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At least 19 recordsLinked to original sources
PubMed2002

The link between allergic rhinitis and allergic asthma: a prospective population-based study. The Copenhagen Allergy Study.

BACKGROUND: It has been hypothesized that allergic rhinitis and allergic asthma are manifestations of the same disease entity. We aimed to investigate the relationship between allergic rhinitis and allergic asthma. METHODS: Participants in a population-based study of 15-69-year-olds in 1990 were invited to a follow-up in 1998. A total of 734 subjects were examined on two occasions eight years apart. Allergic rhinitis to pollen was defined as a history of nasal symptoms on exposure to pollens and IgE specific to pollen. Allergic asthma to pollen was defined as a history of lower airway symptoms on exposure to pollens and IgE specific to pollen. Similarly, diagnoses of allergic rhinitis and allergic asthma to animals or mite were defined. RESULTS: At follow-up, all subjects with allergic asthma to pollen (n = 52) had in addition allergic rhinitis to pollen. In the longitudinal analysis, there were a total of 28 new (incident) cases of allergic asthma to pollen. They all had allergic rhinitis to pollen at baseline, or had developed allergic rhinitis to pollen at follow-up. Accordingly, allergic rhinitis to animals and mite were ubiquitous in subjects with allergic asthma to animals and mite, respectively. CONCLUSIONS: The results support the hypothesis that allergic rhinitis and allergic asthma are manifestations of the same disease entity.

Adolescent↗
PubMed1997

Overview of comorbid associations of allergic rhinitis.

Allergic rhinitis affects approximately 20% of the U.S. population. An association between allergic rhinitis and conditions including asthma, sinusitis, otitis media, nasal polyposis, respiratory infections, and even orthodontic malocclusions has been observed. Clinical research has identified shared pathogenic mechanisms, epidemiologic correlations, and findings from allergy testing to indicate that these conditions represent long-term physical consequences in allergic individuals. The positive response of patients afflicted with these conditions to antiallergic treatment further enhances the association between allergic rhinitis and other airway diseases. The use of nasal corticosteroids in patients with rhinitis and asthma reduces not only rhinitis symptoms but also asthma symptoms and airway reactivity to methacholine challenge. Similarly, antihistamines, with or without decongestants, result in improvement of objective measurements of pulmonary function. In the treatment of acute sinusitis, the combination of an intranasal corticosteroid and an antibiotic provides greater benefit than an antibiotic alone. Treatment strategies for allergic rhinitis should be directed at controlling the symptoms of allergic rhinitis and reducing the development of physical complications in susceptible persons. Three techniques for the treatment of allergic rhinitis are used, including avoidance of offending allergens, selection of appropriate pharmaceuticals, and allergy immunotherapy. Appropriate treatment may spare some patients of related airway diseases and may also reduce the overall cost of care. The broadened scope of allergic rhinitis and increased prevalence of IgE-mediated diseases have heightened awareness regarding the profound consequences of allergic rhinitis and the importance of effective treatment.

Adrenal Cortex Hormones↗
PubMed2000

Systemic immunologic and inflammatory aspects of allergic rhinitis.

Allergic rhinitis is a common chronic condition that is characterized by inflammation of the nasal mucosa. Although allergic rhinitis is a condition with upper respiratory symptoms, there is a growing body of evidence to suggest that allergic rhinitis may be linked to the development of systemic allergic manifestations that include allergic asthma. The evidence reveals that individuals with allergic rhinitis are sensitized to the eliciting allergens and exhibit cutaneous and respiratory hypersensitivity responses on exposure to the allergen. On exposure to a nasal allergen, circulating immunoglobulin E levels increased and remained elevated 2 weeks after the initial provocation. Patients with allergic rhinitis exhibit peripheral eosinophilia and basophilia, the magnitude of which correlates with the severity of symptoms. Additionally, there are several links between allergic rhinitis and asthma. First, 85% to 95% of patients with allergic asthma report rhinitis symptoms, and the severity of the 2 conditions increases in parallel on exposure to an allergen. Second, nasal administration of allergens can provoke impaired lower airway airflow in 25% to 30% of individuals and cause airway eosinophilia, as evidenced by increased numbers of eosinophils in sputum and mucosal biopsy specimens. Third, the treatment of seasonal allergic rhinitis with both systemic (eg, antihistamines) and local agents (eg, glucocorticosteroid analogues) can alleviate the symptoms of asthma. In summary, evidence that associates allergic rhinitis with systemic immunologic and inflammatory processes is growing, thereby warranting further in-depth investigation.

