Local allergic rhinitis - a narrative review

Area of Science:

• Immunology
• Otolaryngology

Background:

• Local allergic rhinitis (LAR) is a distinct condition characterized by Type 2 nasal inflammation mediated by local IgE.
• It differs from systemic allergic rhinitis and cannot be accurately diagnosed using standard skin prick or blood IgE tests.

Approach:

• A systematic literature review of PubMed and Science Direct databases was conducted, supplemented by manual searches.
• Keywords included "local allergic rhinitis," "entopy," "local Immunoglobulin E," and "nasal specific Immunoglobulin E" from 1947 to 2022.

Key Points:

• Diagnosis of LAR necessitates a nasal allergen challenge.
• LAR exhibits local IgE-mediated Type 2 inflammation within the nasal passages.
• Standard systemic allergy tests are insufficient for LAR diagnosis.

Conclusions:

• LAR represents a novel clinical entity requiring further research into its prevalence, diagnostic criteria, and therapeutic outcomes.
• Current allergic rhinitis treatments, including allergen-specific immunotherapy (AIT), show potential efficacy in managing LAR.
• This review aims to foster a consensus on LAR research and diagnosis, stimulating further investigation.