期刊
FRONTIERS IN IMMUNOLOGY
卷 12, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2021.691964
关键词
allergic rhinitis; dual allergic rhinitis; local allergic rhinitis; local allergic asthma; local respiratory allergy; mucosal immunology; IgE synthesis
类别
资金
- Instituto de Salud Carlos III of the Spanish Ministry of Science and Competitiveness [CM20/00160, JR19/00029]
- program of Redes Tematicas de Investigacion Colaborativa en Salud (RETICS): Asma, Reacciones Adversas y Alergicas-ARADyAL [RD16/0006/0001]
- Roche [SFC-0002-2020]
- Andalusian Regional Ministry of Health [PC-0098-2017, PI-0176-2018]
- [PI17/01410]
- [PI20/01715]
Local respiratory allergy (LRA) is characterized by negative atopy tests, clinical history of airway allergy, and positive response to allergen challenge. LRA includes conditions like local allergic rhinitis (LAR) and local allergic asthma in non-atopic patients, and dual allergic rhinitis in atopic individuals. LRA is mediated through mucosal synthesis of allergen-specific IgE and can be treated effectively with allergen immunotherapy (AIT).
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 Fc epsilon RI 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.
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