title: Investigational new drugs for allergic rhinitis.
abstract: Allergic rhinitis (AR) is a multifactorial disease characterized by paroxysmal symptoms of sneezing, rhinorrhea, postnasal drip and nasal congestion. For over a century, subcutaneous allergen immunotherapy (SCIT) has been recognized as the most effective therapy to date that may modify the underlying disease course and provide long-term benefits for individuals refractory to pharmacotherapy. However, over the past 25 years, there has been substantial growth in developing alternative therapies to traditional SCIT. Areas covered: This article will review the most current literature focusing on advancements of AR therapies. Novel AR therapies that are currently under investigation include: the addition of omalizumab, an anti-immunoglobulin E (IgE) monoclonal antibody (mAb), to SCIT; altering the method of delivery of allergen immunotherapy (AIT) including sublingual (SLIT), epicutaneous (EIT), intralymphatic (ILIT), intranasal (INIT) and oral mucosal immunotherapy (OMIT); use of capsaicin spray; novel H3 and H4 antihistamines; activation of the innate immune system through Toll-like receptor agonists; and the use of chemically altered allergens, allergoids, recombinant allergens and relevant T-cell epitope peptides to improve the efficacy and safety of AIT. Expert opinion: These promising novel therapies may offer more effective and/or safer treatment options for AR patients, and in some instances, induce immunologic tolerance.
authors.affiliation: a Department of Internal Medicine , University of South Florida Morsani College of Medicine, Division of Allergy and Immunology , Tampa , FL , USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ricketti
authors.affiliation: a Department of Internal Medicine , University of South Florida Morsani College of Medicine, Division of Allergy and Immunology , Tampa , FL , USA.
authors.forename: Sultan
authors.initials: S
authors.lastname: Alandijani
authors.affiliation: a Department of Internal Medicine , University of South Florida Morsani College of Medicine, Division of Allergy and Immunology , Tampa , FL , USA.
authors.forename: Chen Hsing
authors.initials: CH
authors.lastname: Lin
authors.affiliation: a Department of Internal Medicine , University of South Florida Morsani College of Medicine, Division of Allergy and Immunology , Tampa , FL , USA.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Casale
mesh_terms: D000485:Allergens / Q000276:immunology; D000818:Animals; D018926:Anti-Allergic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003888:Desensitization, Immunologic / Q000379:methods; D015507:Drugs, Investigational / Q000494:pharmacology / Q000627:therapeutic use*; D006633:Histamine Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007108:Immune Tolerance; D065631:Rhinitis, Allergic / Q000188:drug therapy* / Q000276:immunology
chemical_list: D000485:Allergens; D018926:Anti-Allergic Agents; D015507:Drugs, Investigational; D006633:Histamine Antagonists
keywords: Allergic rhinitis; EIT; ILIT; INIT; OMIT; SCIT; SLIT; TLR agonists; allergoids; capsaicin; novel antihistamines; omalizumab; peptides; recombinant allergens