50% according to IgE. Dermatophagoides pteronyssinus sensitivity in the controls was detected as 12.5% according to SPT; however, D. farinae sensitivity was not detected according to both SPT and mite-specific IgE. Differences between patients and controls utilizing SPT results was statistically significant, but not when using mite-specific IgE results. As a result, it was determined that patients with AR in Erzincan province were sensitized to D. pteronyssinus and D. farinae, and that their homes contained those species. It may be helpful to consider these findings in clinical assessment of patients with AR, and also in treatment utilizing immunotherapy techniques.

The Role of Leukotrienes in Nasal Allergy

2003 ◽  
Vol 129 (3) ◽  
pp. 274-279 ◽  
Author(s):  
Ilknur Haberal ◽  
Jacquelynne P. Corey
Keyword(s):  
Allergic Rhinitis ◽  
Work Performance ◽  
Respiratory Infections ◽  
Nasal Congestion ◽  
Comorbid Condition ◽  
Nasal Allergy ◽  
Upper Airways ◽  
School Work ◽  
Asthma Patients

OBJECTIVE: This review focuses on the role of cysteinyl leukotrienes (cysLTs) in nasal allergy. The purpose was to provide knowledge of the role of cysLTs in the pathophysiology of nasal allergy and the role of antileukotrienes in the treatment of nasal allergies. MATERIALS AND METHODS: We conducted a literature review. RESULTS: The proinflammatory effects of cysLTs have been well described in asthma. Antileukotrienes have proved to be an effective anti-inflammatory treatment for asthma patients. Similar to pathogenesis of asthma, cysLTs exert potent inflammatory effects in the upper airways and play a role in the pathogenesis of allergic rhinitis and other nasal allergies. CONCLUSION: Antileukotriene treatment appears to be beneficial in nasal allergies. Allergic rhinitis is a complex, IgE-mediated inflammatory disease of the upper airways. It is the most common allergic disease, occurring in 10% to 30% of adults and up to 30% of children. It may be perennial or seasonal. Sneezing, itching, watery rhinorrhea, and nasal obstruction are classic symptoms. It may impair cognition, school/work performance and productivity, behavior, mood, and quality of life. On physical examination, clear secretions, nasal congestion, pink-bluish nasal mucosa, the allergic salute, and allergic shiners may be detected. Allergic rhinitis is a common comorbid condition with asthma, sinusitis, otitis media, nasal polyposis, and respiratory infections.

scholarly journals Diagnosis and Treatment of Local Allergic Rhinitis

Pathogens ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 80
Author(s):  
Tetsuya Terada ◽  
Ryo Kawata
Keyword(s):  
Allergic Rhinitis ◽  
Current Knowledge ◽  
Provocation Test ◽  
Basophil Activation Test ◽  
Specific Ige ◽  
Nasal Discharge ◽  
Initial State ◽  
Positive Type ◽  
Chronic Rhinitis ◽  
Local Allergic Rhinitis

Some patients with chronic rhinitis have a positive nasal allergen provocation test (NAPT) without systemic IgE sensitization by skin prick tests or serum allergen-specific IgE (sIgE). This novel concept is called local allergic rhinitis (LAR) and affects children and adults worldwide, but is underdiagnosed. LAR is not just the initial state of allergic rhinitis (AR), it is a unique form of chronic rhinitis that is neither classical AR nor non-AR. Many of the features of AR and LAR are similar, such as a positive NAPT, positive type 2 inflammatory markers, including the nasal discharge of sIgE, and a high incidence of asthma. A differential diagnosis of LAR needs to be considered in patients with symptoms suggestive of AR in the absence of systemic atopy, regardless of age. The diagnostic method for LAR relies on positive responses to single or multiple allergens in NAPT, the sensitivity, specificity, and reproducibility of which are high. The basophil activation test and measurement of IgE in nasal secretions also contribute to the diagnosis of LAR. Treatment for LAR is similar to that for AR and is supported by the efficacy and safety of allergen exposure avoidance, drug therapy, and allergen immunotherapy. This review discusses current knowledge on LAR.