Humans↗
PubMedDate not supplied

[Health-related quality of life assessment in patients with allergic rhinitis].

Allergic rhinitis is a chronic inflammatory disease of the airways, which can interfere with many aspects of an individual's life and severely diminish the quality of life of the person affected. The objective of this study was to assess the quality of life of patients suffering from allergic rhinitis during and out of pollen season. The study involved 100 patients diagnosed with allergic rhinitis, 48 of who had seasonal, 25 perennial, and 27 who manifested both forms of allergic rhinitis. All study participants were treated at the Institute of Allergology and Immunology, Clinical Centre of Serbia, Belgrade, in the period March-November 2002. A specific quality of life questionnaire for patients with rhinoconjunctivitis was used in the study. During pollen season, itchy eyes (chi2 = 6.34; p = 0.042), red eyes (chi2 = 7.44; p = 0.024), and swollen eyes (chi2 = 6.65; p = 0.036) caused significantly more difficulties for subjects with seasonal and those with both seasonal and perennial rhinitis than for subjects with perennial allergic rhinitis. A highly significant difference in the mean scores of the indoors activity variable during and out of pollen season (F = 347.28; p = 0.000) was noted, that is to say, significant irritation was noted during pollen season among subjects with seasonal and those with both seasonal and perennial allergic rhinitis, however the dynamics of irritation remained the same in both study groups (F = 0.145; p = 0.704). The patients with seasonal and those with both seasonal and perennial allergic rhinitis experienced a significantly poorer quality of life during pollen season than out of it, as well as an inferior quality of life in comparison to patients with perennial allergic rhinitis during pollen season.

Adult↗
PubMed2005

Recent trends in the diagnosis and management of allergic rhinitis.

Allergic rhinitis is a global health issue and its prevalence is increasing. Allergic rhinitis and asthma coexist in many patients. Allergic rhinitis is an Ig E mediated reaction. Prostaglandins and Leukotriens do not play a significant role in the pathogenesis of allergic rhinitis. Skin prick test and Enzyme linked immunosorbent assays (ELISA) are useful as diagnostic tests. The three major modalities of treatment for allergic rhinitis are allergen avoidance, pharmacotherapy and immunotherapy.

Humans↗
PubMed2001

[Therapy of allergic rhinitis].

Allergic rhinitis is a common disease with a prevalence of 10-20% in western countries. Allergic rhinitis may be complicated by the possible restriction of quality of life and can lead to sequelae like sinusitis, headache or even allergic asthma. The treatment of allergic rhinitis is mainly based on allergen avoidance, pharmacological treatment and specific immunotherapy. For mild symptoms of seasonal or perennial allergic rhinitis topical or nonsedating second generation oral H1-antihistamines or chromones are advised. If the patient presents symptoms of long duration or nasal obstruction is dominant, intranasal steroids should be used, which have proved to be an effective and safe form of therapy for allergic rhinitis. A combination of oral antihistamines and steroids are possible and recommended if one of these agents alone does not provide sufficient relief. If necessary this regimen is supplemented with topical antihistamines or chromone eyedrops. In cases of severe nasal obstruction, a short course of oral steroids or topical decongestants, which both should not be given longer than ten days, is recommended. Intramuscular corticosteroids should not be given, due to the suppression of adrenal glands. In addition it is important to prevent exposure to the allergen. If the treatment is not effective, further investigations should be done to exclude other nasal diseases (polyposis nasi, anatomical anomalies, chronic sinusitis). This article summarizes the recommended medications with their possible side-effects and their place in therapy management of allergic rhinitis in adults and children.

Administration, Intranasal↗
PubMedDate not supplied

Combination therapy in the treatment of allergic rhinitis.

