Skip to main content
SpringerLink
Log in

Latest developments in the management of allergic rhinitis

  • Published:
Clinical Reviews in Allergy & Immunology Aims and scope Submit manuscript

Abstract

Allergic rhinitis (AR) is the most common chronic atopic disease, and it is associated with considerable costs and comorbidities. The management of AR includes environmental control measures, pharmacotherapy, and immunotherapy. This article discusses several developments and findings that have recently emerged in these three areas. The effectiveness of traditional methods of mitigating allergen exposure, such as the use of impermeable dust mite-proof bedding covers, has been rendered debatable. Exposure to environmental factors, such as household pets, is known to provoke exacerbation of allergic disease but now is proposed to have protective effects in certain settings. Changes in the choices of pharmacotherapy continue to occur as antileukotrienes and derivatives of certain antihistamines are added to the armamentarium against AR. However, a critical review of the clinical trials involving these drugs suggests that the changes are not necessarily incremental. Innovative methods of immunomodulation are currently being developed, with the objective of optimizing efficacy and safety. These include alternative routes or forms of delivering immunotherapy and other novel approaches in altering the pathobiology of AR.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Malone, D.C., Lawson, K.A., Smith, D.H., Arrighi, H.M., and Battista, C. (1997), J Allergy Clin Immunol 99, 22–27.

    Article  PubMed  CAS  Google Scholar 

  2. Meltzer, E.O. (1997), J Allergy Clin Immunol 99, S805-S828.

    PubMed  CAS  Google Scholar 

  3. Law, A.W., Reed, S.D., Sundy, J.S., and Schulman, K.A. (2003), J Allergy Clin Immunol 111, 296–300.

    Article  PubMed  Google Scholar 

  4. Potter, P.C., Van Niekerk, C.H., and Schoeman, H.S. (2003), Ann Allergy Asthma Immunol 91, 368–374.

    PubMed  CAS  Google Scholar 

  5. Noonan, M.J., Raphael, G.D., Nayak, A., et al. (2003), Clin Exp Allergy 33, 351–358.

    Article  PubMed  CAS  Google Scholar 

  6. Fineman, S.M. (2002), Ann Allergy Asthma Immunol 88, 2–7.

    PubMed  Google Scholar 

  7. Crystal-Peters, J., Crown, W.H., Goetzel, R.Z., and Schutt, D.C. (2000), Am J Manag Care 6, 373–378.

    PubMed  CAS  Google Scholar 

  8. Vuurman, E.F., van Veggel, L.M., Uiterwijk, M.M., Leutner, D., and O’Hanlon, J.F. (1993), Ann Allergy 71, 121–126.

    PubMed  CAS  Google Scholar 

  9. Wilken, J.A., Berkowitz, R., and Kane, R. (2002), Ann Allergy Asthma Immunol 89, 372–380.

    PubMed  Google Scholar 

  10. Weiler, J., Bloomfield, J., Woodworth, G., et al. (2000), Ann Intern Med 132, 354–363.

    PubMed  CAS  Google Scholar 

  11. Wilken, J.A., Kane, R.L., Ellis, A.K., et al. (2003), 91, 375–385.

  12. Baroody, F.M. (2003), Otolaryngol Head Neck Surg 128, 616–631.

    Article  PubMed  Google Scholar 

  13. Leynaert, B., Neukrich, F., Demoly, P., and Bousquet, J. (2000), J Allergy Clin Immunol 106, S201-S205.

    Article  PubMed  CAS  Google Scholar 

  14. Lack, G. (2001), J Allergy Clin Immunol 108, 9–15.

    Article  Google Scholar 

  15. Simons, F.E. (1999), J Allergy Clin Immunol 104, 534–540.

    Article  PubMed  CAS  Google Scholar 

  16. Passalacqua, G., and Canonica, G.W. (2001), Respir Res 2, 320–323.

    Article  PubMed  CAS  Google Scholar 

  17. Kapsali, T., Horowitz, E., and Togias, A. (1997), J Allergy Clin Immunol 99, S138 (abstract).

  18. Settipane, R.J., Hagy, G.W., and Settipane, G.A. (1994), Allergy Proc 15, 21–25.

    Article  PubMed  CAS  Google Scholar 

  19. Welsh, P., Stricker, W., Chu, C., et al. (1987), Mayo Clin Proc 62, 125–134.

    PubMed  CAS  Google Scholar 

  20. Reed, C.E., Marcoux, J.P., and Welsh, P.W. (1988), J Allergy Clin Immunol 81, 1042–1047.

    Article  PubMed  CAS  Google Scholar 

  21. Adams, R., A., F., Finkelstein, J., and Weiss, S. (2002), J Allergy Clin Immunol 109, 636–642.

    Article  PubMed  CAS  Google Scholar 

  22. Crystal-Peters, J., Neslusan, C., Crown, W., and Torres, A. (2002), J Allergy Clin Immunol 109, 57–62.

    Article  PubMed  Google Scholar 

  23. Moller, C., Dreborg, S., Ferdousi, H., et al. (2002), J Allergy Clin Immunol 109, 251–256.

    Article  PubMed  Google Scholar 

  24. Naclerio, R.M., Proud, D., Togias, A.G., et al. (1985), N Engl J Med 313, 65–70.

    Article  PubMed  CAS  Google Scholar 

  25. Braunstahl, G.-J., Overbeek, S., KleinJan, A., Prins, J.-B., Hoogsteden, H., and Fokkens, W. (2001), J Allergy Clin Immunol 107, 469–476.