scholarly journals Prevalence of aspergillus skin hypersensitivity in allergic rhinitis

2021 ◽  
Author(s):  
Monika Bansal ◽  
Komaldeep Kaur ◽  
Aditi Gupta ◽  
Deepak Goyal ◽  
Nidhi Girdhar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Aspergillus Fumigatus ◽  
Specific Ige ◽  
Chi Square ◽  
Prick Test ◽  
Skin Hypersensitivity ◽  
Chi Square Test ◽  
Ige Mediated

Allergic rhinitis (AR) is a chronic allergen specific, IgE-mediated hypersensitivity disorder which significantly impairs the quality of life in affected patients. Many aeroallergens and molds are responsible for AR. This study was  conducted to find prevalence of Aspergillus fumigatus skin hypersensitivity in patients of AR by skin prick test (SPT).  150 clinically diagnosed AR patients visiting our OPD were enrolled. Skin hypersensitivity for Aspergillus f. was done by SPT in all the enrolled patients. Chi square test and Student’s t-test were applied for statistical analysis. Out of 150 patients, 60 (40%) were positive for Aspergillus fumigatus SPT. Majority of the positive patients had persistent AR and among those 39/60 (65%) had moderate to severe persistent AR and 12/60 (20%) had mild persistent AR.  Our study concluded that there is high (40%) prevalence of Aspergillus f. skin hypersensitivity among AR patients. The hypersensitivity to Aspergillus f. was found more in severe AR patients and it was statistically significant.

scholarly journals Allegric Rhinitis: Pearls of Wisdom

2019 ◽  
Vol 4 (9) ◽  
Keyword(s):  
Allergic Rhinitis ◽  
Treatment Plan ◽  
Antibiotic Use ◽  
Healthcare Personnel ◽  
Nasal Discharge ◽  
Clinical Presentations ◽  
Mucosal Oedema ◽  
Difficult Subject

Statement of the problem: This provides an overview of Allergic Rhinitis and its management. It is very useful for students of Rhinology and clinicians managing this disease. It introduces them to a systematic approach of assessing allergic rhinitis patients which is very commonly found in most populations and causes considerably morbidity. Allergy per se is a very difficult subject to master and it is with great perseverance one can treat patients suffering from this condition. The cornerstone of managing a patient of allergic rhinitis is first and foremost obtaining a good history. This is to be followed by a thorough examination and investigations. The general practitioner is the first expert to be involved in management of allergic rhinitis patient followed by specialists in particular otorhinolaryngologists, and finally by allied healthcare personnel. Inflammation of nose and paranasal sinuses are characterized by two or more symptoms-namely, eithernasal blockage, obstruction, congestion or nasal discharge. Associated symptoms include facial pain, pressure and either reduction or loss of smell. Certain diagnostic endoscopic signs of nasal polyps and or mucopurulent discharge and or mucosal oedema in the middle meatus and or CT changes of mucosa within the ostoemeatal complex, and or sinuses are seen. Definitions, aetiologies, clinical presentations, diagnosis, prognosis and management of allergic rhinitis is dealt with. Common allergens causing the disease are mentioned, pathophysiology and classification of allergic rhinitis is discussed in detail. Different types of allergen testing are highlighted along with their specific role and uniqueness. Principles of immunotherapy in treatment of allergic rhinitis are discussed here. Health effects of allergic rhinitis along with its impact on physical quality of life is mentioned. The basic idea of this presentation is to improve diagnostic accuracy by promoting appropriate use of ancillary tests like nasoendoscopy, allergy testing, computed tomography etc. and reduce inappropriate antibiotic use. The basic treatment plan of allergic rhinitis is according to the severity and duration. It consists of allergen avoidance, pharmacotherapy, allergen immunotherapy and surgery which has limited role.

