PL EN


2014 | 1 | 19-23
Article title

Współczesne postępowanie w alergicznym nieżycie nosa.

Content
Title variants
EN
Current management of allergic rhinitis.
Languages of publication
PL
Abstracts
PL
Wśród wzrastającej liczby chorób alergicznych, alergiczny nieżyt nosa (ANN) zajmuje czołową pozycję. Według badań epidemiologicznych przeprowadzonych w Polsce w ramach projektu ECAP (Epidemiologia Chorób Alergicznych w Polsce), schorzenie to dotyczy blisko 25% populacji, występując częściej u dzieci i w rejonach miejskich. ANN współistnieje w 80% przypadków z astmą oskrzelową i z alergicznym zapaleniem spojówek (AZS) – w 75% przypadków. ANN nieleczony stanowi duży, nawet ośmiokrotny wzrost ryzyka rozwoju astmy, ponadto powoduje częste zaostrzenia choroby i innych schorzeń towarzyszących, m.in. zapalenia zatok. Optymalne leczenie ANN zależy od fenotypu klinicznego (okresowy, przewlekły), wieku pacjenta oraz stopnia ciężkości choroby (lekki, umiarkowany, ciężki) i współistnienia AZS albo astmy. Zgodnie z wytycznymi raportu ARIA (Allergic Rhinitis and its Impact on Astma), podstawowe znaczenie w terapii ANN mają leki przeciwhistaminowe drugiej generacji (LPII), do których dodaje się miejscowe glikokortykosteroidy (mGKS) w przypadku ciężkiego przebiegu choroby. Obydwie grupy leków poprawiają również jakość życia (QoL) ocenianą za pomocą kwestionariuszy ogólnych i dostosowanych do specyfiki choroby. Obowiązuje również zasada zmniejszenia kontaktu z alergenem, ale skuteczność takiego postępowania wykazuje niewielkie znaczenie kliniczne. W uzasadnionych przypadkach skuteczna jest swoista immunoterapia alergenowa (SIT).
EN
Among rising number of allergy cases allergic rhinitis (AR) occupies highest level. According to epidemiological studies in Poland developed as ECAP project, AR occurs in 25% of population and is found more often in children and rural regions. The value of optimal therapy of AR arises not only from mentioned above epidemiological reasons, but also from relationships between AR and asthma where 80% coincidence is observed as well as allergic conjunctivitis (AC) with 75% comorbidity. AR not treated determines eight times higher risk of asthma developing, in addition causes both often asthma exacerbation and other comorbidities, among the others – sinusitis. Optimal treatment of AR depends on clinical phenotype of disease (intermittent, persistent) and the level of severity (mild, moderate, severe) as well as coincidence with AC and asthma. In concordance with ARIA (Allergic Rhinitis and its Impact on Asthma) rapport, mainstay therapy of AR are second generation antihistamines with addition of local glicocorticosteroids in cases of severe course of disease. Both antihistamines and local corticosteroids improves quality of life (QoL), evaluated by generic and specific questionnaires. The rule of allergen avoidance should be taken into consideration, but a value of this procedure is clinically slight. Specific immunotherapy (SIT) is effective in justified cases.
Year
Issue
1
Pages
19-23
Physical description
Contributors
References
  • Bousquet J, Khaltaev N, Cruz AA, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update (in collaboration with the World Health Organization, GA2LEN* and AllerGen**). Allergy 2008; 63(Suppl. 86): 8–160.
  • Samoliński B, Sybilski J, Raciborski F, i wsp.: Alergiczny nieżyt nosa w świetle badania ECAP. Alergia 2009; 2: 41–44.
  • Bielory L. Ocular allergy overview. Immunol Allergy Clin North Am 2008; 28: 1–23.
  • Guerra S, Sherrill DL, Martinez FD, et al. Rhinitis as an independent risk factor for adult-onset asthma. J Allergy Clin Immunol 2002; 109: 419–425.
