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Local allergic rhinitis: a new entity, characterization and further studies
Carmen Rondón1, Gabriela Canto, Miguel Blanca
1Carlos Haya Hospital, Malaga, Spain.
Current Opinion in Allergy and Clinical Immunology
|December 17, 2009
Summary
Local allergic rhinitis (LAR) is a distinct nasal allergy phenotype. It involves local nasal specific IgE (sIgE) production, even without systemic atopy, aiding diagnosis in nonallergic rhinitis patients.
Area of Science:
- Otolaryngology
- Allergology
- Immunology
Background:
- Rhinitis is a common condition with allergic and nonallergic phenotypes.
- Local allergic rhinitis (LAR) presents a diagnostic challenge, often misdiagnosed as nonallergic rhinitis.
- Emerging evidence highlights LAR as a distinct clinical entity.
Purpose of the Study:
- To review new insights into the pathophysiology of LAR.
- To describe the clinical characterization of LAR.
- To identify diagnostic approaches for LAR.
Main Methods:
- Review of recent studies on LAR.
- Analysis of nasal sIgE production in nonallergic rhinitis patients.
- Evaluation of nasal allergen provocation tests (NAPT).
Main Results:
- Over 40% of nonallergic rhinitis patients exhibit local nasal specific IgE (sIgE) production without systemic atopy.
- Evidence includes clinical symptoms, local sIgE, and inflammatory patterns (eosinophils, mast cells, T lymphocytes) in nasal fluids.
- Positive NAPT shows immediate and dual responses with local tryptase, eosinophil cationic protein, and sIgE production.
Conclusions:
- LAR is a newly recognized phenotype of rhinitis.
- An advanced diagnostic approach is proposed for suspected allergic rhinitis with negative skin prick tests and serum sIgE.
- Detecting local sIgE in nasal secretions and positive NAPT results are key for diagnosing LAR.
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