Allergic Sensitization in Rhinitis and Asthma

Abstract

Abstract"llergic rhinitis "R is usually defined as an inflammatory disease of the nasal mucosa induced by an interaction of environmental allergens and IgE in sensitized patients. Its symptoms are sneezing, nasal itching, rhinorrhoea and nasal obstruction. "llergic rhinitis affects approximately -% of the population worldwide and its prevalence is increasing. Isolated "R is rare and it actually has to be considered as a systemic allergic disease, associated to comorbidities, such as conjunctivitis, chronic middle ear effusions, irregular sleep, sinusitis, lymphoid hypertrophy with obstructive sleep apnoea. The most relevant comorbidity is asthma, a heterogeneous disease, usually characterized by chronic airway inflammation in which many cells and cellular elements play an important role. "ronchial asthma is characterized by bronchial hyper-reactivity and symptoms may be triggered or worsened by factors such as viral infections, allergens, tobacco smoke, exercise and stress. " state of "minimal persistent inflammation" is permanently maintained in the lower respiratory tract of asthmatic individuals. The diagnosis of asthma is based on evidence of variable airflow limitation tested with spirometry and a positive bronchodilation reversibility test. Skin prick tests SPTs are widely used to demonstrate an immediate IgE-mediated allergic reaction. They represent a major diagnostic tool in the field of allergy. Skin prick tests have a high specificity and sensitivity for the diagnosis of inhalant allergens. Immunotherapy "IT for allergic diseases has entered in a new age characterized by the development of a few innovative therapeutic classes of standardized allergen formulations registered. Clinical randomized trials have demonstrated the efficacy of "IT in allergic rhinitis in children and in adults, expressed in terms of reduction of symptom score and use of rescue medication. The efficacy is confirmed both for subcutaneous SCIT and sublingual SLIT immunotherapy in adults and in pediatric patients. The long lasting effect of "IT after its discontinuation is an important added value of this therapy. Controlled studies are available, where the carry-over effect of "IT is demonstrated for two years after discontinuance. The capacity to prevent new sensitizations, and to modify the evolution of the disease from the rhinitis to asthma are two important features of "IT. "llergen immunotherapy showed preventive capacity and also a carryover effect once treatment is discontinued.

Higher Wheal Sizes of Dermatophagoides farinae Sensitization Exhibit Worse Nasal Symptoms in Allergic Rhinitis Patients

“…Polysensitization (i.e., sensitization to two or more allergens as confirmed by SPT) is associated with severe symptoms and poor QOL due to different immunologic phenotypes in monosensitized and polysensitized patients ( 25 ). In this study, symptoms severity scores were not associated with increased number of HDM sensitization.…”

The CD4+CD25+FoxP3+ Regulatory T Cells Regulated by MSCs Suppress Plasma Cells in a Mouse Model of Allergic Rhinitis

“…Allergic rhinitis is a common inflammatory disease worldwide characterized by a well-defined phenotype, such as frequent sneezing, breathing difficulty, and increased airway resistance ( 29 - 31 ). Furthermore, a previous study reported that AR is correlated with the increased of B cells and plasma cells ( 32 ).…”