Potential Differences between Local and Systemic Allergic Rhinitis Induced by Birch Pollen

2020 ◽  
Vol 181 (11) ◽  
pp. 831-838
Author(s):  
Andrzej Bozek ◽  
Jolanta Zalejska Fiolka ◽  
Anna Krajewska Wojtys ◽  
Beata Galuszka ◽  
Anna Cudak
Keyword(s):  
Allergic Rhinitis ◽  
Birch Pollen ◽  
Provocation Test ◽  
Basophil Activation Test ◽  
Specific Ige ◽  
Immunological Parameters ◽  
Local Allergic Rhinitis ◽  
Before And After ◽  
Intermittent Allergic Rhinitis ◽  
Bet V1

<b><i>Introduction:</i></b> Different endotypes of rhinitis are known, but its pathomechanism has not been conclusively established. For example, the precise difference between systemic allergic rhinitis (SAR) and local allergic rhinitis (LAR) is still being checked. Comparison of patients with LAR and with allergies to birch of those with intermittent allergic rhinitis, same allergy, or with non-allergic rhinitis (NAR) was the purpose of this study. <b><i>Methods:</i></b> Twenty-six patients with LAR, 18 with SAR and allergy to birch, and 21 with NAR were included. Patients who met the inclusion criteria were selected to undergo the following procedures at baseline: medical examinations, nasal provocation test (NPT), detection of nasal-specific IgE to birch as well as basophil activation test (BAT). All immunological parameters were detected before and after NPT. <b><i>Results:</i></b> Concentration of nasal IgE to Bet v1 increased comparably in the LAR and SAR groups after NPT to birch as follows: in 21 (81%) patients with LAR, 14 (78%) with SAR, and in everyone in the NAR group. Serum concentration of allergen-specific IgE to Bet v1 increased significantly from a median of 20.7 (25–75% interval: 11.2–35.6) IU/mL to 29.9 (13.6–44.1) (<i>p</i> = 0.028) after NPT in patients with SAR. Allergen-specific IgE to Bet v1 was absent in all patients with LAR and NAR before and after NPT. BAT with Bet v1 was positive in 22 (85%) patients with LAR, in 14 (78%) with SAR, and 2 (9.5%) with NAR. <b><i>Conclusion:</i></b> These obtained data suggest there are no potential mechanisms that could explain LAR compared to SAR.

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 Different Development Forms of Local Allergic Rhinitis towards Birch

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Andrzej Bozek ◽  
Janne Winterstein ◽  
Beata Galuszka ◽  
Jerzy Jarzab
Keyword(s):  
Allergic Rhinitis ◽  
Outcome Measurement ◽  
Birch Pollen ◽  
Specific Ige ◽  
Active Group ◽  
Placebo Control ◽  
Double Blind ◽  
Local Allergic Rhinitis ◽  
The Mean ◽  
The Impact

Background. Efficacy of allergen immunotherapy (AIT) in local allergic rhinitis (LAR) is a new subject of research. The presence of asthmatic symptoms in patients with LAR in the context of AIT is unexplored. Objective. The efficacy and safety of AIT in patients with LAR towards birch pollen were investigated. The possibility of concomitant local allergic asthma in studied patients and the impact of AIT on it were examined. Methods. 36 patients with LAR towards birch were included in three years of AIT in a double-blind, placebo-control study. Primary outcome measurement was the mean changes in the combined symptom and medication scores (CSMSs) after AIT, and the second is the changes in the quality of life (QoL). Skin prick tests, serum, nasal allergen-specific IgE to birch, nasal and bronchial provocation challenge tests with birch allergen, methacholine tests, and spirometry were carried out at baseline and after AIT. Results. Mean CSMSs of three years of AIT were significantly decreased in the active group from 5.88 (range: 4.11-9.01) to 1.98 (range: 1.22-4.51; p<0.05). After three years of AIT, there was a significant increase of toleration for birch allergen from the mean concentration of 6250±1200 SQ-U/ml up to 45000±2500 SQ-U/ml (p=0.02) during repeated nasal challenges. 16 patients with LAR had the positive results of methacholine tests, and 11 of them had a positive bronchial challenge to birch allergen. After AIT, the significant decrease of bronchial responsiveness to birch allergen in 5 from 7 patients was confirmed (p=0.03). QoL assessed by the use of the RQLQ score was improved after AIT from 1.84 (95% CI: 1.53-1.97) to 1.45 (95% CI: 1.32-1.62) score in the active group after three years of AIT therapy (p=0.03). Conclusion. AIT to birch can be useful and safe in a patient with local allergic rhinitis and also with concomitant asthmatic symptoms. Further studies are needed.

