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Local Allergic Rhinitis.

Paloma Campo1, Giorgio Walter Canonica2

  • 1U.G.C. Alergología, Hospital Regional Universitario de Málaga, Málaga, Spain.

The Journal of Allergy and Clinical Immunology. in Practice
|April 19, 2024
PubMed
Summary
This summary is machine-generated.

Local allergic rhinitis (LAR) is an independent condition from allergic rhinitis (AR), characterized by nasal inflammation and specific IgE. Nasal allergen challenge (NAC) is key for diagnosing LAR in all ages.

Keywords:
Allergic rhinitisIgE synthesisLocal allergic asthmaLocal allergic rhinitisNasal allergen challenge

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Area of Science:

  • Immunology
  • Otolaryngology
  • Allergology

Background:

  • Local allergic rhinitis (LAR) is distinct from allergic rhinitis (AR), presenting with specific nasal IgE and inflammation.
  • It affects children significantly and is more prevalent in Mediterranean regions.
  • LAR can worsen over time and is associated with comorbidities.

Purpose of the Study:

  • To define Local Allergic Rhinitis (LAR) and its distinction from Allergic Rhinitis (AR).
  • To elucidate the physiopathological mechanisms and diagnostic approaches for LAR.
  • To highlight the role of allergen immunotherapy in LAR management.

Main Methods:

  • Diagnosis relies on clinical history and positive nasal allergen challenge (NAC), with negative systemic IgE.
  • Physiopathological analysis includes nasal eosinophilic inflammation and specific IgE in secretions.
  • Evaluation of B cell markers (CXCR3, CXCR4) and T cell subsets (Th9, Th2).

Main Results:

  • LAR exhibits increased nasal eosinophilic inflammation, tryptase, eosinophil cationic protein, and specific IgE in secretions.
  • Increased IgE+ CD38+ plasmablasts and mucosal homing receptors (CXCR3, CXCR4) on B cells were observed.
  • Allergen immunotherapy showed effectiveness in LAR treatment.

Conclusions:

  • LAR is an independent allergic entity with distinct immunopathological features.
  • Nasal allergen challenge (NAC) is the gold standard diagnostic tool for LAR across all age groups.
  • Increased awareness and utilization of NAC are crucial for effective LAR diagnosis and management.