JACI: Advances in upper airway diseases and allergen immunotherapy in 2007

Allergic rhinitis

Allergic rhinitis (AR) may be caused by local nasal IgE sensitization to aeroallergens in the absence of systemic evidence of IgE sensitization.

Allergic rhinitis impairs school performance and is a risk factor for future asthma.

New treatments for allergic rhinitis include:
- beta-1,3-glucan, a mushroom product that induces T(H)1 response
- olopatadine nasal spray

T helper (Th) 2 cells play an important role in the development of IgE-mediated diseases such as AR, leading to local overproduction of Th2 cytokines (IL-4, IL-5 and IL-13). On the contrary, Th1 cytokines (IL-12 and IFN-gamma) are known to suppress this Th2 immune response. Beta-1,3-1,6-glucan (Glucan) is an immunomodulator stimulating particularly the Th1-mediated immune response.

Orally-administered yeast-glucan decreases levels of IL-4 and IL-5 while increasing the levels of IL-12. Glucan may have a role as an adjunct to standard treatment in patients with AR.


Allergic rhinitis mind map.

Sublingual immunotherapy

Sublingual immunotherapy induces similar immunologic alterations as subcutaneous immunotherapy, although to a lesser degree.

Omalizumab

The combination of omalizumab with allergen subcutaneous immunotherapy can enhance clinical efficacy.

References:
Advances in upper airway diseases and allergen immunotherapy in 2007. Saltoun C, Avila PC. J Allergy Clin Immunol. 2008 Aug 9.
Effects of glucan treatment on the Th1/Th2 balance in patients with allergic rhinitis: a double-blind placebo-controlled study. Eur Cytokine Netw. 2005 Jun;16(2):128-34.
Allergic Rhinitis: A Short Review
Mind Maps: Allergic Rhinitis
Mnemonics: Allergic Rhinitis

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