title: Emerging drugs for perennial allergic rhinitis.
abstract: BACKGROUND
  Allergic rhinitis (AR) is a high-prevalence disease, sustained by an IgE-triggered reaction with histamine release, followed by an inflammatory response which involves cells, mediators, cytokines and adhesion molecules. According to its duration, AR can be either intermittent or persistent. In the persistent form, the inflammatory component usually predominates.
  
  
  METHODS
  The current therapeutic strategy is based on antihistamines, antileukotrienes and on corticosteroids (which broadly act on inflammation). Allergen-specific immunotherapy is a biological response modifier that affects the immune response to allergens in a broad sense. The available pharmacotherapy is overall effective in controlling symptoms and inflammation, but safety concerns may be present (especially for prolonged treatments), and a proportion of patients remain uncontrolled. The available therapeutic innovations, as derived from the most recent literature are reviewed herein.
  
  
  CONCLUSIONS
  In the last years there have been very few innovative approaches to optimize the management of AR. These include new histamine receptor antagonists, combination therapy and strategies to selectively block relevant signaling pathways of the allergic reaction. Some more promising advances have been shown for allergen immunotherapy, where a number of new strategies are currently under development.
authors.affiliation: Allergy & Respiratory Diseases, IRCCS S. Martino-IST-University of Genoa, Padiglione Maragliano, L.go R. Benzi 10, 16132 Genoa, Italy. passalacqua@unige.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
mesh_terms: D000485:Allergens / Q000276:immunology; D000818:Animals; D015195:Drug Design; D006632:Histamine / Q000378:metabolism; D006633:Histamine Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007167:Immunotherapy / Q000379:methods; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000276:immunology / Q000628:therapy; D015398:Signal Transduction / Q000187:drug effects
chemical_list: D000485:Allergens; D006633:Histamine Antagonists; D007073:Immunoglobulin E; D006632:Histamine