Possibility of Local Allergic Rhinitis in Japan

Background The concept of local allergic rhinitis (LAR) has been advocated recently. Allergic rhinitis in Japan is characterized by house dust mites (HDMs) and Japanese cedar pollen (JCP). To investigate LAR in Japan, total IgE and antigen-specific IgE (sIgE) were measured in inferior turbinate mucosa and their relationships with skin test (ST) and nasal allergen provocation test (NAPT) and as well as serum IgE levels were examined. Methods Subjects were 50 rhinosinusitis patients for surgery. ST was performed and serum total IgE and sIgE levels were measured preoperatively. Patients with class-0 serum anti-HDM or anti-JCP sIgE levels were subjected to NAPT with HDM or JCP, respectively, or both. In all patients, inferior turbinate mucosa was weighed and mashed, and total IgE and sIgE levels were then measured as local mucosal date per gram and per milligram. Because there is no clinical consensus how to evaluate nasal sIgE yet, both positive NAPT and detectable sIgE in obtained nasal mucosa were adopted as the diagnostic criteria of LAR in order to strictly elucidate the possibility of presence of LAR in Japan. Results JCP LAR was definitely diagnosed in 2 of 14 patients (14.3%) and HDM LAR in 5 of 21 (23.8%) in cases with rhinosinusitis symptoms in the absence of positive ST nor serum sIgE. Conclusion The present results positively support LAR by HDM or JCP being present in Japan.

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Specific IgE and IgG4 antibodies to Japanese cedar pollen and total IgE antibody in lumbermen

Aerobiologia ◽

10.1007/bf02694300 ◽

1998 ◽

Vol 14 (4) ◽

pp. 321-324 ◽

Cited By ~ 2

Author(s):

Kensei Naito ◽

G. Ishii ◽

T. Ogawa ◽

N. Yokoyama ◽

S. Iwata

Keyword(s):

Japanese Cedar ◽

Specific Ige ◽

Total Ige ◽

Ige Antibody ◽

Japanese Cedar Pollen ◽

Cedar Pollen

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Potential Differences between Local and Systemic Allergic Rhinitis Induced by Birch Pollen

International Archives of Allergy and Immunology ◽

10.1159/000509438 ◽

2020 ◽

Vol 181 (11) ◽

pp. 831-838

Author(s):

Andrzej Bozek ◽

Jolanta Zalejska Fiolka ◽

Anna Krajewska Wojtys ◽

Beata Galuszka ◽

Anna Cudak

Keyword(s):

Allergic Rhinitis ◽

Birch Pollen ◽

Provocation Test ◽

Basophil Activation Test ◽

Specific Ige ◽

Immunological Parameters ◽

Local Allergic Rhinitis ◽

Before And After ◽

Intermittent Allergic Rhinitis ◽

Bet V1

Introduction: Different endotypes of rhinitis are known, but its pathomechanism has not been conclusively established. For example, the precise difference between systemic allergic rhinitis (SAR) and local allergic rhinitis (LAR) is still being checked. Comparison of patients with LAR and with allergies to birch of those with intermittent allergic rhinitis, same allergy, or with non-allergic rhinitis (NAR) was the purpose of this study. Methods: Twenty-six patients with LAR, 18 with SAR and allergy to birch, and 21 with NAR were included. Patients who met the inclusion criteria were selected to undergo the following procedures at baseline: medical examinations, nasal provocation test (NPT), detection of nasal-specific IgE to birch as well as basophil activation test (BAT). All immunological parameters were detected before and after NPT. Results: Concentration of nasal IgE to Bet v1 increased comparably in the LAR and SAR groups after NPT to birch as follows: in 21 (81%) patients with LAR, 14 (78%) with SAR, and in everyone in the NAR group. Serum concentration of allergen-specific IgE to Bet v1 increased significantly from a median of 20.7 (25–75% interval: 11.2–35.6) IU/mL to 29.9 (13.6–44.1) (p = 0.028) after NPT in patients with SAR. Allergen-specific IgE to Bet v1 was absent in all patients with LAR and NAR before and after NPT. BAT with Bet v1 was positive in 22 (85%) patients with LAR, in 14 (78%) with SAR, and 2 (9.5%) with NAR. Conclusion: These obtained data suggest there are no potential mechanisms that could explain LAR compared to SAR.