    Article  PubMed  CAS  Google Scholar 

  26. Togias, A. (2004), J Allergy Clin Immunol 113, S8-S14.

    Article  PubMed  Google Scholar 

  27. Borish, L. (2003), J Allergy Clin Immunol 112, 1021–1031.

    Article  PubMed  CAS  Google Scholar 

  28. Terreehorst, I., Hak, E., Oosting, A.J., et al. (2003), N Engl J Med 349, 237–246.

    Article  PubMed  Google Scholar 

  29. Bjornsdottir, U.S., Jakobinudottir, S., Runarsdottir, V., and Juliusson, S. (2003), Ann Allergy Asthma Immunol 91, 189–194.

    PubMed  Google Scholar 

  30. Lau, S., Wahn, J., Schulz, G., Sommerfeld, C., and Wahn, U. (2002), Pediatr Allergy Immunol 13, 31–36.

    Article  PubMed  Google Scholar 

  31. Ownby, D.R., Johnson, C.C., and Peterson, E.L. (2002), JAMA 288, 963–972.

    Article  PubMed  Google Scholar 

  32. Braun-Fahrlander, C., Riedler, J., Herz, U., et al. (2002), N Engl J Med 347, 869–877.

    Article  PubMed  Google Scholar 

  33. Celedon, J.C., Litonjua, A.A., Ryan, L., Platts-Mills, T., Weiss, S.T., and Gold, D.R. (2002), Lancet 360, 781–782.

    Article  PubMed  Google Scholar 

  34. Apter, A.J. (2003), J Allergy Clin Immunol 111, 938–946.

    Article  PubMed  Google Scholar 

  35. Casale, T.B., Blaiss, M.S., Gelfand, E., et al. (2003), J Allergy Clin Immunol 111, S835-S842.

    Article  PubMed  Google Scholar 

  36. Shih, Y.C., Prasad, M., and Luce, B.R. (2002), Clin Ther 24, 701–716.

    Article  PubMed  Google Scholar 

  37. Simons, F.E., Prenner, B.M., and Finn, A., Jr. (2003), J Allergy Clin Immunol 111, 617–622.

    Article  PubMed  CAS  Google Scholar 

  38. Horak, F., Stubner, P., Zieglmeyer, R., and Harris, A.G. (2003), Allergy 58, 481–485.

    Article  PubMed  CAS  Google Scholar 

  39. Wilken, J.A., Kane, R.L., Ellis, A.K., et al. (2003), Ann Allergy Asthma Immunol 91, 375–385.

    PubMed  CAS  Google Scholar 

  40. Wilson, A.M., Haggart, K., Sims, E.J., and Lipworth, B.J. (2002), Clin Exp Allergy 32, 1504–1509.

    Article  PubMed  CAS  Google Scholar 

  41. Hampel, F., Ratner, P., Mansfield, L., Meeves, S., Liao, Y., and Georges, G. (2003), Ann Allergy Asthma Immunol 91, 354–361.

    Article  PubMed  CAS  Google Scholar 

  42. Potter, P.C. (2003), Allergy 58, 893–899.

    Article  PubMed  CAS  Google Scholar 

  43. Philip, G., Malmstrom, K., Hampel, F.C., et al. (2002), Clin Exp Allergy 32, 1020–1028.

    Article  PubMed  CAS  Google Scholar 

  44. Nayak, A.S., Philip, G., Lu, S., Malice, M.P., and Reiss, T.F. (2002), Ann Allergy Asthma Immunol 88, 592–600.

    PubMed  CAS  Google Scholar 

  45. Meltzer, E.O. (2002), Ann Allergy Asthma Immunol 88, 23–29.

    PubMed  Google Scholar 

  46. van Adelsberg, J., Philip, G., LaForce, C.F., et al. (2003), Ann Allergy Asthma Immunol 90, 214–222.

    PubMed  Google Scholar 

  47. Meltzer, E.O., Malmstrom, K., Lu, S., et al. (2000), J Allergy Clin Immunol 105, 917–922.

    Article  PubMed  CAS  Google Scholar 

  48. Wilson, A.M., Orr, L. C., Coutie, W.J., Sims, E.J., and Lipworth, B.J. (2002), Clin Exp Allergy 32, 126–132.

    Article  PubMed  CAS  Google Scholar 

  49. Moinuddin, R., deTineo, M., Maleckar, B., Naclerio, R.M., and Baroody, F.M. (2004), Ann Allergy Asthma Immunol 92, 73–79.

