title: Local IgE in non-allergic rhinitis.
abstract: Local allergic rhinitis (LAR) is characterized by the presence of a nasal Th2 inflammatory response with local production of specific IgE antibodies and a positive response to a nasal allergen provocation test (NAPT) without evidence of systemic atopy. The prevalence has been shown to be up to 25% in subjects affected with rhinitis with persistence, comorbidity and evolution similar to allergic rhinitis. LAR is a consistent entity that does not evolve to allergic rhinitis with systemic atopy over time although patients have significant impairment in quality of life and increase in the severity of nasal symptoms over time. Lower airways can be also involved. The diagnosis of LAR is based mostly on demonstration of positive response to NAPT and/or local synthesis of specific IgE. Allergens involved include seasonal or perennial such as house dusts mites, pollens, animal epithelia, moulds (alternaria) and others. Basophils from peripheral blood may be activated by the involved allergens suggesting the spill over of locally synthesized specific IgE to the circulation. LAR patients will benefit from the same treatment as allergic patients using antihistamines, inhaled corticosteroids and IgE antagonists. Studies on immunotherapy are ongoing and will determine its efficacy in LAR in terms of symptoms improvement and evolution of the natural course of the disease.
authors.affiliation: Allergy Unit, Regional University Hospital of Malaga, IBIMA, UMA, Malaga, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Campo
authors.affiliation: Allergy Unit, Regional University Hospital of Malaga, IBIMA, UMA, Malaga, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Rondón
authors.affiliation: Randall Division of Cell and Molecular Biophysics, Division of Asthma, Allergy and Lung Biology, King's College London, MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK.
authors.forename: H J
authors.initials: HJ
authors.lastname: Gould
authors.affiliation: Allergy Unit, Regional University Hospital of Malaga, IBIMA, UMA, Malaga, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Barrionuevo
authors.affiliation: Upper Airways Research Laboratory, Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Gevaert
authors.affiliation: Allergy Unit, Regional University Hospital of Malaga, IBIMA, UMA, Malaga, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Blanca
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D009299:Nasal Provocation Tests; D010641:Phenotype; D015995:Prevalence; D012220:Rhinitis / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology* / Q000628:therapy; D065631:Rhinitis, Allergic / Q000175:diagnosis / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology / Q000378:metabolism
chemical_list: D007073:Immunoglobulin E