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Local allergic rhinitis - a big challenge in clinical practice

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh200724032s ◽

2021 ◽

pp. 32-32

Author(s):

Rajica Stosovic ◽

Vesna Tomic-Spiric

Keyword(s):

Allergic Rhinitis ◽

Gold Standard ◽

Allergen Immunotherapy ◽

Provocation Test ◽

Pharmacological Therapy ◽

Local Allergic Rhinitis ◽

Natural Progression ◽

Allergen Provocation ◽

Preventive Effects ◽

Progressive Course

Local allergic rhinitis is a new rhinitis phenotype characterized by symptoms similar to allergic rhinitis, in non-atopic patients with a positive nasal allergen provocation test (NAPT). The disease is diagnosed in over 25% of non-atopic patients with rhinitis, marked as non-atopic rhinitis. It most often has perennial and severe symptoms and a progressive course. It is often associated with conjunctivitis and/or asthma. It is necessary to consider local allergic rhinitis in patients with non-atopic rhinitis. The gold standard for diagnosis is positive NAPT. Pharmacological therapy fails to stop the natural progression and development of comorbidities. Allergen immunotherapy reduces the symptoms, consumption of medicines and increases the tolerance to allergens responsible for local allergic rhinitis. New studies are needed to confirm curative and evaluate the preventive effects of allergen immunotherapy.

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Diagnosis and Treatment of Local Allergic Rhinitis

Pathogens ◽

10.3390/pathogens11010080 ◽

2022 ◽

Vol 11 (1) ◽

pp. 80

Author(s):

Tetsuya Terada ◽

Ryo Kawata

Keyword(s):

Allergic Rhinitis ◽

Current Knowledge ◽

Provocation Test ◽

Basophil Activation Test ◽

Specific Ige ◽

Nasal Discharge ◽

Initial State ◽

Positive Type ◽

Chronic Rhinitis ◽

Local Allergic Rhinitis

Some patients with chronic rhinitis have a positive nasal allergen provocation test (NAPT) without systemic IgE sensitization by skin prick tests or serum allergen-specific IgE (sIgE). This novel concept is called local allergic rhinitis (LAR) and affects children and adults worldwide, but is underdiagnosed. LAR is not just the initial state of allergic rhinitis (AR), it is a unique form of chronic rhinitis that is neither classical AR nor non-AR. Many of the features of AR and LAR are similar, such as a positive NAPT, positive type 2 inflammatory markers, including the nasal discharge of sIgE, and a high incidence of asthma. A differential diagnosis of LAR needs to be considered in patients with symptoms suggestive of AR in the absence of systemic atopy, regardless of age. The diagnostic method for LAR relies on positive responses to single or multiple allergens in NAPT, the sensitivity, specificity, and reproducibility of which are high. The basophil activation test and measurement of IgE in nasal secretions also contribute to the diagnosis of LAR. Treatment for LAR is similar to that for AR and is supported by the efficacy and safety of allergen exposure avoidance, drug therapy, and allergen immunotherapy. This review discusses current knowledge on LAR.

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The role of the nasal allergen provocation test in local allergic rhinitis cases: a preliminary report

Advances in Dermatology and Allergology ◽

10.5114/ada.2019.84719 ◽

2019 ◽

Author(s):

Edyta Krzych-Fałta ◽

Konrad Furmańczyk ◽

Diana Dziewa-Dawidczyk ◽

Oksana Wojas ◽

Katarzyna Reklewska ◽

...

