Advances in understanding allergic rhinitis,
presented at the AAAAI Annual Meeting in San Diego, CA

SAN DIEGO-Allergic fungal sinusitis (AFS) constitutes a distinct form of chronic rhinosinusitis (CRS), according to a study presented at the 2007 AAAAI Annual Meeting in San Diego, CA.

Patricia S. Hutcheson, Saint Louis University Medical School, Saint Louis, MO, and colleagues, studied 84 CRS patients with nasal polyps. If these patients had positive fungal cultures or positive fungal stains from surgical specimen, they were designated as AFS, with the remaining 18 patients as CRS.

Researchers analyzed these two groups and found that AFS patients demonstrate an enhanced IgE and IgG immune response to fungi. This clearly differentiates AFS from other forms of CRS.

Non-allergic triggers affect patients with allergic rhinitis
Patients with allergic rhinitis have more non-allergic triggers than normal controls without allergic rhinitis, according to a study presented at the 2007 AAAAI Annual Meeting in San Diego, CA.

Dennis Shusterman, MD, MPH, University of Washington, Seattle, WA, and colleagues, recruited 60 patients ranging from age 19 to 68 years and studied their chemosensory function in relation to their age, gender and allergic rhinitis status.

Researchers found that the majority of patients who reported reacting to more than three non-allergic triggers had allergic rhinitis, with 42% of patients with allergic rhinitis reporting greater than three triggers, compared with only 3% of controls. Subjects over 35 years of age were more likely to report one or more non-allergic triggers, particularly tobacco smoke.

This study demonstrates that patients with allergic rhinitis often react to non-allergic symptom triggers (such as cold air, perfumes and colognes, cigarette smoke, household cleaning products, and exercise) in addition to responding to allergens, and that older patients are more likely to report at least one non-allergic symptom trigger.

Advances in allergic rhinitis can improve sleep disordered breathing in children
Adequate treatment and elimination of indoor allergens such as cockroach, mouse or rat, may significantly improve sleep-disordered breathing (SDB), according to a study presented at the 2007 AAAAI Annual Meeting in San Diego, CA.

Neeti Gupta, MD, Long Island College Hospital, Brooklyn, NY, and colleagues, evaluated patients, aged 2-18 years, for allergic rhinitis. Next, skin prick testing to aeroallergens, including inner-city allergens such as rat, cockroach, and mouse, were performed. A validated Pediatric Sleep Questionaire (PSQ) was used to determine if treatment with an intranasal steroid improves SBD. After six weeks of treatment, PSQ results showed a clinical improvement in SBD.

Researchers concluded that children who have increased allergic rhinitis-related nasal obstruction leading to sleep-disordered events, may significantly improve SDB with adequate treatment. And in inner-city children, elimination of indoor allergens that contribute to allergic rhinitis symptoms may further improve SBD.

Research shows lack of physician-patient communication in treatment of allergic rhinitis
The prevalence of ocular symptoms and sleep disturbances associated with allergic rhinitis is not fully observed by physicians, according to a study presented at the 2007 AAAAI Annual Meeting in San Diego, CA.

Michael Schatz, MD, MS, FAAAAI, Kaiser Permanente Medical Center, San Diego, CA, and colleagues, asked physicians to complete a patient record form including questions on symptoms of their patients with allergic rhinitis. These patients were also asked to complete a record form with questions on their symptoms.

The study found that the physicians, either primary care or specialist, rated fewer patients as having severe allergic rhinitis compared with the patients' rating of their own disease severity. They also found that itchy, red, watery eyes and trouble sleeping were more often reported by patients than physicians.

This study shows that treatment of allergic rhinitis and physician-patient communication about allergic rhinitis should be improved and would probably benefit from an easy to use patient-based measure of rhinitis control.

These studies were presented at the 2007 Annual Meeting of the American Academy of Allergy, Asthma and Immunology (AAAAI). The AAAAI is the largest professional medical specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals and others with special interest in the research and treatment of allergic disease.

Allergy/immunology specialists are pediatric or internal medicine physicians who have elected an additional two years of training to become specialized in the treatment of asthma, allergy and immunologic disease.

Established in 1943, the AAAAI has more than 6,000 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate for the public by providing educational information through its Web site www.aaaai.org, and its Physician Referral and Information Line at (800) 822-2762.

# # #