Abstract
Allergic Rhinitis (AR) is an IgE-mediated inflammatory disease characterized by nasal congestion, rhinorrhea, sneezing, and itching as well as symptoms involving the eyes, ears, or throat. Uncontrolled AR significantly affects physical and social functioning, resulting in increased societal costs and diminished quality of life (QOL). Appropriate therapy can substantially reduce societal costs and significantly improve QOL. Classification of symptoms by severity and frequency can assist in selecting appropriate treatment strategies, with the identification of relevant allergens helping to guide administration. Pharmacotherapy to control symptoms remains the mainstay of treatment; however, allergen Immunotherapy (AIT) may be used in select individuals to induce sustained tolerance to sensitized allergens and provide symptomatic relief by modifying immune responses. In this chapter, we will use case-based discussion to provide a comprehensive review of the pathophysiology of AR, the mechanisms of AIT, treatment algorithms, and the basics of AIT preparation.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Bibliography
Ansotegui IJ, Melioli G, Canonica GW, Caraballo L, Villa E, Ebisawa M, et al. IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper. World Allergy Organ J. 2020;13(2)
Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R, et al. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008;100(3 Suppl 3):S1–S148.
Bousquet J, Anto JM, Bachert C, Baiardini I, Bosnic-Anticevich S, Walter Canonica G, et al. Allergic rhinitis. Nat Rev Dis Primers. 2020;6:1.
Bousquet PJ, Combescure C, Neukirch F, Klossek JM, Méchin H, Daures JP, et al. Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines. J Allergy. 2007;62(4):367–72.
Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol. 2011;127(1 Suppl):S1–S55.
Daigle BJ, Rekkerth DJ. Practical recommendations for mixing allergy immunotherapy extracts. Allergy Rhinol (Providence). 2015;6(1):1–7.
Dykewicz MS, Wallace DV, Amrol DJ, Baroody FM, Bernstein JA, Craig TJ, et al. Rhinitis 2020: a practice parameter update. J Allergy Clin Immunol. 2020;146(4):721–67.
Dykewicz MS, Wallace DV, Baroody F, Bernstein J, Craig T, Finegold I, et al. Treatment of seasonal allergic rhinitis: an evidence-based focused 2017 guideline update. Ann Allergy Asthma Immunol. 2017;119(6):489–511.e41.
Frew AJ. Allergen immunotherapy. J Allergy Clin Immunol. 2010;125(2 Suppl. 2):S306–S13.
Heinzerling L, Mari A, Bergmann KC, Bresciani M, Burbach G, Darsow U, et al. The skin prick test - European standards. Clin Transl Allergy. 2013;3(1):1–10.
Hossenbaccus L, Linton S, Garvey S, Ellis AK. Towards definitive management of allergic rhinitis: Best use of new and established therapies. Allergy Asthma Clin Immunol. 2020;16(1):1–17.
Kowalski ML, Ansotegui I, Aberer W, Al-Ahmad M, Akdis M, Ballmer-Weber BK, et al. Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement. World Allergy Organ J. 2016;9(1):1–42.
Ledford DK, Lockey RF. Controversies in allergy: intradermal aeroallergen skin testing. J Allergy Clin Immunol Pract. 2018;6(6):1863–5.
Patel HD, Chambliss JM, Gupta MR. Utility and comparative efficacy of recombinant allergens versus allergen extract. Curr Allergy Asthma Rep. 2017;17(9):63.
Penagos M, Eifan AO, Durham SR, Scadding GW. Duration of allergen immunotherapy for long-term efficacy in allergic rhinoconjunctivitis. Curr Treat Options Allergy. 2018;5(3):275–90.
Sin B, Togias A. Pathophysiology of allergic and nonallergic rhinitis. Proc Am Thorac Soc. 2011;8(1):106–14.
Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008;122(2 Suppl):1–84.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Gupta, M.R., Palmieri, J. (2022). Allergic Rhinitis. In: Mahmoudi, M. (eds) Absolute Allergy and Immunology Board Review. Springer, Cham. https://doi.org/10.1007/978-3-031-12867-7_5
Download citation
DOI: https://doi.org/10.1007/978-3-031-12867-7_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-12866-0
Online ISBN: 978-3-031-12867-7
eBook Packages: MedicineMedicine (R0)