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May
16,
2019

Allergic Rhinitis : definition, prevalence, therapies and coming congress

May 16, 2019

What is Allergic Rhinitis?

Allergic rhinitis is an inflammation of the nasal membranes that is characterized by sneezing, nasal congestion, nasal itching and rhinorrhea.

Although, the disease is believed to be a mild condition, patients suffering from allergic rhinitis can be affected in their quality of life, especially due to sleep disturbances, and fatigue, which impact in turn the mood, school or work competence.

In fact most allergic conditions start in childhood and peak during highly productive years of individuals, with allergic rhinitis affecting up to 45% of 20–40 year old Europeans. It is estimated that the annual cost of allergic rhinitis may cost up to €100 billion, according to unpublished data from the Global Allergy and Asthma Network of Excellence, GALEN, investigators.

Morbidity of the condition can also be significant, as allergic rhinitis often co-exists with asthma in a same patient. Allergic rhinitis is also associated with otitis media, sinusitis, nasal polyps, allergic conjunctivitis and atopic dermatitis.

What is the prevalence?

Every year, millions of people suffer from allergies. “Allergies represent the most frequent chronic diseases in Europe affecting, with the most conservative estimates, the daily lives of more than 60 million people. The European Academy of Allergy and Clinical Immunology (EAACI) warns that in less than 15 years more than half of the European population will suffer from some type of allergy!”[1]

According to Papadopoulos, environmental changes, including climate change, pollution and microbial sterilization, caused by the rapid industrial and technological revolution combined with a more sedentary lifestyle, have affected the intensity, type and diversity of external exposures, but also altered the normal immune/inflammatory responses.

However, both bacterial and viral infections but also microbiome play an important role in the development and severity of allergic disorders, and leading to their chronicity.

It is to note that infections caused by human rhinoviruses (RV) are responsible for the majority of mild rhinitis, and contribute further to symptoms in respiratory allergic patients.

Existing therapies[2]

Treatment for Allergic Rhinitis includes antihistamines, decongestants, anticholinergic agents, intranasal cromolyn, leukotriene modifiers and inhaled steroids. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines suggest a stepwise approach to Allergic Rhinitis treatment.

The latest guidelines revision of 2016 addresses the relative merits of using therapy with oral H1-antihistamines, intranasal H1-antihistamines, intranasal corticosteroids, and leukotriene receptor antagonists either alone or in combination.

Specific immunotherapy represents the unique treatment able not only to improve symptoms and quality of life but also to modify the disease progression.

However despite of the high prevalence of the disease and the availability of treatments, Papadopoulos states that a significant number of patients remain deprived of an accurate diagnosis and specific anti-allergic treatment, while another group of patients remain symptomatic in spite of adequate medical therapy.

Use of bacterial lysates : the upcoming EAACI congress.

In 2007, a pre-clinical study in vivo showed that PMBL could be interesting in the reduction of the symptoms in rhinitis subjects.[3]

On Monday, June 3rd 2019, Kamil Piotr Janeczek will take part in the EAACI congress to talk about “The Effect Of Polyvalent Mechanical Bacterial Lysate On The Clinical Course Of Pollen Allergic Rhinitis In Children.”

The EAACI is an association of clinicians, researchers and allied health professionals, dedicated to improving the health of people affected by allergic diseases. With nearly 10,000 members from 121 countries and over 50 National Allergy Societies, EAACI is the primary source of expertise in Europe for all aspects of allergy.

REFERENCES:

[1]Papadopoulos et al.: Research needs in allergy: an EAACI position paper, in collaboration with EFA. Clinical and Translational Allergy 2012 2:21 [PubMed: 23121771]

[2] Braido F, Lagasio C, Piroddi I, Baiardini I, Canonica G. New treatment options in allergic rhinitis: patient considerations and the role of ciclesonide. Ther Clin Risk Manag. 2008;4(2):353–361. [PubMed: 18728855]

[3] Banche G1, Allizond V, Mandras N, Garzaro M, Cavallo GP, Baldi C, Scutera S, Musso T, Roana J, Tullio V, Carlone NA, Cuffini AM. Improvement of clinical response in allergic rhinitis patients treated with an oral immunostimulating bacterial lysate: in vivo immunological effects. Int J Immunopathol Pharmacol. 2007 Jan-Mar;20(1):129-38. [PubMed: 17346436]