Yifan Meng, Chengshuo Wang, Luo Zhang

Allergy. 2020 Sep 9. doi: 10.1111/all.14586. Online ahead of print.

Allergic rhinitis is a condition of the upper airways, with a high prevalence worldwide, characterized by symptoms such as nasal obstruction, rhinorrhea, sneezing, and nasal pruritus. This is due to inhaled allergens and respective mucosal inflammation. This review’s objective was to highlight novel mechanisms and treatments of allergic rhinitis to optimize its management.

Proteins such as histone deacetylase (HDAC) and mucin 1 (MUC1) have a role in the epithelial tight junction barrier’s integrity. Inflammatory mediators, such as type 2 innate lymphoid cells (ILC2), myeloid dendritic cells (mDC), and plasmacytoid dendritic cells (pDC), are involved in the development of allergic rhinitis. Other risk factors include genetic susceptibility, age, intrauterine growth restriction, fetal oxidative balance, diet, environmental changes, and essential roles in allergic rhinitis.

Management of allergic rhinitis includes patient education, pharmacotherapy, allergen-specific immunotherapy, and biologics. Novel therapies include highly purified allergens, allergoids, peptides, and new adjuvants for use in specific allergen immunotherapy and specific monoclonal antibodies for blocking the effects of immune mediators.

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