Allergic Rhinitis

Abstract

Allergic rhinitis (AR) is a prevalent, yet underappreciated, inflammatory condition of the nasal mucosa, characterized by pruritus, sneezing, rhinorrhea, and nasal congestion. It is mediated by early- and late-phase hypersensitivity responses to indoor and outdoor environmental allergens. AR affects a large portion of children in the developed world. Both basic science and epidemiological studies have demonstrated that AR is part of a systemic inflammatory process and is associated with other inflammatory conditions of the mucous membranes. These include otitis media with effusion, rhinosinusitis, allergic conjunctivitis (AC), and asthma. The ARIA guidelines (Allergic Rhinitis and its Impact on Asthma) have provided a pragmatic, stepwise approach to treating AR. Allergen avoidance remains one of the guiding principles of treatment, although it may sometimes be difficult to implement. While there is an ever-increasing armamentarium of pharmacotherapeutic agents available to the clinician, intranasal corticosteroids remain the single most effective class of medications for treating AR.