Watts Annabelle M, Cripps Allan W, West Nicholas P, Cox Amanda J
Menzies Health Institute Queensland, School of Medical Science, Griffith University, Southport, QLD, Australia.
Menzies Health Institute Queensland, School of Medicine, Griffith University, Southport, QLD, Australia.
Front Pharmacol. 2019 Mar 29;10:294. doi: 10.3389/fphar.2019.00294. eCollection 2019.
Allergic rhinitis (AR) is a chronic upper respiratory disease estimated to affect between 10 and 40% of the worldwide population. The mechanisms underlying AR are highly complex and involve multiple immune cells, mediators, and cytokines. As such, the development of a single drug to treat allergic inflammation and/or symptoms is confounded by the complexity of the disease pathophysiology. Complete avoidance of allergens that trigger AR symptoms is not possible and without a cure, the available therapeutic options are typically focused on achieving symptomatic relief. Topical therapies offer many advantages over oral therapies, such as delivering greater concentrations of drugs to the receptor sites at the source of the allergic inflammation and the reduced risk of systemic side effects. This review describes the complex pathophysiology of AR and identifies the mechanism(s) of action of topical treatments including antihistamines, steroids, anticholinergics, decongestants and chromones in relation to AR pathophysiology. Following the literature review a discussion on the future therapeutic strategies for AR treatment is provided.
变应性鼻炎（AR）是一种慢性上呼吸道疾病，据估计全球有10%至40%的人口受其影响。AR的发病机制高度复杂，涉及多种免疫细胞、介质和细胞因子。因此，由于疾病病理生理学的复杂性，开发单一药物来治疗变应性炎症和/或症状受到困扰。完全避免引发AR症状的过敏原是不可能的，而且在没有治愈方法的情况下，现有的治疗选择通常侧重于实现症状缓解。局部治疗相对于口服治疗具有许多优势，例如在变应性炎症源头将更高浓度的药物输送到受体部位，以及降低全身副作用的风险。本综述描述了AR复杂的病理生理学，并确定了局部治疗（包括抗组胺药、类固醇、抗胆碱能药、减充血剂和色酮）相对于AR病理生理学的作用机制。在文献综述之后，提供了关于AR治疗未来策略的讨论。
