United Airways
Jonathan A. Bernstein, Mark L. Levy in Clinical Asthma, 2014
Hay fever (seasonal allergic rhinitis [SAR]) is a form of rhinitis that is frequently undiagnosed and undertreated.2,3 Seasonal allergen triggers vary geographically around the world, with grass pollen being the most common trigger in the United Kingdom. For example, the highest grass pollen levels in the United Kingdom are at the end of June (early summer). As the air cools in the evening, pollen descends and the levels inspired can be very high, particularly when exercising. Rhinitis is defined by the presence of two or more of the following nasal symptoms: rhinorrhea, congestion, itching, and sneezing. It can be allergic, nonallergic, infective, or a combination of these.4 In children, allergy accounts for the majority of rhinitis cases; while in adults, allergy causes approximately one-third of cases. It is estimated that 25% of young people in the United Kingdom have rhinitis, which is similar to the prevalence of allergic rhinitis in other westernized countries.
Non-Allergic Perennial Rhinitis
John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie in Basic Sciences Endocrine Surgery Rhinology, 2018
If the case history is suggestive of clinically relevant non-infectious rhinitis: check possible stimuli, severity and duration of disease;check drug use (systemic and topical), exposure at work place, hormonal status (pregnancy, hypothyroidism, acromegaly) and involvement of other organs (asthma, hormonal status);exclude other nasal disease (rigid nasal endoscopy);exclude allergy: skin prick test, serum IgE-antibodies to the most frequent inhalant allergens, and ultimately nasal provocation testing in selected cases;exclude chronic rhinosinusitis (nasoendoscopy +/− computed tomography (CT) scan);perform nasal cytology (eosinophilia), and if shown to be positive then perform oral Aspirin challenge.
Diagnosis of Chronic Fatigue Syndrome
Jay A. Goldstein in Chronic Fatigue Syndromes, 2020
Local nasal problems include allergic rhinitis or perennial rhinitis, intolerance of odors or fumes, and alteration in the sense of smell or taste. Rhinitis is extremely common and should not always be treated symptomatically. I order CT scans of the sinuses more frequently now in the fatigued patient with rhinitis; they are much more accurate than sinus X rays for diagnosing occult sinusitis. Many CFS symptoms, especially fatigue, will often improve when sinusitis is diagnosed and treated. On the other hand, numerous patients have had surgical procedures which have benefitted them transiently, if at all. Patients with environmental illnesses sometimes describe a generalization of their intolerances. Could this be due to kindling in the pyriform cortex?
An updated patent review on P-glycoprotein inhibitors (2011-2018)
Published in Expert Opinion on Therapeutic Patents, 2019
Marcello Leopoldo, Patrizia Nardulli, Marialessandra Contino, Francesco Leonetti, Gert Luurtsema, Nicola Antonio Colabufo
Sinusitis is an inflammation of the mucous membrane lining one or more paranasal sinuses. Rhinitis is an inflammation of the mucous membrane lining the nasal passage. Rhinitis and sinusitis coexist and the expert in this field adopts the term rhinosinusitis. The symptoms of rhinosinusitis include nasal congestion and obstruction, colored nasal discharge, anterior or posterior nasal drip. Recently, Belier and Nocera in WO2017/123933A1 (Table 1) [32] reported that P-gp is secreted into nasal mucus under physiological condition whereas high concentration of pump is present in chronic rhinosinusitis. Therefore, the first innovative step is to evaluate P-gp in the nasal secretion of Chronic Rhinosinusitis. After this important innovative step, Bleier in the same patent and in another specific patent, US2017/0348384 [33], reported the innovative treatment of rhinosinusitis with P-glycoprotein inhibitor alone or in association with antibiotic, and or corticosteroids. P-glycoprotein inhibitor could be administered systematically or locally to the subject’s nasal passage and sinuses by inhalation device, by flushing, spraying, and nebulization.
B cells and upper airway disease: allergic rhinitis and chronic rhinosinusitis with nasal polyps evaluated
Published in Expert Review of Clinical Immunology, 2021
Harsha H Kariyawasam, Louisa K James
Rhinitis is the term used to define inflammation of the nasal mucosa. The clinical definition is by way of at least two of the following symptoms: nasal itching/sneezing, increased anterior secretions termed rhinorrhea and bilateral congestion for more than 1 h on most days. Chronicity of disease is arbitrarily defined by the persistence of such symptoms for more than three months [1]. AR is present when such symptoms are rapidly produced in response to a specific aeroallergen nasal exposure. Estimated to affect perhaps 400 million people worldwide, AR is accordingly one of the most persistent diseases. Worryingly prevalence is increasing [2], indeed, in some parts of Europe for example, the prevalence is as high as 50% of the population [3]. It is not only common but for many it is a disease that has a significant impact on general well-being, sleep quality, work productivity, school performance, and inevitably overall quality of life [4]. AR increases the risk of progression to asthma with an adjusted relative risk as high as 3.53 [5]. A trivial disease AR is not, despite being considered so by some health professionals, researchers, and government health bodies. There is an urgent need both to prevent and treat the disease more effectively, ultimately developing a cure.
Combined measurements of fractional exhaled nitric oxide and nasal nitric oxide levels for assessing upper airway diseases in asthmatic patients
Published in Journal of Asthma, 2018
Takamitsu Asano, Masaya Takemura, Yoshihiro Kanemitsu, Makoto Yokota, Kensuke Fukumitsu, Norihisa Takeda, Hiroya Ichikawa, Hisatoshi Hijikata, Takehiro Uemura, Osamu Takakuwa, Hirotsugu Ohkubo, Ken Maeno, Yutaka Ito, Tetsuya Oguri, Atsushi Nakamura, Yumi Maki, Yoshihisa Nakamura, Motohiko Suzuki, Akio Niimi
Nasal inflammation of rhinitis has been associated with lower airway inflammation. Indeed, Gata et al. showed a significant increase in the number of nasal eosinophils in asthmatic patients irrespective of the concomitance of rhinitis and were correlated with the number of bronchial eosinophils [42]. Consistent with these findings, we also revealed a positive correlation between the nasal NO and FeNO50 levels in the BA+, R+ group (Table 3). These results support the suggested inflammatory link between the upper and lower airways termed, the ‘united airway concept’ [26,43,44]. Interestingly, the nasal NO levels were positively correlated with the J'awNO(TMAD), but not with the CANO (TMAD) levels. It is possible that common allergens with a large particle size (e.g. pollens) may predominantly deposit within the nose and proximal bronchi, but not within the lower peripheral airways [45].
Related Knowledge Centers
- Allergen
- Bacteria
- Inflammation
- Nasal Mucosa
- Rhinorrhea
- Virus
- Nose
- Nasal Congestion
- Sneeze
- Post-Nasal Drip