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Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum
Local respiratory allergy (LRA) is defined by the negativity of atopy tests, a clinical history suggestive of airway allergy and a positive response to the nasal and/or bronchial allergen challenge. The clinical spectrum of LRA is comprised of three conditions: local allergic rhinitis (LAR) and loca...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206788/ https://www.ncbi.nlm.nih.gov/pubmed/34149736 http://dx.doi.org/10.3389/fimmu.2021.691964 |
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author | Testera-Montes, Almudena Salas, Maria Palomares, Francisca Ariza, Adriana Torres, María J. Rondón, Carmen Eguiluz-Gracia, Ibon |
author_facet | Testera-Montes, Almudena Salas, Maria Palomares, Francisca Ariza, Adriana Torres, María J. Rondón, Carmen Eguiluz-Gracia, Ibon |
author_sort | Testera-Montes, Almudena |
collection | PubMed |
description | Local respiratory allergy (LRA) is defined by the negativity of atopy tests, a clinical history suggestive of airway allergy and a positive response to the nasal and/or bronchial allergen challenge. The clinical spectrum of LRA is comprised of three conditions: local allergic rhinitis (LAR) and local allergic asthma in non-atopic patients, and dual allergic rhinitis (coexistence of allergic rhinitis and LAR) in atopic individuals. LRA is an independent disease phenotype not progressing to atopy over time, but naturally evolving to the clinical worsening and the onset of comorbidities. Published data suggests that LRA is mediated through the mucosal synthesis of allergen-specific (s)IgE, which binds to FcϵRI on resident mast cells, and in >50% of cases traffics to the blood stream to sensitize circulating basophils. To date, 4 clinical trials have demonstrated the capacity of allergen immunotherapy (AIT) to decrease nasal, conjunctival and bronchial symptoms, to improve quality of life, to increase the threshold dose of allergen eliciting respiratory symptoms, and to induce serum sIgG(4) in LRA individuals. Collectively, these data indicate that local allergy is a relevant disease mechanisms in both atopic and non-atopic patients with airway diseases. |
format | Online Article Text |
id | pubmed-8206788 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82067882021-06-17 Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum Testera-Montes, Almudena Salas, Maria Palomares, Francisca Ariza, Adriana Torres, María J. Rondón, Carmen Eguiluz-Gracia, Ibon Front Immunol Immunology Local respiratory allergy (LRA) is defined by the negativity of atopy tests, a clinical history suggestive of airway allergy and a positive response to the nasal and/or bronchial allergen challenge. The clinical spectrum of LRA is comprised of three conditions: local allergic rhinitis (LAR) and local allergic asthma in non-atopic patients, and dual allergic rhinitis (coexistence of allergic rhinitis and LAR) in atopic individuals. LRA is an independent disease phenotype not progressing to atopy over time, but naturally evolving to the clinical worsening and the onset of comorbidities. Published data suggests that LRA is mediated through the mucosal synthesis of allergen-specific (s)IgE, which binds to FcϵRI on resident mast cells, and in >50% of cases traffics to the blood stream to sensitize circulating basophils. To date, 4 clinical trials have demonstrated the capacity of allergen immunotherapy (AIT) to decrease nasal, conjunctival and bronchial symptoms, to improve quality of life, to increase the threshold dose of allergen eliciting respiratory symptoms, and to induce serum sIgG(4) in LRA individuals. Collectively, these data indicate that local allergy is a relevant disease mechanisms in both atopic and non-atopic patients with airway diseases. Frontiers Media S.A. 2021-06-02 /pmc/articles/PMC8206788/ /pubmed/34149736 http://dx.doi.org/10.3389/fimmu.2021.691964 Text en Copyright © 2021 Testera-Montes, Salas, Palomares, Ariza, Torres, Rondón and Eguiluz-Gracia https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Immunology Testera-Montes, Almudena Salas, Maria Palomares, Francisca Ariza, Adriana Torres, María J. Rondón, Carmen Eguiluz-Gracia, Ibon Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum |
title | Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum |
title_full | Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum |
title_fullStr | Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum |
title_full_unstemmed | Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum |
title_short | Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum |
title_sort | local respiratory allergy: from rhinitis phenotype to disease spectrum |
topic | Immunology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206788/ https://www.ncbi.nlm.nih.gov/pubmed/34149736 http://dx.doi.org/10.3389/fimmu.2021.691964 |
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