  • Canis M, Gröger M, Becker S, et al. Recombinant allergen profiles and health-related quality of life in seasonal allergic rhinitis. Allergy Asthma Proc 2010; 31: 219–226.
  • Esteitie R, Detineo M, Naclerio RM, et al. Effect of the addition of montelukast to fluticasone propionate for the treatment of perennial allergic rhinitis. Ann Allergy Asthma Immunol 2010; 105: 155–161.
  • Stanowisko Grupy Ekspertów Polskiego Towarzystwa Alergologicznego i Polskiego Towarzystwa Okulistycznego w Sprawie Diagnostyki i Leczenia Alergicznych Chorób Oczu. Łódź: Wydawnictwo PTA, PTO; 2008: 1–62.
  • Compalati E, Ridolo E, Passalacqua G, et al. The link between Allergic Rhinitis and Asthma: The United Airways Disease. Expert Rev Clin Immunol 2010; 6: 413–423.
  • Notcovich C, Diez F, Tubio MR, et al. Histamine acting on H1 receptor promotes inhibition of proliferation via PLC, RAC, and JNK-dependent pathways. Exp Cell Res 2010; 316: 401–411.
  • Kruszewski J. Antihistamines in the treatment of allergic rhinitis-update 2008/2009. Otolaryngol Pol 2009; 63: 5–10.
  • Ciprandi G, Pronzato C, Ricca V, et al. Loratadine treatment of rhinitis due to pollen allergy reduces epithelial ICAM-1 expression. Clin Exp Allergy 1997; 27: 1175–1183.
  • Van Steekelenburg J, Clement PAR, Beel MHL. Comparison of five new antihistamines (H1-receptor antagonists) in patients with allergic rhinitis using nasal provocation studies and skin tests. Allergy 2002; 57: 346–350.
  • Lee CF, Sun KL, Lu KH, et al. The comparison of cetirizine, levocetirizine and placebo for the treatment of childhood perennial allergic rhinitis. Pediatr Allergy Immunol 2009; 20: 494–499.
  • Kaiser HB, Gopalan G, Chung W. Loratadine provides early symptom control in seasonal allergic rhinitis. Allergy Asthma Proc 2008; 29: 654–658.
  • Stübner P, Zieglmayer R, Horak F. A direct comparison of the efficacy of antihistamines in SAR and PAR: randomised, placebo-controlled studies with levocetirizine and loratadine using an environmental exposure unit – the Vienna Challenge Chamber (VCC). Curr Med Res Opin 2004; 20: 891–902.
  • Mann RD, Pearce GL, Dunn N, et al. Sedation with “non-sedating” antihistamines: four prescription-event monitoring studies in general practice. BMJ 2000; 320: 1184–1186.
  • Roth T, Roehrs T, Koshorek G, et al. Sedative effects of antihistamines. J Allergy Clin lmmunol 1987; 80: 94–98.
  • Kassem N, Roman I, Gural R, et al. Effects of loratadine (SCH 29851) in suppression of histamine-induced skin wheals. Ann Allergy 1988; 60(6): 505–507.
  • Ghosal A, Gupta S, Ramanathan R, et al. Metabolism of loratadine and further characterization of its in vitro metabolites. Drug Metab Lett 2009; 3: 162–170.
  • Simons FER. Advances in H1-antihistamines. N Engl J Med 2004; 351: 2203–2217.
  • Kruszewski J, Kłos K, Sułek K. Hamowanie pohistaminowego bąbla, rumienia i włośniczkowego przepływu skórnego po jednorazowym podaniu zalecanej dawki 10 mg cetyryzyny, 5 mg desloratadyny, 120 i 180 mg feksofenadyny, 5 mg lewocetyryzyny I 10 mog loratadyny – badanie randomizowane, kontrolowane placebo. Pol Merk Lek 2006; 21: 443–448.
  • Larbig M, Burtin B, Martin L, et al. Facial thermography is a sensitive tool to determine antihistaminic activity: comparison of levocetirizine and fexofenadine. Br J Clin Pharmacol 2006; 62: 158–164.
