Pathophysiology of Allergic Rhinitis



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.


Allergic rhinitis Pathophysiology Allergy tests Seasonal allergens Concomitant diseases 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyDavraz Yaşam HospitalIspartaTurkey
  2. 2.Eskişehir Osmangazi University, Medical FacultyDepartment of OtorhinolaryngologyEskisehirTurkey
  3. 3.Department of Pediatric Basic Sciences, Institute of Child HealthIstanbul UniversityIstanbulTurkey
  4. 4.Division of Pediatric Allergy and Immunology, Department of Pediatrics, Istanbul Faculty of MedicineIstanbulIstanbul UniversityIstanbulTurkey
  5. 5.Department of ImmunologyAziz Sancar Institute of Experimental Medicine, Istanbul UniversityIstanbulTurkey
  6. 6.Swiss Institute of Allergy and Asthma Research (SIAF), University of ZurichDavosSwitzerland
  7. 7.Christine Kühne-Center for Allergy Research and EducationDavosSwitzerland

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