scholarly journals Current Update of Local Allergic Rhinitis

2021 ◽  
Vol 64 (8) ◽  
pp. 533-539
Author(s):  
Su-Jong Kim ◽  
Jee Won Moon ◽  
Heung-Man Lee
Keyword(s):  
Allergic Rhinitis ◽  
Provocation Test ◽  
High Sensitivity ◽  
Specific Ige ◽  
Nasal Provocation Test ◽  
Local Allergic Rhinitis ◽  
Nasal Provocation ◽  
Nasal Secretions ◽  
Positive Results ◽  
A Current

Local allergic rhinitis (LAR) is a localized nasal allergic response in the absence of systemic atopy. The symptoms, duration, severity, and comorbidities of LAR are similar to those of allergic rhinitis. Although pathophysiology of LAR is not fully understood, in some patients specific IgE can be demonstrated in the nasal secretions. The diagnosis currently relies on the positive results of nasal provocation test. Nasal provocation test has shown high sensitivity and specificity with safety, and is considered as the gold standard. LAR patients benefit from the same therapeutic strategies as allergic rhinitis patients, including the avoidance of allergen exposure and the pharmacotherapy. Effectiveness and safety of allergen immunotherapy open a window of treatment opportunity in LAR. This review provides a current update on LAR.

Possibility of Local Allergic Rhinitis in Japan

2019 ◽  
Vol 34 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Mariko Ishida ◽  
Shoji Matsune ◽  
Nozomu Wakayama ◽  
Ryuji Ohashi ◽  
Kimihiro Okubo
Keyword(s):  
Allergic Rhinitis ◽  
Provocation Test ◽  
Japanese Cedar ◽  
Inferior Turbinate ◽  
Specific Ige ◽  
House Dust Mites ◽  
Total Ige ◽  
Local Allergic Rhinitis ◽  
Allergen Provocation ◽  
Cedar Pollen

Background The concept of local allergic rhinitis (LAR) has been advocated recently. Allergic rhinitis in Japan is characterized by house dust mites (HDMs) and Japanese cedar pollen (JCP). To investigate LAR in Japan, total IgE and antigen-specific IgE (sIgE) were measured in inferior turbinate mucosa and their relationships with skin test (ST) and nasal allergen provocation test (NAPT) and as well as serum IgE levels were examined. Methods Subjects were 50 rhinosinusitis patients for surgery. ST was performed and serum total IgE and sIgE levels were measured preoperatively. Patients with class-0 serum anti-HDM or anti-JCP sIgE levels were subjected to NAPT with HDM or JCP, respectively, or both. In all patients, inferior turbinate mucosa was weighed and mashed, and total IgE and sIgE levels were then measured as local mucosal date per gram and per milligram. Because there is no clinical consensus how to evaluate nasal sIgE yet, both positive NAPT and detectable sIgE in obtained nasal mucosa were adopted as the diagnostic criteria of LAR in order to strictly elucidate the possibility of presence of LAR in Japan. Results JCP LAR was definitely diagnosed in 2 of 14 patients (14.3%) and HDM LAR in 5 of 21 (23.8%) in cases with rhinosinusitis symptoms in the absence of positive ST nor serum sIgE. Conclusion The present results positively support LAR by HDM or JCP being present in Japan.