Allergic rhinitis is a common allergic condition. There are a variety of pharmacologic treatments, including antihistamines, oral decongestants, and intranasal corticosteroids. Leukotrienes cause significant nasal obstruction. Leukotriene receptor antagonists decrease symptoms and improve quality of life in patients with seasonal allergic rhinitis. Similar to antihistamines, antileukotrienes appear to be less efficacious than nasal corticosteroids. Combination therapy of histamine and leukotriene antagonists produces symptomatic improvement as well as improved quality of life. Areas of study for combination antimediator therapy include expanding the initial findings with regard to nasal steroids, investigation of patient preference and compliance, use in perennial allergic rhinitis, and treatment of "one airway," i.e., treatment of concurrent allergic rhinitis and asthma.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Pharmacotherapy to prevent the complications of allergic rhinitis.

Allergic rhinitis is an immunologic disease with effects that extend beyond the symptoms that occur subsequent to allergen exposure. A reduced quality of life and medical conditions such as asthma, sinusitis and otitis media are well recognized complications of allergic rhinitis. Craniofacial abnormalities, nasal ployps, and respiratory infections have been linked to allergic rhinitis, but the evidence is conflicting. This article reviews the complications of allergic rhinitis, their prevalences, possible mechanisms for their relationship to allergic rhinitis, and the prevention of these complications via pharmacologic treatment of allergic rhinitis.

Adolescent↗
PubMed2002

Use of intranasal cromolyn sodium for allergic rhinitis.

Allergic rhinitis affects 10% to 20% of Americans. It frequently coexists with other conditions, such as allergic conjunctivitis, sinusitis, and asthma, and is associated with impaired occupational function and performance in school, decreased quality of life, and increased health care costs. An efficacious agent with minimal adverse effects and a lack of drug interactions is needed to help simplify treatment of allergic rhinitis, especially in patients with comorbidities. Controlled studies of intranasal cromolyn sodium therapy for patients with seasonal and perennial allergic rhinitis are reviewed, and appropriate candidates for treatment with this agent are discussed. Cromolyn inhibits the degranulation of sensitized mast cells, thereby blocking the release of inflammatory and allergic mediators. It reduces symptoms of allergic rhinitis, and, when used prophylactically, cromolyn can prevent symptoms from occurring. Controlled studies comparing cromolyn with placebo, intranasal corticosteroids, and antihistamines have shown the efficacy of cromolyn in relieving rhinitis symptoms. In addition, because cromolyn is poorly absorbed systemically, it is well tolerated and not associated with drug interactions. Intranasal cromolyn has an excellent safety record, is available as an over-the-counter medication, and has been proved to be efficacious in patients with allergic rhinitis.

Administration, Intranasal↗
PubMed1990

Antihistamine therapy in allergic rhinitis.

Allergic rhinitis is a common disorder that is associated with a high incidence of morbidity and considerable costs. The symptoms of allergic rhinitis are primarily dependent upon the tissue effects of histamine. Antihistamines are the mainstay of therapy for allergic rhinitis. Recently, a second generation of antihistamines has become available. These agents lack the adverse effect of sedation, which is commonly associated with older antihistamines. Current practice of antihistamine therapy in allergic rhinitis often involves random selection among the various agents. Based upon the available clinical trials, chlorpheniramine appears to be the most reasonable initial antihistaminic agent. A nonsedating antihistamine should be used initially if a patient is involved in activities where drowsiness is dangerous. In this comprehensive review of allergic rhinitis and its treatment, the current as well as future options in antihistamine pharmacotherapy are emphasized.

Histamine H1 Antagonists↗
PubMedDate not supplied

Cognitive, social, and economic costs of allergic rhinitis.

Allergic rhinitis is a highly prevalent, chronic condition. In addition to physical discomfort, rhinitis symptoms have been associated with detrimental effects on the psychological and social aspects of patients' lives. In allergy-specific questionnaires, subjects with allergic rhinitis consistently report lower quality of life than nonallergic controls. Untreated patients are embarrassed and frustrated by their allergy symptoms. Atopic individuals consistently exhibit significant declines in cognitive processing, psychomotor speed, verbal learning, and memory during allergy season. The discomfort, cognitive impairment, and absenteeism associated with allergic rhinitis exact a significant economic toll on U.S. businesses through decreased productivity. When combined with direct medical expenditures, the economic burden of allergic rhinitis is considerable. The effect of treatment on the economics of allergic rhinitis is highly variable: relatively inexpensive medications (lower direct costs) have central nervous system side effects that can cause somnolence and impair learning, memory, and performance (higher indirect costs). Health outcomes data on the effects of allergic rhinitis and its treatments can help establish, monitor, and improve standards of care; as well as inform priority setting, direct resource allocation, and eliminate unnecessary practices.

