Allergic rhinitis has recently become of increasing clinical and social importance due to such a wide prevalence. WHO has found that about 40% of people in developed countries have an allergic tendency. This indicates a further increase in the frequency of allergic diseases.
Main clinical forms of allergic rhinitis
Allergic rhinitis can manifest itself in two forms – seasonal and year-round. Recently began to allocate the third form of allergic rhinitis – professional.
- Seasonal form - appears when pollen from flowering plants is present in the air. These are cypress, ambrosia, artemisia, birch, poplar fluff, cereal plants. Such rhinitis is also called hay runny nose or hay fever. This form is repeated at the same time, which confirms its cause. At the same time, frequent recurrences of seasonal rhinitis lead to disruption of vasomotor processes in the nasal mucosa. This may contribute to the transition of the seasonal form to a permanent one.
- A permanent form of allergic rhinitis appears against the background of constant contact with a substance that is an allergen for a certain organism. This allergen can be house and paper dust, which often contains mites, animal hair that has epidermal allergens, fish food in an aquarium, allergens from lower fungi, drugs and food.
Mites of the genus Dermatophagoides are a significant allergen from house dust. These mites, together with pet hair, are the most potent allergens.
Mechanism of the development of a pathological reaction in allergic rhinitis
The mechanism of development of allergic rhinitis is an IgE-mediated reaction of the first type. In this allergic reaction, the main components are lymphocytes, eosinophils, mast cells, basophils and endothelial cells. All these cells determine the development of the early and then the late phase of the allergic reaction.
In a normal state, substances that have fallen on the nasal mucosa are eliminated within 20 minutes. Allergenic substances are rapidly absorbed, so within 1 minute after the penetration of the allergen, it triggers the pathological reaction of allergic rhinitis. These reactions release histamine, a metabolite of arachidonic acid, platelet activating factors and leukotrienes.
The main mediator of immediate allergic reactions is histamine. It is released from mast cells in the early phase of the allergic reaction, while basophils are released in the late phase (after 4-6 hours). Histamine binds to H1 – receptors, which are located in type C nerve fibers. These fibers are responsible for pain sensitivity and are located in the mucous membrane and submucosal layer.
The developed inflammation in the nasal mucosa persists for several weeks. Under the action of low concentrations of allergens, chronic inflammation develops.
Triad of main symptoms in allergic rhinitis
The main clinical symptoms of both clinical forms of allergic rhinitis are the triad of symptoms:
- Paroxysmal frequent sneezing.
- Tickling and itching in the nose.
- Rhinorrhea, which makes it difficult to breathe through the nose.
Rhinorrhea is always profuse, may be watery or mucous in nature.
Also, many patients with allergic rhinitis have skin itching, lacrimation, reddening of the conjunctiva, headaches, fatigue, decreased ability to work, sleep disturbance, decreased sense of smell.
Vasomotor rhinitis often accompanies bronchopulmonary pathology - asthmatic bronchitis, which occurs with the "asthmatic triad". This is due to intolerance to drugs of acetylsalicylic acid, penicillin, metamizole, as well as polyposis changes in the nasal mucosa.
Modern diagnosis and treatment of allergic rhinitis
Allergic rhinitis is diagnosed on the basis of examination – the nasal mucosa is edematous, reddened, with a large amount of transparent fluid. Later, the mucous membrane acquires a bluish tint. The turbinates on examination have a pasty-like density. Often rhinitis is accompanied by an increase in polyps in the labyrinth area.
Skin tests, immunological tests, mast cell degranulation test, inhalation test, sinus secretion test are very important in the diagnosis of allergic rhinitis.
To treat allergic rhinitis, it is important to find an integrated approach. To do this, it is necessary to eliminate contact with causative allergens, it is important to carry out specific immunotherapy and pharmacotherapy. Surgical methods are required with a long prescription of the process and a significant growth of the nasal choanae. Surgical treatment is aimed at reducing the volume of enlarged inferior turbinates. Reflexology and topical corticosteroid therapy are effective.
Specific immunotherapy in the treatment of allergic rhinitis
Specific immunotherapy (SIT) is used when the allergen is accurately identified. An allergen is determined by introducing into the body the minimum amount of a possible allergen with a gradual increase in dose. This method allows the body to develop protective antibodies, which lead to a reduction in symptoms.
So, often for the treatment of allergic rhinitis, such a reaction is carried out. SIT is carried out only in the period of stable remission. To achieve the effect, it is recommended to undergo 3 courses of immunotherapy.
Non-specific therapy is aimed at eliminating or reducing the severity of the symptoms of allergic rhinitis. This is achieved antihistamines. But they only reduce the symptoms.
Therefore, in order for the body not to be prone to manifestations of allergic reactions when an allergen enters, it is necessary to periodically cleanse the body. After all, it is not in vain that an allergic reaction is considered a process of unauthorized cleansing of the body from "excess". You need to cleanse the body with proper light nutrition, one-day fasts and fasting.
Share:
Add a comment