A Novel Method of Measuring Nasal Specific IgE in Systemic and Local Allergic Rhinitis Patients

2016 ◽  
Vol 137 (2) ◽  
pp. AB284 ◽  
Author(s):  
Paloma Campo ◽  
Carmen Rondon ◽  
Ana Prieto del Prado ◽  
Maria Salas ◽  
Luisa Galindo ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Specific Ige ◽  
Local Allergic Rhinitis ◽  
Novel Method

scholarly journals Local allergic rhinitis

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 49-56
Author(s):  
Maja Buljcik-Cupic ◽  
Dragana Lemez ◽  
Slobodan Savovic ◽  
Ljiljana Jovancevic ◽  
Danijela Dragicevic
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Mucosa ◽  
Immunoglobulin E ◽  
Provocation Test ◽  
Allergic Response ◽  
Prick Test ◽  
Local Allergic Rhinitis ◽  
Provocation Tests ◽  
Number Of Patients ◽  
The Impact

Local allergic rhinitis is a localized allergic response of the nasal mucosa to aeroallergens in the absence of atopy with characteristic production of specific local immunoglobulin E antibodies in the nasal mucosa, T helper type 2 cellular infiltration response during the exposure to aeroallergens and positive results via the nasal allergic provocation test with the release of inflammatory mediators (triptase and eosinophil cationic proteins). Even though the prevalence of local allergic rhinitis has been and is still being investigated, a large number of patients with diagnosed non-allergic rhinitis or idiopathic rhinitis are currently classified as having local allergic rhinitis. The causes of local allergic rhinitis are most commonly house dust, dust mites, pollens and many others. Diagnosis of local allergic rhinitis is made using nasal allergen provocation tests when the prick test for standard inhalation allergens and the serum specific immunoglobulin analysis for aeroallergens are negative. The increasing amount of data on localized allergic response in non-atopic patients asks for many answers regarding local allergic rhinitis. These answers can be obtained by a study on the prevalence and incidence in children and adults, the impact of positive family atopy in the development of disease, the impact of associated diseases of the lower respiratory tract and conjunctiva, the effectiveness of drug treatment and the issue of administration of specific immunotherapy.

Role of the basophil activation test in the diagnosis of local allergic rhinitis

2013 ◽  
Vol 132 (4) ◽  
pp. 975-976.e5 ◽  
Author(s):  
Enrique Gómez ◽  
Paloma Campo ◽  
Carmen Rondón ◽  
Esther Barrionuevo ◽  
Natalia Blanca-López ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Basophil Activation Test ◽  
Basophil Activation ◽  
Activation Test ◽  
Local Allergic Rhinitis

scholarly journals Local allergic rhinitis - a big challenge in clinical practice

2021 ◽  
pp. 32-32
Author(s):  
Rajica Stosovic ◽  
Vesna Tomic-Spiric
Keyword(s):  
Allergic Rhinitis ◽  
Gold Standard ◽  
Allergen Immunotherapy ◽  
Provocation Test ◽  
Pharmacological Therapy ◽  
Local Allergic Rhinitis ◽  
Natural Progression ◽  
Allergen Provocation ◽  
Preventive Effects ◽  
Progressive Course

Local allergic rhinitis is a new rhinitis phenotype characterized by symptoms similar to allergic rhinitis, in non-atopic patients with a positive nasal allergen provocation test (NAPT). The disease is diagnosed in over 25% of non-atopic patients with rhinitis, marked as non-atopic rhinitis. It most often has perennial and severe symptoms and a progressive course. It is often associated with conjunctivitis and/or asthma. It is necessary to consider local allergic rhinitis in patients with non-atopic rhinitis. The gold standard for diagnosis is positive NAPT. Pharmacological therapy fails to stop the natural progression and development of comorbidities. Allergen immunotherapy reduces the symptoms, consumption of medicines and increases the tolerance to allergens responsible for local allergic rhinitis. New studies are needed to confirm curative and evaluate the preventive effects of allergen immunotherapy.

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