Novel therapeutic interventions for allergic rhinitis.
Allergic rhinitis is a high-prevalence disease, affecting 10 - 20% of the general population. Allergic rhinitis is sustained by an IgE-mediated reaction and by a complex inflammatory network of cells, mediators and cytokines that becomes chronic when exposure to allergen persists. A T(H)2-biased immune response is the background of the allergic inflammation. The current therapeutic strategy is mainly based on drugs (antihistamines, nasal corticosteroids, cromones and decongestants) and allergen immunotherapy. Drugs are (overall) effective in controlling symptoms but do not modify the immune background that leads to allergic inflammation and safety concerns may be present, especially for prolonged treatments. Immunotherapy can modify the allergic response but there is still room for improvement. Nowadays, several approaches are under investigation to optimise the management of allergic rhinitis. On one hand, new drugs and antimediators are being developed. On the other hand, attempts are being made to selectively block relevant signal pathways of allergic reaction. Finally, one of the major goals is to modify the T(H)2-biased immune response by improving the characteristics and modes of action of allergen immunotherapy.
Passalacqua
Giovanni
G
University of Genoa, Padiglione Maragliano, Allergy and Respiratory Diseases, Department of Internal Medicine, Largo Rossana Benzi 10, Genoa, Italy. passalacqua@unige.it
Ciprandi
Giorgio
G
D000485:Allergens / Q000009:adverse effects / Q000627:therapeutic use; D018926:Anti-Allergic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000494:pharmacology / Q000627:therapeutic use; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000276:immunology; D003888:Desensitization, Immunologic; D004359:Drug Therapy, Combination; D015507:Drugs, Investigational / Q000494:pharmacology / Q000627:therapeutic use*; D005544:Forecasting; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology; D007073:Immunoglobulin E / Q000276:immunology; D007155:Immunologic Factors / Q000494:pharmacology / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use; D010353:Patient Education as Topic; D019936:Probiotics / Q000494:pharmacology / Q000627:therapeutic use; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D015398:Signal Transduction / Q000187:drug effects; D018418:Th2 Cells / Q000276:immunology
D000485:Allergens; D018926:Anti-Allergic Agents; D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D015507:Drugs, Investigational; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; C026408:anti-IgE antibodies; D007073:Immunoglobulin E