REVIEWS  ALLERGIC RHINITIS 

Otorinolaringologia 2006 March;56(1):9-16

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

New treatments for allergic rhinitis

Ciprandi G. ¹, Passalacqua G. ²

¹ Department of Head and Neck Azienda Ospedaliera Universitaria San Martino Genova, Genoa, Italy 2 Department of Internal Medicine University of Genoa, Genoa, Italy

Allergic rhinitis (AR) is a high-prevalence disease, affecting up to 20% of the general population. AR is characterized by an IgE-mediated reaction and is sustained by a complex inflammatory network of cells, mediators, and cytokines that becomes chronic when exposure to allergen persists. A Th2 polarized immune response is the basis for the allergic inflammation. The current therapeutic strategy is mainly based on drugs (antihistamines, nasal corticosteroids, cromones, decongestants) and allergen immunotherapy. Drugs are overall effective in controlling symptoms, but do not modify the immune background that leads to allergic inflammation, and safety concerns may be present especially for prolonged treatments. Immunotherapy can modify the allergic response, but there is still space for improvement. Nowadays several approaches are under investigation to optimize the management of AR. On one hand, new drugs and anti-mediators are being developed. On the other hand, attempts are made to selectively block relevant signal pathways of allergic reaction. Finally, one of the major goals is to modify the Th2-polarized immune response by improving the characteristics and modes of action of allergen immunotherapy.