Chronic Disease↗
PubMed2000

[Allergic rhinitis].

Allergic rhinitis is one of the commonest diseases. The main allergens responsible are respiratory allergens. Pollinic or seasonal allergic rhinitis is currently distinguished from perannual or nonseasonal rhinitis, generally related to sensitization to allergens of the home environment. The diagnostic approach of allergic rhinitis is based on a careful clinical examination, in order to eliminate other causes of nasal dysfunction, and on complementary investigations, most importantly allergic skin tests. Several types of drugs, topically or systemically administered are currently available to treat allergic rhinitis. Surgical techniques should be reserved to patients who resist to medical treatment or to correct nasal architectural abnormality.

Adolescent↗
PubMed1998

Overview of diagnosis and management of allergic rhinitis.

Allergic rhinitis remains an important problem that affects people of all ages. Although allergic rhinitis is considered a trivial disease by the public and medical community alike, the evidence of allergic rhinitis as a risk factor to the development of associated diseases such as asthma, sinusitis, otitis media with effusion, and nasal polyps is better appreciated. Pathophysiology and current therapy of allergic rhinitis is reviewed.

Adolescent↗
PubMed2005

Evaluation of nasal barrier dysfunction at acute- and late-phase reactions in a guinea pig model of allergic rhinitis.

Allergic rhinitis is a common disease characterized by the symptoms of pruritus, sneezing, hypersecretion and nasal blockage. Increased mucosal barrier permeability has been suggested to be an indicator for the severity of allergic rhinitis. This study investigates the passage of radiolabelled albumin from the nasal mucosal circulation into the lumen in guinea pigs intraperitoneally sensitized and intranasally challenged with antigen. In order to characterize the allergic rhinitis model, we evaluated a number of potential influencing factors in nasal plasma exudation, including antigen doses, volumes of antigen solution used, and animal position during the nasal lavage, and the conditions of nasal lavage. The number of eosinophils and levels of histamine and leukotriene B4 in the nasal lavage and eosinophils in the nasal mucosa were determined at the early and late phases after antigen challenge. We also compared the effects of topical nasal treatments for allergic rhinitis on nasal inflammatory responses. Our results demonstrate that, in the guinea pig nasal mucosa, topical challenge with antigens induces plasma exudation and histamine release at the acute-phase reaction, and plasma exudation and eosinophil infiltration at the late-phase reaction. These changes are similar to those reported in human allergic rhinitis. Alterations of nasal plasma exudation, histamine release and eosinophil influx were dependent upon the concentrations and volumes of antigens. An antihistamine inhibited the acute-phase reaction partially, whereas budesonide inhibited effects at the late-phase reaction. We suggest that this model of guinea pig allergic rhinitis with the early and late responses may be useful for high-throughout screening of new drugs.

Administration, Topical↗
PubMed2006

Association of carotenoids, tocopherols and vitamin C in plasma with allergic rhinitis and allergic sensitisation in adults.

