Clinical course of rhinitis and changes in vivo and in vitro of allergic parameters in elderly patients: a long-term follow-up study

Abstract

Changes in rhinitis symptom severity tend to decrease with aging, but whether the decrease is associated with allergic skin test reactivity, serum total and specific IgE, and nasal eosinophils or determined only by aging is poorly understood. The aim of the study was to analyze sensitivity in vivo and in vitro some 15 years after primary testing, skin prick test (SPT), serum total and specific IgE, ratio sIgE/tIgE, and nasal eosinophils in order to evaluate changes due to age and changes due to the severity of rhinitis symptoms. One hundred and eight rhinitis patients who had been investigated in 1995 were re-interviewed and their current allergy re-assessed after a follow-up of 15 years. All patients were SPT with eight common allergens in the area of Palermo (Italy). Rhinitis symptoms tended, on average, to have become milder at the follow-up. All parameters examined showed a decreasing trend in older age groups over the period between the two investigations. Rhinitis symptoms tend to become milder and the allergic parameters both in vivo and in vitro usually decrease in the long run; however, the changes in rhinitis symptoms appear to be related to changes in the nasal eosinophils, independently of SPT and serum-specific IgE.

Gender‐specific differences in chronic rhinosinusitis patients electing endoscopic sinus surgery

“…This drop in symptom scores may reflect reduction in disease severity (mild decline in the CT scores of men). In patients with established allergic rhinitis, allergic symptoms are also noted to lessen over time . Age may also affect CRS symptomatology.…”

Serum allergen-specific IgE, allergic rhinitis severity, and age

“…They reported that there was not difference concerning total IgE levels between groups as well as cytological findings, but the epithelial-globet cells ratio was decreased in elderly patients; the quality of life was also more impaired in older subjects. Di Lorenzo and colleagues evaluated a group of 108 AR patients and followed them for a 15-year follow-up: rhinitis symptoms became milder over time as well as serum-specific IgE diminished at follow-up (35) . Cazzoletti reported a significant decline in self-reported AR prevalence from 26.6% in younger subjects to 15.6% in the elderly, without gender difference (36) .…”

Impact of age on outcomes following endoscopic sinus surgery for chronic rhinosinusitis

“…Given no difference in Lund‐Mackay score between age groups, but significantly different symptom scores, it is possible that rhinologists rely more heavily on evaluation of the disease severity on CT scan than the symptom scores when discussing the option of surgical intervention with patients despite the lack of correlation between CT scores and symptom scores . Additionally, symptoms of allergic rhinitis have been reported to decline with age . Details on allergy status were not available and were thus not considered in the analysis.…”