Keyword(s):

Allergic Rhinitis ◽

Preliminary Report ◽

Provocation Test ◽

Local Allergic Rhinitis ◽

Allergen Provocation

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Current Update of Local Allergic Rhinitis

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2021.00416 ◽

2021 ◽

Vol 64 (8) ◽

pp. 533-539

Author(s):

Su-Jong Kim ◽

Jee Won Moon ◽

Heung-Man Lee

Keyword(s):

Allergic Rhinitis ◽

Provocation Test ◽

High Sensitivity ◽

Specific Ige ◽

Nasal Provocation Test ◽

Local Allergic Rhinitis ◽

Nasal Provocation ◽

Nasal Secretions ◽

Positive Results ◽

A Current

Local allergic rhinitis (LAR) is a localized nasal allergic response in the absence of systemic atopy. The symptoms, duration, severity, and comorbidities of LAR are similar to those of allergic rhinitis. Although pathophysiology of LAR is not fully understood, in some patients specific IgE can be demonstrated in the nasal secretions. The diagnosis currently relies on the positive results of nasal provocation test. Nasal provocation test has shown high sensitivity and specificity with safety, and is considered as the gold standard. LAR patients benefit from the same therapeutic strategies as allergic rhinitis patients, including the avoidance of allergen exposure and the pharmacotherapy. Effectiveness and safety of allergen immunotherapy open a window of treatment opportunity in LAR. This review provides a current update on LAR.

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Allergic rhinitis complicated by hypertrophy of the mucous membrane of nasal turbinates in patients of Northern Vietnam

Biomedical Research and Therapy ◽

10.15419/bmrat.v7i6.609 ◽

2020 ◽

Vol 7 (6) ◽

pp. 3813-3818

Author(s):

Kryukov Andrei Ivanovich ◽

Galina Petrovna Bondareva ◽

Nguyen Thi Phuong Thao

Keyword(s):

Allergic Rhinitis ◽

Nasal Cavity ◽

Mucous Membrane ◽

House Dust ◽

Inferior Turbinate ◽

Specific Ige ◽

House Dust Mites ◽

Moderate Degree ◽

Dust Mites ◽

Northern Vietnam

Introduction: Constant contact with allergens contributes to the formation of allergic rhinitis and swelling of the mucous membrane of the nasal cavity. Moreover, constant inflammation stimulates hypertrophy of the mucous membrane of the nasal turbinates and paranasal sinuses. This study aimed to assess the clinical features of hypertrophic rhinitis (HR) in combination with allergic rhinitis (AR) in patients from Northern Vietnam to improve the effectiveness of treatment and quality of life of patients with this pathology of the nasal cavity. Methods: The study was conducted from June to September 2018 by the Department of Otorhinolaryngology, Thai Nguyen Central General Hospital, Vietnam. A total of 158 patients with symptoms of chronic rhinitis, aged 5–70 years, were examined. All patients with allergic rhinitis were subjected to standard, specific allergological tests, such as the determination of specific IgE in the blood, and statistics were assessed according to the otorhinolaryngology examination and CT scan. All patients were also examined by otolaryngologists. Results: According to the results of our study, among 64 patients with a diagnosis of AR, a total of 45 (70.31%) patients were diagnosed as AR in combination with a hypertrophy of the mucous membrane of the nasal turbinate, with an average duration of morbidity of 5.8 ±1.6 years. Moreover, 17 (37.78%) patients were diagnosed with severe hypertrophy of the mucous membrane of the nasal inferior turbinate (the nasal inferior turbinate is 50% or more of nasal cavity and with nasal polyps). The sensitization to house dust mites and fungi was high. Conclusion: The peculiar findings of AR in combination with HR detected in patients of Northern Vietnam was associated with the onset of the disease at the age of 20-40 years, the predominance in men, the predominance of the disease in smokers, and the predominance in residents of cities and industrial areas (71.1%). Indeed, there was an observed combination of AR with severe and moderate degree of HR. The sensitization of patients with AR in combination with HR in Northern Vietnam are similar to those in Asia, with predominant allergy to house dust mites.

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