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Pathophysiology of Allergic Rhinitis

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All Around the Nose

Abstract

Allergic rhinitis (AR) occasionally arises alone and is required to be evaluated as part of systemic allergic disorders related to various concomitant diseases, including sinusitis, asthma, chronic middle ear effusions, and lymphoid hypertrophy accompanying with obstructive sleep apnea, impaired sleep, and subsequent educational and behavioral impacts. Allergic rhinitis characteristically emerges following the second year of life; however, certain frequency in early age is not known. AR influences 10–30% of people, with the highest prevalence in adolescents and children. At the time of the immune system development of a child during the first and fourth years of his/her growth, children who have atopic predisposition start to manifest allergic diseases with a significant Th2 response, following allergen exposure, which is responsible for symptoms. Pollen exposure of two or more seasons is usually necessary to become sensitized in the case of pediatric AR; therefore, allergy tests for seasonal allergens (grass, weed, tree) are required to be performed after the second or third years of life. Getting sensitized to the perennial allergens (cockroaches, animals, dust mites) may manifest many months after the exposure. Categorization of AR involves quantifying the incidence and continuation period of the symptoms. AR at intervals is characterized by symptoms effective in less than 4 days/weeks or less than 4 following weeks. Persistent AR is characterized and diagnosed as a disease if it continues longer than 4 days/weeks or longer than 4 consecutive weeks. AR is linked with emotional issues, sleep disturbances, decrease in life quality, and decrease in activities such as social function, school, and work efficiency. AR can also be classified with respect to severity as either severe/moderate or mild. Moreover, there are concomitant diseases linked to AR, and chronic impacts of the inflammatory period influence the ears, lungs, growth, and others. AR may lead to learning difficulties, complications, and sleep disorders such as obstructive sleep apnea, acute and serous otitis media, acute and chronic sinusitis, and worsening of asthma and adenoidal hypertrophy. In this chapter, pathophysiology of allergic rhinitis is discussed.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Davraz Yaşam Hospital, Isparta, Turkey

    Mehmet Emrah Ceylan

  2. Eskişehir Osmangazi University, Medical Faculty, Department of Otorhinolaryngology, Eskisehir, Turkey

    Cemal Cingi

  3. Department of Pediatric Basic Sciences, Institute of Child Health, Istanbul University, Istanbul, Turkey

    Cevdet Özdemir

  4. Division of Pediatric Allergy and Immunology, Department of Pediatrics, Istanbul Faculty of MedicineIstanbul, Istanbul University, Istanbul, Turkey

    Cevdet Özdemir

  5. Department of Immunology, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey

    Umut Can Kücüksezer

  6. Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland

    Cezmi A. Akdis

  7. Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland

    Cezmi A. Akdis

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  1. Mehmet Emrah Ceylan
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  2. Cemal Cingi
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  3. Cevdet Özdemir
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  4. Umut Can Kücüksezer
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  5. Cezmi A. Akdis
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  1. Eskişehir Osmangazi University, Medical Faculty, Department of Otorhinolaryngology, Eskisehir, Turkey

    Cemal Cingi

  2. Department of Otorhinolaryngology, Medical Faculty, Kirikkale University, Kirikkale, Turkey

    Nuray Bayar Muluk

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Ceylan, M.E., Cingi, C., Özdemir, C., Kücüksezer, U.C., Akdis, C.A. (2020). Pathophysiology of Allergic Rhinitis. In: Cingi, C., Bayar Muluk, N. (eds) All Around the Nose. Springer, Cham. https://doi.org/10.1007/978-3-030-21217-9_32

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