Rhinitis and Inhalant Allergens

Abstract

Allergic rhinitis affects about 20% of the US population. The diagnosis is based on patterns of symptoms, physical examination, and assessment of IgE antibodies by skin or in vitro testing. The most common offending allergens are pollens of grasses, trees, and weeds; fungi; animal allergens; and dust mites. In an individual with nasal allergy, exposure leads to rapid release of mast cell-derived mediators. This immediate response is followed by a cell-dominated response, including eosinophils and lymphocytes. Cytokines from T(H)2 lymphocytes, such as interleukin 4 and interleukin 5, orchestrate allergic inflammation. Resulting tissue changes produce symptoms of the disease and augment responses on subsequent exposure to allergens and irritants. Strategies for avoiding offending agents are important in management. In intermittent disease, antihistamines and/or decongestants are first prescribed. More continuous symptoms may mandate intranasal steroids. Immunotherapy is often helpful for patients who respond poorly to pharmacotherapy and avoidance.

Predicting days of high allergenic risk during Betula pollination using weather types

“…A table of this sort constitutes an interesting tool for the prevention of high-risk allergenic exposure, because the weather types can be predicted by the meteorological office (Météo-France). It would be interesting in the future if the forecast could be broadcast to allergists and to the general public, in particular by the Internet or television, giving appropriate advice to those concerned: take measures that limit contact with the pollen allergens (avoid going out if possible, do not undertake any outdoor physical activity and close the windows of your home or car); take any preventive medecine prescribed by the physician that has a rapid effect (a few minutes or 1 or 2 days) on rhinitis and conjunctivitis (Durham 1998) so that its use on the day before a highrisk day can lead to effective prevention (Naclerio and Solomon 1997). This preventive action has a slower response in asthma, where it manifests itself only after several days or weeks because of the extent of the bronchus and the bronchioles and because of bronchial nonspecific hyper-reactivity.…”

Allergic Rhinitis in Children: Selecting an Intranasal Corticosteroid

“…13 Antihistamines are effective against some of the early-phase AR symptoms; however, they are not effective against the late-phase AR symptoms such as nasal blockage. [13][14][15] One topically available antihistamine, azelastine hydrochloride, has been shown to inhibit some late-phase inflammatory responses 16 ; however, INSs are still more effective in relieving AR symptoms. 11,17 Sedating antihistamines have also been found to contribute to decreased work productivity, increased cognitive impairment, and impaired learning and academic performance.…”

Inflammatory sinonasal disease

“…The mean age of diagnosis for allergic rhinitis is 9 to 11 years [8]. While the disease usually begins in childhood, its peak symptoms are present between the ages of 10 and 40 years [9]. In 1974, a population-based prevalence study in rural Michigan suggested a prevalence of 10% for both men and women [10].…”