What is allergic rhinitis?
Allergic rhinitis is an inflammation of the nasal and oral mucous membranes that occurs following exposure to an allergen. Allergens are substances that trigger an immune system response in allergic subjects.
Allergic rhinitis can be seasonal, linked, for example, to the pollination period of plants, or chronic, as in the case of an allergy to mites or animal hair.
What are the symptoms of allergic rhinitis?
The symptoms are similar to those of a common cold, including sneezing, nasal congestion, watery eyes, itching and sleep disorders.
When symptoms also affect the eyes, we speak of allergic oculorhinitis, which involves weeping, redness and itching of the eyes.
In most cases, the symptoms are mild, but sometimes they can become intense and persistent and cause, for example, difficulty breathing (dyspnoea) and a sense of tightness in the chest.
In patients suffering from asthma, allergic rhinitis can lead to a worsening of the pathological condition.
In any case, it is important not to underestimate allergic rhinitis as it can favor the onset of other diseases such as:
- otitis,
- nasal polyposis,
- chronic sinusitis,
- bronchial asthma,
- sleep apnoea syndrome.
Allergic rhinitis: causes
Allergic rhinitis is caused by the response of the immune system to an allergen, with the consequent production of specific antibodies (type E immunoglobulins, IgE) which, in turn, induce the release of histamine, a substance responsible for the inflammation of the nasal mucosa.
In the case of seasonal rhinitis, the most frequent allergens are plant pollen. The most critical period for those allergic to pollen is spring. Currently, however, due to climate change, we are witnessing a prolonged pollination period in summer even of typically springtime plants.
In some patients, allergic rhinitis occurs throughout the year (even in winter). In this case, we are talking about persistent rhinitis, which is mainly caused by exposure to dust mites, mould spores and the hair (but also saliva) of pets.
Allergic rhinitis: remedies
To limit the risk of allergic rhinitis, it is good to reduce exposure to inhaled allergens. The most effective treatment would be the total removal of the source of the allergy, which, however, is not always possible. To keep the problem under control and limit discomfort, however, you can follow some simple precautions according to the type of allergen:
- in the case of dust mites: reduce the humidity rate and frequently clean the home and work environments;
- in the case of animal hair: keep pets outdoors as much as possible;
- in the case of mold spores: promote ventilation and air exchange indoors and avoid the use of humidifiers;
- in the case of pollen: consult the pollination calendar, keep the windows mostly closed during critical periods and avoid practising outdoor sports activities in the middle of the day.
How can allergic rhinitis be treated?
Treatment may vary according to its duration and severity. To relieve symptoms, topical antihistamine drugs (nasal sprays) or oral medications that block the action of histamine are usually prescribed. Antihistamines can be combined with decongestants for the airways.
In some cases, the allergist can evaluate the specific immunotherapy, the vaccine, which is based on the controlled and progressively increasing administration of small amounts of allergenic extracts in order to induce the immune system to tolerate the allergen itself.
How can rhinitis be diagnosed and what tests should be performed?
A precise diagnosis to identify the allergens responsible for allergic rhinitis is based on allergy tests.
The tests available for the diagnosis of allergies are:
- serological tests for the detection of IgE responsible for allergic reactions;
- the ALEX test which, through a molecular approach, allows us to quickly and reliably evaluate antibody responses to 295 different allergens.
Dr Maria Luisa Casella
