Local allergic rhinitis: entopy or spontaneous response?

Gelardi, Matteo; Guglielmi, Antonio V. N.; Iannuzzi, Lucia; Quaranta, Vitaliano Nicola; Quaranta, Nicola; Landi, Massimo; Correale, M.; Sonnante, Annamaria; Rossini, Margherita; Mariggiò, Maria Addolorata; Canonica, Giorgio Walter; Passalacqua, Giovanni

doi:10.1186/s40413-016-0126-z

Cited by 27 publications

(16 citation statements)

References 29 publications

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“…[71], yet not all of them have been applied to LAR. Therefore, nasal sIgE should be regarded mostly as a research tool, which cannot be recommended for routine LAR diagnosis [75,76,77].…”

Section: Diagnosismentioning

confidence: 99%

How to Diagnose and Treat Local Allergic Rhinitis: A Challenge for Clinicians

Eguiluz‐Gracia

Pérez‐Sánchez

Bogas

et al. 2019

JCM

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Chronic rhinitis is a very common disease that can be divided in various phenotypes. Historically, the condition has been classified into the allergic rhinitis (AR) and non-allergic non-infectious rhinitis (NAR) forms, based on the results of the classical biomarkers of atopy: skin prick test and serum allergen-specific IgE However, this classification does not reflect the complexity of the rhinitis syndrome, as illustrated by the existence of non-atopic rhinitis patients who display a nasal reactivity to environmental allergens. This new phenotype has been termed local allergic rhinitis (LAR) and can be only recognized if an additional test such as the nasal allergen challenge (NAC) is integrated in the diagnostic algorithm for chronic rhinitis. Recent data shows that the NAC is a very safe and reliable technique ready for the clinical practice. LAR is a differentiated rhinitis phenotype which often commences during childhood and quickly progresses towards a clinical worsening and the association of comorbidities in other mucosal organs. Recent evidence supports the existence of a bronchial counterpart of LAR (local allergic asthma), which highlights the pathophysiological links between the upper and lower airways and reinforces the united airways concept. Importantly, several controlled studies have demonstrated the ability of allergen immunotherapy to control LAR symptoms while the therapy is being administered. This review emphasizes the need to implement the NAC in the clinical practice in order to facilitate the recognition of LAR patients, allowing for an early prescription of specific therapies with disease-modifying potential.

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“…[71], yet not all of them have been applied to LAR. Therefore, nasal sIgE should be regarded mostly as a research tool, which cannot be recommended for routine LAR diagnosis [75,76,77].…”

Section: Diagnosismentioning

confidence: 99%

How to Diagnose and Treat Local Allergic Rhinitis: A Challenge for Clinicians

Eguiluz‐Gracia

Pérez‐Sánchez

Bogas

et al. 2019

JCM

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“…It is not certain whether LAR is a separate condition or merely an “introduction” to the development of the classic allergic rhinitis. Research by Gelardi et al suggests that local production of IgE may be a part of a nonspecific immune response to environmental factors, and the researchers recommend that great care should be taken in the diagnosis of LAR [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

The role of the nasal allergen provocation test in local allergic rhinitis cases: a preliminary report

Krzych‐Fałta

Furmańczyk

Dziewa-Dawidczyk

et al. 2020

pdia

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Introduction: The current state of knowledge is that allergic rhinitis can occur in two forms. One is allergic rhinitis as a manifestation of a systemic allergy with systemic atopy and positive results of skin prick tests or sIgE tests. The other is local allergic rhinitis (LAR) as a local allergic reaction affecting only the nasal mucosa without systemic atopy. Aim: To attempt to assess the usefulness of the nasal allergen provocation test for the purposes of differential diagnosis and the qualification of LAR patients for therapy. Material and methods: The subjects in the study were a group of 6 adults diagnosed with LAR on the basis of their medical history and the results of nasal allergen provocation tests, with the allergens being house dust mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae). The methods adopted in the study were a pointbased rating scale as a measure of nasal/extranasal complaints and active anterior rhinomanometry. Results: Significant differences (p < 0.05) were observed, using the subjective rating scale, in relation to registered nasal and extranasal complaints in the early phase of the allergic reaction. Similarly, the rhinomanometry method revealed significant differences in nasal resistance values before and after the administration of an allergen. Conclusions: The nasal allergen provocation test is the only testing tool that objectively measures the degree of the patient's allergic reactions and is useful in qualifying LAR patients for further therapy.

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“…For now, it is not clear whether nasal allergen specific IgE production in LAR is secondary to local sensitization or a spontaneous immune response. It is shown that nasal allergen specific IgE may be found in about 50% of the healthy control subjects and we believe that our hypothesis may bring a new point of view to the conflicting concept of LAR [ 4 ]. Although our case also states the importance of the objective demonstration of allergen sensitization in different skin areas which will enable anti-IgE treatment opportunity in patients with severe asthma and rhinitis with low levels of specific IgEs and negative SPTs.…”

Section: Discussionmentioning

confidence: 99%