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Current Controversies and Challenges in Allergic Rhinitis Management
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Current Controversies and Challenges in Allergic Rhinitis Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: closed (20 August 2019)

Special Issue Editors

Dr. Carmen Rondón

E-Mail Website
Guest Editor
Hospital Regional Universitario-IBIMA, Allergy Unit, Málaga, Spain
Interests: allergic rhinitis and asthma phenotypes and endotypes; nasal and bronchial allergen challenge; component-based molecular diagnose; allergen immunotherapy
Prof. Dr. Joaquim Mullol

E-Mail Website
Guest Editor
1. Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
2. Clinical & Esperimental Respiratory Immunoallergy, IDIBAPS, CIBERES. Barcelona, Catalonia, Spain
Interests: rhinitis and rhinosinusitis phenotypes & endotypes; severe chronic upper airway diseases (SCUAD); olfactory disorders; NSAID-Exacerbated Respiratory Diseases (N-ERD)

Special Issue Information

Dear Colleagues,

Allergic hinitis represents an important health problem affecting 10-25% of the general population, and is increasing worldwoide. This chronic inflammatory disease represent a risk factor for the development of asthma, impact on patients’ social life, school performance, work productivity, and has a large impact on healthcare resource use.

Allergic rhinitis and allergic asthma constitutes two different expression of a single entity recently named allergic respiratory disease (ARD). The clinical management of these patients, including an accurate and unified allergen diagnose and the selection of the appropriate etiologic treatment (allergen immunotherapy), constitute an excellent example of precission and personalized medicine.

For such a common condition, it is perhaps surprising that there are still so many unanswered questions about the phenotypes and endotypes of allergic rhinitis and its main multimorbidities (asthma, conjunctivitis), possible strategies for its fast and accurate diagnosis, and the best options of treating the disease and preventing its progression.

The main objective of this Special Issue of the journal is to reflect the current controversies, diagnostic challenges, and new therapeutic insights in the clinical management of patients with allergic rhinitis.

Dr. Carmen Rondón
Prof. Dr. Joaquim Mullol
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ARD
  • Allergic rhinitis
  • Non-allergic rhinitis
  • Allergen immunotherapy
  • Local allergic rhinitis
  • Aeroallergens
  • Immunologic mechanism
  • Phenotypes
  • Endotypes
  • Epidemiology
  • Nasal provocation test
  • Molecular diagnosis
  • SCUAD
  • Mechanism of action
  • Immunotherapy

Published Papers (3 papers)

