A hallmark of allergic rhinitis is persistent sneezing, which can range from occasional to frequent episodes. Also known as allergic nasal inflammation, allergic rhinitis is a non-infectious inflammatory condition that affects the nasal mucosa. This condition involves various immune cells and cytokines, with IgE (immunoglobulin E) playing a central role, particularly through the release of histamine. When individuals with hypersensitivity encounter allergens, histamine is released, leading to the symptoms of allergic rhinitis. This global health issue can contribute to various diseases and a decline in productivity.
Research has established a strong association between IgE and the development of symptoms in allergic diseases. Elevated serum IgE levels are linked to the incidence of asthma, with persistent wheezing in children also correlating with high serum IgE levels. Anti-IgE antibodies have been shown to be effective in treating allergic respiratory diseases by reducing serum IgE and FceRI receptor levels. This treatment has led to improved outcomes in asthma patients of all ages and reduced the reliance on steroid medications. The safety and efficacy of anti-IgE antibodies have earned them approval for managing moderate to severe allergic asthma in adults and adolescents.
However, additional research is needed to fully assess the benefits of these therapies for asthma patients with IgE-mediated conditions like allergic rhinitis and food allergies. The development of anti-IgE-based therapies continues to evolve and requires ongoing refinement.
For individuals already suffering from allergic rhinitis, various interventions can help alleviate symptoms. Common treatments include antihistamines such as loratadine and desloratadine, as well as nasal corticosteroid sprays to relieve nasal congestion and runny nose. Saline nasal sprays or drops can also be used to cleanse the nasal passages and reduce inflammation.
In clinical practice, allergen immunotherapy (AIT) is a cutting-edge treatment that gradually builds tolerance to allergens. This therapy involves administering small amounts of allergens over time, helping patients develop a more normalized immune response. AIT aims to induce immune tolerance, which is associated with the levels of specific IgE and IgA antibodies. Unlike IgE, allergen-specific IgA is typically present in healthy individuals, and regulatory processes often suppress allergic reactions. Research into the role of IgA in managing allergies, including allergic rhinitis and asthma, holds potential for new therapeutic approaches.
To manage allergic rhinitis effectively, individualized strategies should be employed to minimize allergen exposure:
Dust Mite Allergens: Keep indoor humidity below 50%, use dust mite-proof bedding and pillowcases, wash bedding and clothing in hot water above 55°C, avoid carpets, and regularly clean home textiles and surfaces.
Pollen Allergens: Keep windows closed during pollen seasons, use air purifiers with pollen filters, start antiallergic medications before pollen season, and wear sunglasses, hats, and masks outdoors.
Fungal Allergens: Limit outdoor activities during high mold levels, maintain indoor humidity below 45% (preferably below 35%), and promptly clean damp areas such as bathrooms and basements.
Animal Dander Allergens: Keep pets out of bedrooms, clean bedrooms regularly, remove or clean pet-favorite furniture, and change clothes after extended contact with animals.
Food Allergens: Avoid allergenic foods, follow a non-greasy diet, and reduce consumption of carbonated beverages.