Focus on Allergic Rhinitis

Rhinitis is a general term which describes inflammation of the nasal epithelial cells (the mucous-producing cells that comprise the inner walls of the nose cavity and sinuses).

Rhinitis is characterized by sneezing, itching and nasal congestion. There are several main causes for rhinitis, the most common ones are of allergic origin (nearly half of the cases).

An allergic response includes a massive production of special cells called Mast cells. These cells are "famous" mediators that participate in any allergic reaction, and lead to a chain reaction of inflammation and other mediator secretion.

Allergic rhinitis can be due to change of seasons- then it is referred to as seasonal rhinitis, or "hay-fever". Allergic rhinitis can also be periodic or episodic, meaning it comes and goes with the exposure to certain factors that trigger the body's immune system, and present an acute immunological response.

Seasonal allergic rhinitis is caused by pollen from growing grass or weeds, with a seasonal pattern. Insect-pollinated plants (flowers, trees) don't usually cause these allergic responses. Typically trees pollinate in the springtime, whereas weeds in the summer and fall. The microscopic pollen can travel through the air directly into the patient's airway system, causing the inflammatory response.

Other types of allergens include several indoor particles such as dust mites, mold and animal fur. Episodic rhinitis appears when a specific allergen is present, but there is no constant exposure.
The most important factors that contribute to the development of allergic rhinitis is genetic origin and previous repeated exposure to certain allergens.

Children with an allergic tendency are often referred to as atopic children. This phenomenon is usually not present before the age of six months and is more common after the age of three years.
Treating allergic rhinitis is very patient-oriented. Each patient can react to different types of treatment in different ways. Some will react to the simplest antihistamines that are on the market and will only need an SOS treatment (after an exposure).

Other patients may suffer from constant allergies which require frequent treatment, sometimes on a daily basis. Basic treatment modalities include avoiding exposure to the allergen (prevention), pharmacologic therapy and newer methods called immunotherapy.

Antihistamines and decongestants are the most common types of medications used to treat an allergic reaction causing rhinitis. If environmental control and medications fail, immunotherapy should be tried. One should always consider asthma as an underlying reason for being prone to allergic rhinitis for the two often go together.