Pathophysiology of Allergic Rhinitis

Bousquet, Jean; Vignola, Antonio M.; Campbell, Alison M.; Michel, François‐Bernard

doi:10.1159/000237289

Cited by 87 publications

(52 citation statements)

References 80 publications

(92 reference statements)

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“…An allergic reaction significantly increases the reactivity of the nose because of the priming effect initially described by Connell (72,74,(1307)(1308)(1309). This effect may be seen for up to 6 weeks.…”

Section: Nasal Challenge Testsmentioning

confidence: 92%

“…These exposure units are mostly used to assess the efficacy of antiallergic treatments. However, there are pitfalls in these studies because the priming effect on the nasal mucosa is not considered in most studies (72,74,(1307)(1308)(1309) and the results of the challenges may not accord with the clinical data obtained from RCTs. These chambers are commonly used to assess the onset of action of medications.…”

Section: Environmental Exposure Unitsmentioning

confidence: 99%

See 1 more Smart Citation

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,826

1,761

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Section: Nasal Challenge Testsmentioning

confidence: 92%

Section: Environmental Exposure Unitsmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,826

1,761

View full text Add to dashboard Cite

“…Most patients with allergy also have an associated rhinitis and a significant number of patients with rhinitis will eventually develop asthma, suggesting that rhinitis may be a prestage of asthma in some individuals (15). Indeed, up to 30% of patients with chronic allergic rhinitis have asthma and rhinitic patients often show AHR (16). Lower airway inflammation has been demonstrated in rhinitic subjects without any evidence of asthma or AHR (17)(18)(19).…”

mentioning

confidence: 99%

The allergen bronchoprovocation model: an important tool for the investigation of new asthma anti‐inflammatory therapies

Gauvreau

et al. 2007

Allergy

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Allergen bronchoprovocation tests have been used for more than two decades in the investigation of respiratory allergic diseases such as asthma and rhinitis. These bronchial challenges are now well standardized and can offer key information on the therapeutic potential of new agents and on their anti‐inflammatory effects on the airways. Both standard and low‐dose allergen provocations are safe when performed by experienced investigators and do not lead to persistent worsening of asthma or change in airway function. The evaluation of new therapeutic agents by these methods can also provide important information on the mechanisms of development and persistence of airway diseases.

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“…Epidemiologic (1), pathophysiologic (2,3), and clinical studies (4,5) strongly suggest a link between rhinitis and asthma. Asthma and rhinitis, which are considered to be manifestations of the atopic syndrome, often coexist and share a common genetic background.…”

mentioning

confidence: 99%

Segmental Bronchial Provocation Induces Nasal Inflammation in Allergic Rhinitis Patients

Braunstahl

KleinJan

Overbeek

et al. 2000

Am J Respir Crit Care Med

355

211

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Allergic rhinitis and asthma often coexist and share a genetic background. Pathophysiologic connections between the nose and lungs are still not entirely understood. This study was undertaken to compare allergic inflammation and clinical findings in the upper and lower airways after segmental bronchial provocation (SBP) in nonasthmatic allergic rhinitis patients. Eight nonasthmatic, grass pollen-sensitive patients with allergic rhinitis and eight healthy controls were included. Bronchial biopsies and blood samples were taken before (T 0 ) and 24 h (T 24 ) after SBP. Nasal biopsies were obtained at T 0 , 1 h after SBP (T 1 ), and T 24 . Immunohistochemical staining was performed for eosinophils (BMK13), interleukin (IL)-5, and eotaxin. The number of eosinophils increased in the challenged and unchallenged bronchial mucosa (p Ͻ 0.05) and in the blood (p ϭ 0.03) of atopic subjects at T 24 . We detected an increase of BMK13-positive and eotaxin-positive cells in the nasal lamina propria and enhanced expression of IL-5 in the nasal epithelium of atopic subjects only at T 24 (p Ͻ 0.05). SBP induced nasal and bronchial symptoms as well as reductions in pulmonary and nasal function in the allergic group. No significant changes could be observed in healthy controls. The study shows that SBP in nonasthmatic allergic rhinitis patients results in peripheral blood eosinophilia, and that SBP can induce allergic inflammation in the nose.Epidemiologic (1), pathophysiologic (2, 3), and clinical studies (4, 5) strongly suggest a link between rhinitis and asthma. Asthma and rhinitis, which are considered to be manifestations of the atopic syndrome, often coexist and share a common genetic background. Although several studies have shown that asthma and rhinitis are characterized by a similar inflammatory process (6-9), pathophysiologic interactions between upper and lower airways are not entirely understood. It is clear that the condition of the upper airways definitely influences the lower airways. In allergic rhinitis patients without bronchial hyperreactivity (BHR), signs of allergic inflammation of the lower airways have been found in induced sputum, bronchoalveolar lavage fluid (BALF), and bronchial biopsy specimens (10-13). The nasal-bronchial reflex, an altered breathing pattern, pulmonary aspiration of nasal contents, and increased levels of inflammatory factors in the blood are possible mechanisms for lower airway dysfunction among patients with rhinitis (14). To shed more light on the role of systemic induction in the allergic inflammatory response, we designed a study in which blood samples and nasal and bronchial mucosal biopsy specimens were taken from a group of nonasthmatic allergic rhinitis patients with an isolated grass pollen allergy after segmental bronchial provocation (SBP) at a time other than the grass pollen season. The aim of the study was to compare allergic mucosal inflammation and clinical findings in the upper and lower airways. Eosinophils, major effector cells in allergic inflammation, interleukin (I...

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Pathophysiology of Allergic Rhinitis

Cited by 87 publications

References 80 publications

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

The allergen bronchoprovocation model: an important tool for the investigation of new asthma anti‐inflammatory therapies

Segmental Bronchial Provocation Induces Nasal Inflammation in Allergic Rhinitis Patients

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