    PubMed  CAS  Google Scholar 

  50. Weiner, J.M., Abramson, M.J., and Puy, R.M. (1998), BMJ 317, 1624–1629.

    PubMed  CAS  Google Scholar 

  51. Yanez, A., and Rodrigo, G.J. (2002), Ann Allergy Asthma Immunol 89, 479–484.

    PubMed  CAS  Google Scholar 

  52. Kaszuba, S.M., Baroody, F.M., deTineo, M., Haney, L., Blair, C., and Naclerio, R.M. (2001), Arch Intern Med 161, 2581–2587.

    Article  PubMed  CAS  Google Scholar 

  53. Ratner, P.H., Howland, W.C., 3rd, Arastu, R., et al. (2003), Ann Allergy Asthma Immunol 90, 536–542.

    PubMed  CAS  Google Scholar 

  54. Pullerits, T., Praks, L., Ristioja, V., and Lotvall, J. (2002), J Allergy Clin Immunol 109, 949–955.

    Article  PubMed  CAS  Google Scholar 

  55. Saengpanich, S., deTineo, M., Naclerio, R.M., and Baroody, F.M. (2003), Arch Otolaryngol Head Neck Surg 129, 557–562.

    Article  PubMed  Google Scholar 

  56. Wilson, A.M., Orr, L.C., Sims, E.J., and Lipworth, B.J. (2001), Clin Exp Allergy 31, 61–68.

    Article  PubMed  CAS  Google Scholar 

  57. Wilson, A.M., O’Byrne, P.M., and Parameswaran, K. (2004), Am J Med 116, 338–344.

    Article  PubMed  CAS  Google Scholar 

  58. Rinne, J., Simola, M., Malmberg, H., and Haahtela, T. (2002), J Allergy Clin Immunol 109, 426–432.

    Article  PubMed  CAS  Google Scholar 

  59. Durham, S.R., Walker, S.M., Varga, E.M., et al. (1999), N Engl J Med 341, 468–475.

    Article  PubMed  CAS  Google Scholar 

  60. Ross, R.N., Nelson, H.S., and Finegold, I. (2000), Clin Ther 22, 342–350.

    Article  PubMed  CAS  Google Scholar 

  61. Nettis, E., Giordano, D., Pannofino, A., Ferrannini, A., and Tursi, A. (2002), Clin Exp Allergy 32, 1745–1749.

    Article  PubMed  CAS  Google Scholar 

  62. Tinkelman, D.G., Cole, W.Q., 3rd, and Tunno, J. (1995), J Allergy Clin Immunol 95, 8–14.

    Article  PubMed  CAS  Google Scholar 

  63. Wilson, D.R., Torres, L.I., and Durham, S.R. (2003), Cochrane Database Syst Rev. CD002893.

  64. Quirino, T., Iemoli, E., Siciliani, E., Parmiani, S., and Milazzo, F. (1996), Clin Exp Allergy 26, 1253–1261.

    Article  PubMed  CAS  Google Scholar 

  65. Khinchi, M.S., Poulsen, L.K., Carat, F., Andre, C., Hansen, A.B., and Malling, H.J. (2004), Allergy 59, 45–53.

    Article  PubMed  CAS  Google Scholar 

  66. Di Rienzo, V., Pagani, A., Parmiani, S., Passalacqua, G., and Canonica, G.W. (1999), Allergy 54, 1110–1113.

    Article  PubMed  Google Scholar 

  67. Lombardi, C., Gargioni, S., Melchiorre, A., et al. (2001), Allergy 56, 989–992.

    Article  PubMed  CAS  Google Scholar 

  68. TePas, E.C., Hoyte, E.G., McIntire, J.J., and Umetsu, D.T. (2004), Ann Allergy Asthma Immunol 92, 25–31.

    PubMed  Google Scholar 

  69. Marshall, J.D., Abtahi, S., Eiden, J.J., et al. (2001), J Allergy Clin Immunol 108, 191–197.

    Article  PubMed  CAS  Google Scholar 

  70. Tighe, H., Takabayashi, K., Schwartz, D., et al. (2000), J Allergy Clin Immunol 106, 124–134.

    Article  PubMed  CAS  Google Scholar 

  71. Tulic, M.K., Fiset, P.O., Christodoulopoulos, P., et al. (2004), J Allergy Clin Immunol 113, 235–241.

    Article  PubMed  CAS  Google Scholar 

  72. Casale, T.B., Condemi, J., LaForce, C., et al. (2001), JAMA 286, 2956–2967.

    Article  PubMed  CAS  Google Scholar 

  73. Chervinsky, P., Casale, T., Townley, R., et al. (2003), Ann Allergy Asthma Immunol 91, 160–167.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Johns Hopkins Asthma and Allergy Center, Baltimore, MD

    Alvin M. Sanico

Authors
  1. Alvin M. Sanico
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sanico, A.M. Latest developments in the management of allergic rhinitis. Clinic Rev Allerg Immunol 27, 181–189 (2004). https://doi.org/10.1385/CRIAI:27:3:181

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1385/CRIAI:27:3:181

Index Entries

Search

Navigation