Allergy Asthma Immunol Res.  2010 Apr;2(2):65-76. 10.4168/aair.2010.2.2.65.

The Pathophysiology, Diagnosis and Treatment of Allergic Rhinitis

• Min YG

• KMID: 2260592
• DOI: http://doi.org/10.4168/aair.2010.2.2.65

Abstract

Treatment of AR requires a stepwise approach depending on the severity and duration of symptoms. Treatment options for AR consist of allergen avoidance, pharmacotherapy, immunotherapy and surgery. For the mechanisms of AR, anti-IgE antibody and specific antibody to cytokines such as IL-4 or IL-5 that correlate with allergic inflammation have recently emerged. SLIT is currently widely used due to its efficacy, safety and convenience, which replaces subcutaneous immunotherapy. Although allergen avoidance and immunotherapy are theoretically ideal, antihistamines and intranasal corticosteroids will play the main role in the management of AR until an innovative treatment develops. However, patients' main symptom, the duration and severity of AR, patients' compliance, safety of medication and cost-effectiveness should be considered when treatment options are chosen. In conclusion, physicians should be aware of etiology, pathophysiology, symptoms, signs and diseases related to AR in order to make a correct diagnosis and choose a proper treatment option for each patient.

Keyword

Hypersensitivity; perennial allergic rhinitis; seasonal allergic rhinitis; physiopathology; diagnosis; therapy

MeSH Terms

Adrenal Cortex Hormones
Antibodies, Anti-Idiotypic
Compliance
Cytokines
Histamine Antagonists
Humans
Hypersensitivity
Immunotherapy
Inflammation
Interleukin-4
Interleukin-5
Rhinitis
Rhinitis, Allergic, Perennial
Rhinitis, Allergic, Seasonal
Adrenal Cortex Hormones
Antibodies, Anti-Idiotypic
Cytokines
Histamine Antagonists
Interleukin-4
Interleukin-5

Figure

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  Fig. 1 Allergen-induced sensitization and inflammation.11

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  Fig. 2 ARIA classification of severity of allergic rhinitis.1

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  Fig. 3 Rhinitis management.9

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  Fig. 4 The possible mechanism of action of sublingual immunotherapy.64

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