How to interpret skin prick tests and serum-specific IgE in children and young people with food allergy

2021 ◽  
pp. edpract-2020-320562
Author(s):  
Kathryn Ferris ◽  
Marianne Cowan ◽  
Christine Williams ◽  
Sinead McAteer ◽  
Caoimhe Glancy ◽  
...  
Keyword(s):  
Food Allergy ◽  
Skin Prick Testing ◽  
Clinical History ◽  
Specific Ige ◽  
Children And Young People ◽  
Subsequent Investigation ◽  
Targeted Testing ◽  
Important Diagnostic Tool ◽  
Skin Prick Tests

Food allergy is common, it can lead to significant morbidity andnegatively impacts on quality of life; therefore, it is vitally important we get the diagnosis right. However, making the diagnosis can be complex. Clinical history is the most important diagnostic tool and subsequent investigation may help confirm the diagnosis. The investigations available to most paediatric departments are skin prick testing and specific IgE so we will focus on these. Within this article we explore the evidence related to targeted testing and how to interpret these within the clinical context.

scholarly journals STUDY OF THE EFFICIENCY OF ALLERGEN IMMUNOTHERAPY IN PATIENTS WITH ALLERGIC RHINITIS

2020 ◽  
Vol 20 (4) ◽  
pp. 48-53
Author(s):  
S.O. Zubchenko
Keyword(s):  
Allergic Rhinitis ◽  
Allergen Immunotherapy ◽  
Laboratory Data ◽  
Immunological Response ◽  
Allergic Diseases ◽  
Diagnostic Value ◽  
Medication Score ◽  
Molecular Studies ◽  
Skin Prick Tests

Allergen immunotherapy is one of the effective treatments for many allergic diseases. The principle of allergen immunotherapy is to achieve tolerance to causative allergens. The effectiveness of allergen immunotherapy depends on the correct diagnostic approach, the quality of the vaccine and patient compliance. This article presents the analysis of the effectiveness of the allergen immunotherapy using sublingual and subcutaneous methods of administration in patients with allergic rhinitis. The study group consisted of 236 patients with allergic rhinitis, 126 (53.4%) female and 110 (46.6%) male individuals aged 32.6 ± 2.4 years. Clinical and laboratory data collection, instrumental, cytological, specific allergological studies (total IgG4, skin prick-tests, molecular studies ALEX) were carried out. The efficacy of the аllergen immunotherapy was assessed by a combined symptom medication score. According to the results of skin prick-tests, it was determined that 163 (69.0%) people had polysensitization, 61 (25.8%) individuals had monosensitization, and 12 (5.2%) had negative skin prick-tests. ALEX component studies were performed for 52 people. The most common major components found were Phl p 1, 69.2%, Lol p 1, 57.7%, Der f 2, 48.1%, Der p 2, 42.3%, Bet v 1, 34.6 %. Minor components Phl p 7, Phl p 12 were detected in 9 (17.3%) patients. According to molecular studies, the prognostic efficiency of the аllergen immunotherapy was defined as high in 41 people and as average in 9 people; 86 patients with allergic rhinitis took the allergen immunotherapy: 37 people by sublingual route, and 49 people by subcutaneous methods. There was a significant decrease in the overall assessment of symptoms, medication needs, and a comprehensive assessment that did not depend on the method of administration of the allergy vaccine. Comparative analysis of total IgG4 levels before and in the third year of the allergen immunotherapy showed only a tendency to increase (p = 0.492). The component-resolved diagnosis plays an important role in choosing a treatment strategy for patients with allergy and predicting the efficacy of the allergen immunotherapy. Allergen immunotherapy, regardless of the methods of its introduction, shows high clinical efficacy in patients with allergic rhinitis that was confirmed by the criteria of combined evaluation. Assessment of total IgG4 levels has not had a reliable diagnostic value as a biomarker of the immunological response to the allergen immunotherapy.

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