  • Ciprandi G, Cirillo I, Vizzaccaro A, et al. Desloratadine and levocetirizine improve nasal symptoms, airflow, and allergic inflammation in patients with perennial allergic rhinitis: a pilot study. Int Immunopharmacol 2005; 5: 1800–1808.
  • Baki A, Ohran R. The effect of loratadine in exercise-induced asthma. Arch Dis Child 2002; 86: 38–39.
  • Liberman P, Kaliner MA, Wheeler WJ. Open-label evaluation of azelastine nasal spray in patients with seasonal allergic rhinitis and non-seasonal vasomothor rhinitis. Cur Med Res Opinion 2005; 21: 611–618.
  • Gani F, Braida A, Lombardi C, et al. Rhinitis in pregnancy. Eur Ann Allergy Clin Immunol 2003; 35: 306–313.
  • Pitsios C, Papadopoulos D, Kompoti E, et al. Efficacy and safety of mometasone furoate vs nedocromil sodium as prophylactic treatment for moderate/severe seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2006; 96: 673–678.
  • Nayak A, Langdon RB. Montelukast in the treatment of allergic rhinitis: an evidence-based review. Drugs 2007; 67: 887–901.
  • Berges-Gimeno MP, Simon RA, Stevenson DD. The effect of leukotriene- modifier drugs on aspirin-induced asthma and rhinitis reactions. Clin Exp Allergy 2002; 32: 1491–1496.
  • Ciebiada M, Gorska-Ciebiada M, DuBuske LM, et al. Montelukast with desloratadine or levocetirizine for the treatment of persistent allergic rhinitis. Ann Allergy Asthma Immunol 2006; 97: 664–671.
  • Kim KT, Kerwin E, Landwehr L, et al. Use of 0.06% ipratropium bromide nasal spray in children aged 2 to 5 years with rhinorrhea due to a common cold or allergies. Ann Allergy Asthma Immunol 2005; 94: 73–79.
  • Bahekar PC, Shah JH, Ayer UB, et al. Validation of guinea pig model of allergic rhinitis by oral and topical drugs. Int Immunopharmacol 2008; 8: 1540.
  • Meltzer EO, Caballero F, Fromer LM, et al. Treatment of congestion in upper respiratory diseases. Int J Gen Med 2010; 3: 69–91.
  • Sur DK, Scandale S. Treatment of allergic rhinitis. Am Fam Physician 2010; 81: 1440–1460.
  • Chervinsky P, Nayak A, Rooklin A, et al. Efficacy and safety of desloratadine/ pseudoephedrine tablet, 2.5/120 mg two times a day, versus individual components in the treatment of patients with seasonal allergic rhinitis. Allergy Asthma Proc 2005; 26: 391.
  • Allergen immunotherapy. A practice parameter. Annals Allergy Asthma Immunol 2003; 90(Suppl. 1): 1–40.
  • Moller C, Dreborg S, Fredousi HA, et al. Pollen immunoterapy reduces the development of astma in children with seasonal rhinoconjunctivitis (the PAT study). J Allergy Clin Immunol 2002; 109: 251–256.
  • Ciprandi G, Cadario G, Di Gioacchino GM, et al. Sublingual immunotherapy in children with allergic polysensitization. Allergy Asthma Proc 2010; 31: 227–231.
  • Müller U, Hari Y, Berchtold E. Premedication with antihistamines may enhance efficacy of specific-allergen immunotherapy. J Allergy Clin Immunol 2001; 107: 81–86.
  • Tworek D, Bocheńska-Marciniak M, Kupczyk M, et al. Safety of venom immunotherapy in patients pretreated with antihistamines – a retrospective study. Pneumonol Alergol Pol 2006; 74: 153–158.
Document Type
Publication order reference
Identifiers
ISSN
2084-4212
YADDA identifier
bwmeta1.element.desklight-7a99303d-9d51-4ffd-8935-4fa63e26fd6a
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.