OBJECTIVES: Antioxidant nutrients like carotenoids, tocopherols and vitamin C have been suggested to protect against allergic rhinitis and allergic sensitisation but scientific evidence is scarce. The aims of the study were to measure the plasma concentration of six carotenoids, alpha- and gamma-tocopherol and vitamin C as biomarkers of the intake, absorption and subsequent metabolism of these nutrients, and to assess their association with allergic rhinitis and sensitisation. METHOD: Data from a cross-sectional study on representative dietary and lifestyle habits of the population of Bavaria, Germany, were analysed. The plasma levels of six carotenoids (alpha-carotene, beta-carotene, lycopene, lutein/zeaxanthin, canthaxanthin and cryptoxanthin) as well as of alpha-tocopherol, gamma-tocopherol and vitamin C were measured in 547 adults aged between 19 and 81 years. Participants with specific serum immunoglobulin E > or =700 U l(-1) were categorised as sensitised. The association of plasma antioxidant levels, allergic rhinitis and allergic sensitisation was assessed by means of unconditional logistic regression models. RESULTS: We observed a negative association between plasma total carotenoids and the prevalence of allergic rhinitis, with odds ratio (95% confidence interval) of 1.13 (0.54-2.39) for the second, 0.72 (0.33-1.58) for the third and 0.44 (0.19-1.03) for the fourth quartile of total carotenoids concentration (P for trend=0.0332); results for lycopene failed to reach statistical significance (P=0.0608). Other single carotenoids, tocopherols and vitamin C were unrelated to allergic rhinitis. Allergic sensitisation was negatively associated with plasma gamma-tocopherol, with odds ratio (95% confidence interval) of 0.92 (0.51-1.65) for the second, 1.00 (0.56-1.80) for the third and 0.45 (0.23-0.88) for the fourth quartile of plasma gamma-tocopherol concentration (P for trend=0.0410). No other antioxidant was significantly related to allergic sensitisation. CONCLUSIONS: High plasma carotenoid concentrations reflecting a diet high in various fruits and vegetables might have a protective effect on allergic rhinitis in adulthood.

Adult↗
PubMed2002

Treatment of allergic rhinitis.

Allergic rhinitis, a common and often debilitating disease marked by rhinorrhea, nasal congestion, nasal itching, and sneezing, is on the increase worldwide. Treatment involves allergen avoidance, pharmacotherapy, and, in selected cases, immunotherapy. This overview describes the characteristics, pathogenesis, and diagnosis of allergic rhinitis. The major contributing allergens of seasonal and perennial allergic rhinitis are identified. Pharmacotherapy is described within the context of treatment guidelines developed by the major asthma and allergy professional organizations. Oral H1 antihistamines are first-line therapy for mild-to-moderate allergic rhinitis. The newer, nonsedating agents are recommended over first-generation antihistamines. Some of the newer oral antihistamines, such as cetirizine, desloratadine, and fexofenadine, have been shown to relieve the symptom of nasal congestion. Intranasal steroids are first-line therapy for patients with more severe symptoms.

Humans↗
PubMed2006

[Nasal provocation tests in the diagnosis of allergic rhinitis].

Allergic rhinitis is a frequent immunological disease affecting about 10-25% of the total population. The pathogenesis of allergic rhinitis is presumed to involve an IgE-mediated mechanism. Careful patient history, together with the skin prick test or RAST, usually allows an easy diagnosis of allergic rhinitis. In other cases it may be necessary to confirm diagnosis by the nasal provocation test. Different methods of provocation and measurement of nasal responses have been used in recent years. Scoring of the severity of clinical symptoms is too subjective to be clinically useful and should therefore be supplemented by one of the objective measurement techniques, such as anterior rhinomanometry. Additional analysis of nasal cytologic findings and determination of biomarkers in nasal secretions can be a critical tool in the evaluation of pathophisiology of allergic rhinitis. We critically discuss indications and contraindications for nasal challenges and review current techniques of provocation. We also provide various methods of assessment of nasal responses. The included examples of nasal provocation tests protocols may be helpful in introducing nasal provocation tests into everyday clinical practice.

Administration, Intranasal↗
PubMed1997

Pathogenesis of allergic rhinitis.

Allergic rhinitis is an increasing problem for which new and exciting therapies are being developed. These can be understood through an appreciation of the newer concepts of pathogenesis of allergic rhinitis. Allergen induces Th2 lymphocyte proliferation in persons with allergies with the release of their characteristic combination of cytokines including IL-3, IL-4, IL-5, IL-9, IL-10, and IL-13. These substances promote IgE and mast cell production. Mucosal mast cells that produce IL-4, IL-5, IL-6, and tryptase proliferate in the allergic epithelium. Inflammatory mediators and cytokines upregulate endothelial cell adhesion markers, such as vascular cell adhesion molecule-1. Chemoattractants, including eotaxin, IL-5, and RANTES, lead to characteristic infiltration by eosinophils, basophils, Th2 lymphocytes, and mast cells in chronic allergic rhinitis. As our understanding of the basic pathophysiologic features of allergic rhinitis continues to increase, the development of new diagnostic and treatment strategies may allow more effective modulation of the immune system, the atopic disease process, and the associated morbidity.

Allergens↗