Allergic Rhinitis: A Clinical and Pathophysiological Overview

Abstract

Allergic rhinitis (AR) represents a global health concern where it affects approximately 400 million people worldwide. The prevalence of AR has increased over the years along with increased urbanization and environmental pollutants thought to be some of the leading causes of the disease. Understanding the pathophysiology of AR is crucial in the development of novel therapies to treat this incurable disease that often comorbids with other airway diseases. Hence in this mini review, we summarize the well-established yet vital aspects of AR. These include the epidemiology, clinical and laboratory diagnostic criteria, AR in pediatrics, pathophysiology of AR, Th2 responses in the disease, as well as pharmacological and immunomodulating therapies for AR patients.

Cell division cycle 42 reflects disease risk, symptoms, Th1/Th2 disproportion, and its short‐term variation indicates symptom amelioration after treatment in allergic rhinitis patients

“…A possible explanation was that CDC42 could amplify the allergic reaction and inflammatory procedure, leading to more severe symptoms in AR patients. 16,26 These findings suggest that CDC42 might serve as an objective biomarker to reflect the symptoms of AR, thus improving the management of AR patients. In addition, our study also discovered that CDC42 was positively correlated with Th2 cells.…”

“…These data suggested that CDC42 was related to more severe symptoms in AR patients. A possible explanation was that CDC42 could amplify the allergic reaction and inflammatory procedure, leading to more severe symptoms in AR patients 16,26 . These findings suggest that CDC42 might serve as an objective biomarker to reflect the symptoms of AR, thus improving the management of AR patients.…”

IL-4/IL-13 axis as therapeutic targets in allergic rhinitis and asthma

“…Both diseases are mediated by T helper 2 (Th2) inflammatory processes where Th2 cytokines such as IL-4, IL-5 and IL-13 play key roles in their pathogenesis ( Nur Husna et al 2022c ). IL-4 plays key roles in inducing IgE production by plasma cells and upregulating the expression of Fc ɛ RI and MHC class II molecules in mast cells, basophils, monocytes, macrophages and B cells ( Yamanishi et al, 2017 ; Yip et al, 2021 ).…”

“…A proportion of chronic AR and asthma patients do not respond towards conventional, symptoms-based medications. These patients require disease-modifying therapeutic agents such as targeted agents against IL-4/IL-13 that can shift the natural course of disease progression in AR and asthma ( Nur Husna et al 2022c ). Accumulating evidence from ex vivo studies as well as AR or asthma animal models lend credence to the further assessment of IL-4/IL-13-targeted therapy in AR and asthma patients ( Bourdin et al, 2021 ; Conde et al, 2021 ; Harb & Chatila, 2020 ; Russkamp et al, 2019 ).…”

Febuxostat Alleviates Allergic Rhinitis by Inhibiting Inflammation and Monocyte Adhesion in Human Nasal Epithelial Cells via Regulating KLF6

“…Allergic rhinitis (AR) is a common rhinitis with clinical symptoms such as itchy nose, sneezing, and runny nose, which cause significant inconvenience in the normal lives of AR patients [ 1 ]. At present, approximately 30% of the global population is affected by AR and the morbidity rate in America is 5%-22%.…”