Pet dander and perennial allergic rhinitis: therapeutic options.
Pet allergy may now be the most common perennial allergen in the United States based on recent skin-prick testing data. This trend corresponds with the rise (from 56 to 63%) in U.S. households having indoor pets over the past 10 years. Furthermore small, suspended, particulate animal allergens may be found in 90% of all homes and most public indoor areas. Although the most important cat and dog allergens are Fel d 1 and Can f 1, respectively, there are five well-described allergens for both cats and dogs. The effects of early life domestic pet and endotoxin exposure and subsequent clinical sensitivity remain controversial. Given that only the rare pet-allergic patient is willing to give away his/her pet, it is important to take an evidence-based approach to environmental control. Unfortunately, the benefits from changes in the environment that have been shown in research studies relate more to a reduction of allergens than symptoms. The pharmacotherapy for pet allergy will vary based on whether this is episodic or perennial allergic rhinitis (PAR) and on the severity of the symptoms. A stepwise approach for management, using both mono- and combination therapy, is proposed. Allergen immunotherapy, the only disease-modifying treatment available, may be the best therapeutic recommendation for patients with moderate to severe pet-induced PAR.
Wallace
Dana V
DV
Nova Southeastern University, Davie, Florida, USA. drdanawallace@gmail.com
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000485:Allergens / Q000276:immunology* / Q000378:metabolism; D000818:Animals; D000829:Animals, Domestic; D052179:Antigens, Plant; D002415:Cats; D003888:Desensitization, Immunologic; D004285:Dogs; D004780:Environment, Controlled; D019317:Evidence-Based Medicine; D006023:Glycoproteins / Q000276:immunology* / Q000378:metabolism; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D012709:Serum Albumin / Q000276:immunology* / Q000378:metabolism; D014481:United States
D000305:Adrenal Cortex Hormones; D000485:Allergens; D052179:Antigens, Plant; C522890:Can f 3 allergen, Canis familiaris; D006023:Glycoproteins; D006633:Histamine Antagonists; D020024:Leukotriene Antagonists; D012709:Serum Albumin; C059296:Fel d 1 protein, Felis domesticus