Allergic rhinitis – new challenges before the pollen season Review article

Abstract

Allergic rhinitis (AR), inflammation of the mucosa of the nose and paranasal sinuses is one of the most common chronic diseases (up to 25–35% of the population). The characteristic symptoms are sneezing, itchy and red nose, nasal congestion, and runny nose. The symptoms of AR can make it difficult to concentrate and lead to learning problems, inattention, irritability and mood disorders, and even social and family problems. Seasonal AR is caused by allergens of pollen from trees, grasses, and weeds. Treatment of allergic rhinitis includes prophylaxis, e.g., limiting activity outside during the pollen season and the use of air purifiers in closed places, pharmacological treatment (second-generation antihistamines and intranasal glucocorticosteroids) and the causal treatment of allergen immunotherapy. The administration of the second-generation antihistamines started before the pollen season is more helpful for the patient than the treatment started only after the first symptoms of the disease appeared. This procedure is correlated with the inhibition of the expression of the H₁ receptor (H₁R mRNA) in the nasal mucosa. The best efficacy was demonstrated when administering antihistamines 2–4 weeks before the pollen season. Currently, it is recommended to self-medicate patients with AR using specially developed applications. This approach is intended to accelerate the onset of treatment and possible intensification depending on the severity of the symptoms of AR. In children, always remember about the safety and registration framework of preparations. Many drugs used in adolescents and adults are not registered in preschool children. The strategy of prophylactic, preseasonal use of histamine H₁ receptor antagonists currently seems to be a justified and attractive therapeutic option in the treatment of AR.