Allergic rhinitis

Allergic rhinitis (AR) is a non-infectious chronic inflammatory disease of the nasal mucosa that is mainly mediated by IgE after exposure to the allergen. A large number of epidemiological surveys at home and abroad have shown that the prevalence of allergic rhinitis has increased significantly in recent years, resulting in a large disease burden. Allergic rhinitis has become a major chronic inflammatory disease of the respiratory tract, which has a serious impact on patients' quality of life and social economy 1.
Type I allergic reaction is immune and inflammatory responses of the body to produce excess specific IgE against environmental allergens. The pathogenesis of AR is related to genetic and environmental interactions: on the one hand, allergic rhinitis is genetically susceptible; on the other hand, microbial flora also plays an important role in the pathogenesis of allergic diseases 1.
Typical symptoms of allergic rhinitis are paroxysmal sneezing, watery nasal discharge, nasal itching, and nasal congestion. May be associated with eye symptoms, including itching, tearing, redness and burning sensation, etc., more common in pollen allergies. If the pathogenic factors are mainly indoor allergens (dust mite, mites, animal dander, etc.), the symptoms are mostly perennial. The main signs of allergic rhinitis are pale and swollen nasal mucosa, edema of the inferior turbinate, and a large amount of watery secretions in the nasal cavity 1. 40% of allergic rhinitis patients have bronchial asthma, accompanied by wheezing, cough, shortness of breath and chest tightness and other lung symptoms 2.
The principles of treatment for allergic rhinitis include environmental control, medication, immunotherapy, and health education. The general description is "control combination, four in one." The main treatments for allergic rhinitis are medication and allergen-specific immunotherapy. Intranasal steroids, oral and nasal anti-histamines and anti-leukotrienes are first-line treatments and are recommended for clinical use. Although the disease can not be completely cured at present, through the standardized comprehensive prevention and treatment, the symptoms of patients can be well controlled and the quality of life is significantly improved 1.
1.  中华医学会耳鼻咽喉头颈外科学分会, 变应性鼻炎诊断和治疗指南(2015年,天津)[J]. 中国耳鼻喉头颈外科杂志,2016, 51(1): 6-24.
2.  Wheatley LM, Togias A. Clinical practice. Allergic rhinitis [J]. N Engl J Med, 2015, 372(5): 456-463.