Al Suleimani Yousuf M, Walker Michael J A
Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Oman.
Pharmacol Ther. 2007 Jun;114(3):233-60. doi: 10.1016/j.pharmthera.2007.01.012. Epub 2007 Feb 28.
The pathophysiology of allergic rhinitis and its drug treatment is reviewed. Special emphasis is placed upon potential new treatments. Allergic rhinitis is characterized by allergen(s), symptoms (sneezing, itching, rhinorrhea, nasal congestion and nasal hypersensitivity), and signs such as invasion of nasal mucosa by inflammatory cells. Such pathological changes are due to inflammatory responses mediated by way of allergen-immunoglobulin E (IgE)-cell complex formation. The complexity of the disease and the multiple pathways involved offer many targets for drug treatment, but to date no single drug is totally effective. This review summarizes the current knowledge of allergic rhinitis, its prevalence, pathophysiology and experimental and clinical treatments. In the search for new drugs, different experimental animal models of allergic rhinitis are required. As a result the models have also been reviewed. Furthermore, particular aspects of the pathophysiology of allergic rhinitis are discussed in greater detail including the immune cells involved in the mediation of the disease, chemical mediators, their actions, and the receptors on which they act. Therapy, particularly that with current drugs, targets many of the known mediators and some of the cellular processes with varying success. Other drugs, for example, vasoconstrictors given to reduce rhinorrhea, provide symptomatic relief by counteracting symptoms. Since the incidence of allergic rhinitis is prevalent and growing in many parts of the world and current treatments are not ideal, it is important to continue to study the pharmacology of this disease as part of a search for better drugs.
本文综述了变应性鼻炎的病理生理学及其药物治疗。特别强调了潜在的新治疗方法。变应性鼻炎的特征包括过敏原、症状(打喷嚏、瘙痒、流涕、鼻塞和鼻超敏反应)以及诸如炎性细胞侵入鼻黏膜等体征。此类病理变化是由过敏原 - 免疫球蛋白E(IgE) - 细胞复合物形成介导的炎症反应所致。该疾病的复杂性以及所涉及的多种途径为药物治疗提供了许多靶点,但迄今为止尚无单一药物完全有效。本综述总结了变应性鼻炎的现有知识,包括其患病率、病理生理学以及实验和临床治疗方法。在寻找新药的过程中,需要不同的变应性鼻炎实验动物模型。因此,也对这些模型进行了综述。此外,还更详细地讨论了变应性鼻炎病理生理学的特定方面,包括参与该疾病介导的免疫细胞、化学介质、它们的作用以及它们作用的受体。治疗,尤其是当前药物的治疗,针对许多已知介质和一些细胞过程,取得了不同程度的成功。其他药物,例如用于减少流涕的血管收缩剂,通过对抗症状提供症状缓解。由于变应性鼻炎在世界许多地区的发病率普遍且呈上升趋势,而目前的治疗并不理想,因此作为寻找更好药物的一部分,继续研究该疾病的药理学非常重要。