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Review

10 pages, 207 KiB  
Review
Allergic and Mixed Rhinitis: Diagnosis and Natural Evolution
by Justin C. Greiwe and Jonathan A. Bernstein
J. Clin. Med. 2019, 8(11), 2019; https://doi.org/10.3390/jcm8112019 - 19 Nov 2019
Cited by 24 | Viewed by 4765
Abstract
Chronic rhinitis (CR) is divided into two main categories: allergic rhinitis (AR) and nonallergic rhinitis (NAR). These conditions are more recognizable to an experienced clinician, as they can be more clearly demarcated diagnostically. However, an additional 30% to 50% of patients with CR [...] Read more.
Chronic rhinitis (CR) is divided into two main categories: allergic rhinitis (AR) and nonallergic rhinitis (NAR). These conditions are more recognizable to an experienced clinician, as they can be more clearly demarcated diagnostically. However, an additional 30% to 50% of patients with CR might have an overlap of NAR and AR, referred to as mixed rhinitis (MR). Progress in elucidating the pathophysiologic mechanisms behind MR and NAR has been made in the past several years, and there are now several guidelines published to assist the clinician in accurately diagnosing AR, NAR, and MR. Clinical history and subjective symptoms can provide clues for differentiating AR from MR and NAR, but allergy testing is recommended to confirm these conditions. Progress in accurately diagnosing patients with CR will be made as studies incorporate subjective (i.e., validated questionnaires such as the irritant index questionnaire (IIQ), medication responsiveness, and quality-of-life tools) and objective (i.e., nasal cytologic testing, nasal provocation, and biomarkers) methods characterizing rhinitis subtypes. Full article
(This article belongs to the Special Issue Current Controversies and Challenges in Allergic Rhinitis Management)
13 pages, 1414 KiB  
Review
Platelet-Activating Factor (PAF) in Allergic Rhinitis: Clinical and Therapeutic Implications
by Rosa M. Muñoz-Cano, Rocio Casas-Saucedo, Antonio Valero Santiago, Irina Bobolea, Paula Ribó and Joaquim Mullol
J. Clin. Med. 2019, 8(9), 1338; https://doi.org/10.3390/jcm8091338 - 29 Aug 2019
Cited by 29 | Viewed by 12651
Abstract
Platelet-activating factor (PAF) is a lipid mediator involved in several allergic reactions. It is released from multiple cells of the immune system, such as eosinophils, neutrophils, and mast cells, and also exerts its effect on most of them upon specific binding to its [...] Read more.
Platelet-activating factor (PAF) is a lipid mediator involved in several allergic reactions. It is released from multiple cells of the immune system, such as eosinophils, neutrophils, and mast cells, and also exerts its effect on most of them upon specific binding to its receptor, becoming a pleiotropic mediator. PAF is considered a potential relevant mediator in allergic rhinitis, with a key role in nasal congestion and rhinorrhoea due to its effect on vascular permeability. Interestingly, despite its potential relevance as a therapeutic target, no specific PAF inhibitors have been studied in humans. However, rupatadine, a second-generation antihistamine with dual antihistamine and anti-PAF effects has shown promising results by both blocking nasal symptoms and inhibiting mast cell activation induced by PAF, in comparison to antihistamine receptor drugs. In conclusion, the inhibition of PAF may be an interesting approach in the treatment of allergic rhinitis as part of a global strategy directed at blocking as many relevant inflammatory mediators as possible. Full article
(This article belongs to the Special Issue Current Controversies and Challenges in Allergic Rhinitis Management)
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13 pages, 1042 KiB  
Review
How to Diagnose and Treat Local Allergic Rhinitis: A Challenge for Clinicians
by Ibon Eguiluz-Gracia, Natalia Pérez-Sánchez, Gádor Bogas, Paloma Campo and Carmen Rondón
J. Clin. Med. 2019, 8(7), 1062; https://doi.org/10.3390/jcm8071062 - 19 Jul 2019
Cited by 49 | Viewed by 10639
Abstract
Chronic rhinitis is a very common disease that can be divided in various phenotypes. Historically, the condition has been classified into the allergic rhinitis (AR) and non-allergic non-infectious rhinitis (NAR) forms, based on the results of the classical biomarkers of atopy: skin prick [...] Read more.
Chronic rhinitis is a very common disease that can be divided in various phenotypes. Historically, the condition has been classified into the allergic rhinitis (AR) and non-allergic non-infectious rhinitis (NAR) forms, based on the results of the classical biomarkers of atopy: skin prick test and serum allergen-specific IgE However, this classification does not reflect the complexity of the rhinitis syndrome, as illustrated by the existence of non-atopic rhinitis patients who display a nasal reactivity to environmental allergens. This new phenotype has been termed local allergic rhinitis (LAR) and can be only recognized if an additional test such as the nasal allergen challenge (NAC) is integrated in the diagnostic algorithm for chronic rhinitis. Recent data shows that the NAC is a very safe and reliable technique ready for the clinical practice. LAR is a differentiated rhinitis phenotype which often commences during childhood and quickly progresses towards a clinical worsening and the association of comorbidities in other mucosal organs. Recent evidence supports the existence of a bronchial counterpart of LAR (local allergic asthma), which highlights the pathophysiological links between the upper and lower airways and reinforces the united airways concept. Importantly, several controlled studies have demonstrated the ability of allergen immunotherapy to control LAR symptoms while the therapy is being administered. This review emphasizes the need to implement the NAC in the clinical practice in order to facilitate the recognition of LAR patients, allowing for an early prescription of specific therapies with disease-modifying potential. Full article
(This article belongs to the Special Issue Current Controversies and Challenges in Allergic Rhinitis Management)
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