Allergic Rhinitis and Atopy: The Causative Role of Aeroallergens: A Review
G Shyam, R Chandana, G Anusha Reddy, M Asimuddin and Kaiser Jamil*
Department of Genetics, Bhagwan Mahavir Medical Research Centre, Hyderabad, India
*Corresponding Author: Kaiser Jamil, Department of Genetics, Bhagwan Mahavir Medical Research Centre, Hyderabad, India.
February 04, 2022; Published: May 06, 2022
The prevalence of Allergic Rhinitis (AR) has increased globally in recent times from 10 to 20% which can further deteriorate to atopy affecting adults and children equally. The main causative agents include aeroallergens which produce symptoms, not only like sneezing, itching, and nasal congestion, but also affecting the quality of life (QoL) and disturbed sleep. This review evaluates the risk parameters of allergic rhinitis which generally occur due to indoor and environmental aeroallergens, these interact with the host’s immune system to increases the production of specific immunoglobins like IgE. These specific IgE antibodies bind to high-affinity IgE receptors on mast cells and basophils and trigger a sequence of events leading to allergic rhinitis, chronic rhinitis, and atopy. The propensity to produce IgE to allergens is referred as Atopy. This article examines the mechanism of the causative agents leading to the disease, with regards to the potential differences in health care and allergic rhinitis. The diagnoses, pathophysiology and subsequent treatment of the disease impacts an economic burden on the patients, further, co-morbidities associated with AR impose additional financial burden and can have a negative impact on the QoL of the patients. Hence this article observes the economic burden due to AR which is estimated at 10-40% of the country’s economic burden. This review further highlights on improving the well-being of the patients through better diagnosis and utilizing currently available treatment options for Allergic rhinitis.
Keywords: Allergic Rhinitis; Allergens; Atopy; Treatment Options; Pharmacotherapy; Immunotherapy; Mechanisms; Economic Burden
- Peter Small and Harold Kim. “Allergic Rhinitis: Review”. Asthma and Clinical Immunology 7 (2011): S3.
- Chauhan G and Khokar CP. “Quality of life in allergic rhinitis patients”. International Journal of Indian Psychology 2 (2015): 114.
- Sharma N., et al. “To assess the quality of life in patients suffering from allergic rhinitis”. Journal of Basic and Applied Sciences 11 (2015): 501-506.
- Chaplin D D. “Overview of the immune response”. The Journal of Allergy and Clinical Immunology 125 (2010): S3-S23.
- AB Kay. “Allergy and allergic diseases”. The New England Journal of Medicine1 (2004).
- Anand B Singh and Pawan Kumar. “Aeroallergens in clinical practice of allergy in India. An overview”. Annals of Agricultural and Environmental Medicine 10 (2003): 131-136.
- Wang DY. “Risk factors of allergic rhinitis: genetic or environmental?” Therapeutics and Clinical Risk Management 2 (2005): 115-123.
- Campo P., et al. “Local allergic rhinitis: Implications for management”. Clinical and Experimental Allergy 1 (2019): 6-16.
- Small P., et al. “Rhinitis: a practical and comprehensive approach to assessment and therapy”. Journal of Otolaryngology 36 (2007): S5-27.
- Dávila I., et al. “Genetic aspects of allergic rhinitis”. Journal of Investigational Allergology and Clinical Immunology 19 (2009): 25-31.
- Louis M., et al. “Genomics, Genetics and Genes of the Immune system”. Immunity 15 (2001): 335-336.
- Enrique Medina-Acosta., et al. “Genetic Control of Immune Response and Susceptibility to Infectious Diseases". BioMed Research International 3 (2014).
- Hellgren J., et al. “Allergic rhinitis and the common cold - high cost to society”. Allergy6 (2010): 776-783.
- Cardell LO., et al. “TOTALL: high cost of allergic rhinitis—a national Swedish population-based questionnaire study”. NPJ Primary Care Respiratory Medicine 26 (2016): 15082.
