Prevalence and clinical characteristics of local allergic rhinitis to house dust mites

Abstract

Purpose of review Local allergic rhinitis (LAR) is a recently classified subtype of rhinitis defined by a nasal allergic response in patients without systemic evidence of atopy. Recent studies have reported the prevalence, clinical course, culprit allergens, diagnostic methods and treatment outcomes of LAR. The purpose of this review is to summarize the most relevant and updated scientific evidence for LAR, especially focusing on its prevalence and clinical characteristics. Recent findings LAR is found in a significant proportion (3.7–61.9%) of patients previously diagnosed with nonallergic rhinitis, but the prevalence may differ among ethnic groups and countries. Common allergens of LAR are similar to those of allergic rhinitis, in which house dust mites are the most common cause, followed by grass pollen, tree pollen, weed pollen and animal dander confirmed by provocation tests. Although the nasal provocation test to a single allergen is considered the gold standard method, the detection of allergen-specific IgE and other inflammatory mediators from nasal secretions and the basophil activation test can assist in the diagnosis of LAR. Conjunctivitis and asthma are the most common comorbid conditions, and the occurrence rate of asthma increases over period. However, the conversion rate to allergic rhinitis was not significantly different between LAR and healthy controls. Summary LAR is a well-differentiated entity of rhinitis, which should be considered in patients with persistent and severe symptoms without any systemic evidence of atopy. Further research is needed to investigate the long-term outcome, and geographic and ethnic differences of LAR.

Rhinitis 2020: A practice parameter update

“…50,51 However, prevalence rates of LAR in China have been reported to be much lower (eg, 7.7%). 52 LAR is reported to be more prevalent in women, to be associated with a family history of atopy equal to or greater than that of AR, and to have a mean onset of 21 years; however, LAR may start in childhood 36% of the time. 49,53,54 Local occupational rhinitis, diagnosed by nasal provocation studies, should be considered in workers with a convincing history but with negative immunological tests.…”

Bronchial asthma triggered by house dust mites in patients with local allergic rhinitis

“…In the last decade, a new rhinitis phenotype termed local allergic rhinitis (LAR) has been defined for patients with seasonal or perennial rhinitis symptoms, absence of systemic atopy (negative skin prick test [SPT] and/or serum specific IgE [sIgE]), and a positive nasal allergen provocation test (NAPT) . Local allergic rhinitis is an independent rhinitis phenotype not evolving to allergic rhinitis (AR), and showing moderate‐to‐severe symptoms.…”

Strain-Specific Differences in House Dust Mite (Dermatophagoides farinae)-Induced Mouse Models of Allergic Rhinitis

“…However, OVA is not an antigen that patients are naturally exposed to, which limits the model's clinical relevance. The house dust mite (HDM) is the most common cause of allergic diseases, and Dermatophagoides farinae (Der f) and Dermatophagoides pteronyssinus (Der p) are known contributors to this disease [14,15]. Mouse models of allergic rhinitis induced by HDM antigens have recently been established.…”