Recent advances in the management of allergic rhinitis

Abstract

Allergic rhinitis (AR) is a type I allergic disease characterized by sneezing, watery rhinorrhea, and nasal obstruction. An epidemiological survey found that approximately 50% of Japanese individuals have AR.Histamine is a major chemical mediator that induces AR symptoms through its binding to histamine H1 receptor(H1R). We demonstrated that antihistamines have a blocking effect on histamine signaling of H1R, and the suppressive effect on histamine-induced up-regulation of transcriptional activation, and the suppressive effect on basal transcription of H1R in the absence of histamine which may be part of the inverse agonist action of antihistamine. Sublingual immunotherapy (SLIT) with a standardized Japanese cedar (JC) pollen significantly improved nasal symptoms and AR-related sleep disturbance in patients with JC pollinosis. Dual SLIT with JC pollen and house dust mites (HDM) suppressed both JC pollen-induced seasonal and HDM-induced perennial nasal symptoms in bisensitized patients with AR. Dual SLIT was more effective in suppressing nasal obstruction at the peak JC pollen period than mono SLIT with JC pollen. Posterior nasal neurectomy (PNN) improved nasal symptoms and medication scores in patients with severe perennial AR. Herein, we describe recent advances in the management of AR. J. Med. Invest. 72 : 14-20, February, 2025.

Keywords: allergic rhinitis; histamine H1 receptor; interleukin-9; posterior nasal neurectomy; sublingual immunotherapy.