Asia Pac Allergy.  2011 Oct;1(3):157-167. 10.5415/apallergy.2011.1.3.157.

Overview on the pathomechanisms of allergic rhinitis

• Pawankar R
• Mori S
• Ozu C
• Kimura S

• KMID: 2397435
• DOI: http://doi.org/10.5415/apallergy.2011.1.3.157

Abstract

Allergic rhinitis a chronic inflammatory disease of the upper airways that has a major impact on the quality of life of patients and is a socio-economic burden. Understanding the underlying immune mechanisms is central to developing better and more targeted therapies. The inflammatory response in the nasal mucosa includes an immediate IgE-mediated mast cell response as well as a latephase response characterized by recruitment of eosinophils, basophils, and T cells expressing Th2 cytokines including interleukin (IL)-4, a switch factor for IgE synthesis, and IL-5, an eosinophil growth factor and on-going allergic inflammation. Recent advances have suggested new pathways like local synthesis of IgE, the IgE-IgE receptor mast cell cascade in on-going allergic inflammation and the epithelial expression of cytokines that regulate Th2 cytokine responses (i.e., thymic stromal lymphopoietin, IL-25, and IL-33). In this review, we briefly review the conventional pathways in the pathophysiology of allergic rhinitis and then elaborate on the recent advances in the pathophysiology of allergic rhinitis. An improved understanding of the immune mechanisms of allergic rhinitis can provide a better insight on novel therapeutic targets.

Keyword

Allergic rhinitis; Cytokines; Chemokines; Immune cells; Epithelial cells

MeSH Terms

Basophils
Chemokines
Cytokines
Eosinophils
Epithelial Cells
Humans
Immunoglobulin E
Inflammation
Interleukin-5
Interleukins
Mast Cells
Nasal Mucosa
Quality of Life
Rhinitis, Allergic*
T-Lymphocytes
Chemokines
Cytokines
Immunoglobulin E
Interleukin-5
Interleukins

Figure

• 

  Fig. 1 Chronic allergic respiratory syndrome. Adapted from Stokes JR, Casale T. Allergic rhinitis, asthma and Obstructive sleep apnea - the link. In: Pawankar R, Holgate ST, Rosenwasser LJ, editors. Allergy Frontiers. Vol. 3. 2009. p. 129-140.

• 

  Fig. 2 Ongoing inflammation in allergic rhintis. Adapted from Pawankar R et al. Curr Opin Allergy Clin Immunol 2002;2:1-5.

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