Angiogenesis in Different Types of the Skin: Pathologies

Abstract

OBJECTIVES: 1) Evaluate the evidence for the role of local immunity in the nose and paranasal sinuses; specifically addressing patients who have symptoms consistent with allergic rhinitis but do not test positive systemically with skin testing and/or assessment of specific IgE. 2) Examine the relationships between local immunity in patients with systemically confirmed allergic rhinitis and in patients in whom local inflammation is present in the absence of systemic markers. METHODS: Systematic review of MEDLINE (via PubMed) and the Cochrane central register of controlled trials for local immunity and allergic rhinitis performed through March 2009 according to the a priori protocol recommended by Rosenfeld (1996). Search terms for innate immunity, and local immunity, were combined with search terms for allergy, allergic rhinitis, paranasal sinuses, and nasal mucosa. PubMed results were limited to adult, English-language studies. RESULTS: The MEDLINE search yielded 387 studies; the Cochrane search yielded over 4,000 articles. Preliminary review indicated that at least seven studies met inclusion criteria. Years of publication ranged from 1975 to 2008. Sample sizes ranged from 14 to 110 patients with an average of 44 patients. Systemic allergy tests included intradermal testing (3/7), prick/ puncture testing (5/7), and in vitro testing (2/7). CONCLUSIONS: There is a body of evidence to support the role of local immune responsivity in patients with signs and symptoms of allergic rhinitis but with negative systemic testing of allergic sensitivities. These studies suggest that localized immune mediators may play a role in the absence of systemic immune response. Quality of life in allergic and non-allergic rhinitis Sarah Koepp, PA-C, MPAS (presenter);