- Pawankar R., et al. “WAO White Book on Allergy”. World Allergy Organization (2011).
- Carr WW., et al. “Managing rhinitis: Strategies for improved patient outcomes”. Allergy and Asthma Proceedings 4 (2008): 349-357.
- Prasad R and Kumar R. “Allergy situation in India: what is being done?” Indian Journal of Chest Diseases and Allied Sciences 55 (2013): 7-8.
- Varshney J Varshney. “Allergic rhinitis: an overview”. Indian Journal of Otolaryngology and Head and Neck Surgery 2 (2015): 143-149.
- Singh A and Kumar H. “Cost-analysis study of second generation antihistamines used in the treatment of allergic rhinitis in India”. International Journal of Basic and Clinical Pharmacology4 (2016): 1228-1233.
- Bernstein DI., et al. “Allergic Rhinitis: Mechanisms and Treatment”. Immunology and Allergy Clinics of North America 2 (2016): 261-278.
- Nurmatov U., et al. “House dust mite avoidance measures for perennial allergic rhinitis: an updated Cochrane systematic review”. Allergy 67 (2012): 158-165.
- Satyaraj E., et al. “Keep the cat, change the care pathway: a transformational approach to managing Fel d 1, the major cat allergen”. Allergy 74 (2019): 5-17.
- Kawauchi H., et al. “Antihistamines for allergic rhinitis treatment from the viewpoint of nonsedative properties”. International Journal of Molecular Sciences 20 (2019): 213.
- Bozek J L A. “Pharmacological management of allergic rhinitis in the elderly”. Drugs Aging 34 (2017): 21-28.
- Church M K., et al. “Risk of first-generation H1-antihistamines: a GA2LEN position paper”. Allergy 65 (2010): 459-466.
- Kar S., et al. “A review of antihistamines used during pregnancy”. Journal of Pharmacology and Pharmacotherapeutics 3 (2012): 105-108.
- Patel P., et al. “Onset of action of azelastine nasal spray compared with mometasone nasal spray and placebo in subjects with seasonal allergic rhinitis evaluated in an environmental exposure chamber”. American Journal of Rhinology 21 (2007): 499-503.
- Rodrigo G J., et al. “Efficacy of fluticasone furoate nasal spray vs. placebo for the treatment of ocular and nasal symptoms of allergic rhinitis: a systematic review”. Clinical and Experimental Allergy 41 (2011): 160-170.
- Segall N., et al. “Long-term safety and efficacy of olopatadine-mometasone combination nasal spray in patients with perennial allergic rhinitis”. Allergy and Asthma Proceedings 40 (2019): 301-310.
- Brozek JL., et al. “Allergic rhinitis and its impact on asthma (ARIA) guidelines: 2010 revision”. The Journal of Allergy and Clinical Immunology 126 (2010): 466-476.
- Kozlov V., et al. “Evidence-based phytotherapy in allergic rhinitis”. Clinical Phytoscience 4 (2018): 23.
- Berger W., et al. “Efficacy of MP-AzeFlu in children with seasonal allergic rhinitis: importance of paediatric symptom assessment”. Pediatric Allergy and Immunology 27 (2016): 126-133.
- Jorgen Nedergaard Larsen., et al. “Allergy immunotherapy: the future of allergy treatment”. Drug Discovery Today1 (2016).
- Tripathi A and Patterson R. “Impact of allergic rhinitis treatment on quality of life”. Pharma Economics9 (2001): 891-9.
- Harsha H Kariyawasam, Giuseppina Rotiroti, in Encyclopedia of Respiratory Medicine (Second Edition), Volume 2 (2022).
- Wrighton SA and Stevens JC. “The human hepatic cytochrome P450 involved in drug metabolism”. Critical Reviews in Toxicology 22 (1992): 1-21.
- .Janeway CA Jr., et al. “Immunobiology: The Immune System in Health and Disease”. 5th New York: Garland Science; 2001. Effector mechanisms in allergic reactions (2001).