Ridolo Erminia, Incorvaia Cristoforo, Pucciarini Francesco, Makri Elena, Paoletti Giovanni, Canonica Giorgio Walter
Dept. Medicine and Surgery, University of Parma, Parma, Italy.
Niguarda Ca' Granda Hospital, Milan, Italy.
Clin Mol Allergy. 2022 Aug 10;20(1):9. doi: 10.1186/s12948-022-00176-x.
Allergic rhinitis (AR) is very commonly caused by pollens. The symptoms of AR consist of sneezing, nasal congestion, rhinorrhea, nasal itching and airflow obstruction. The diagnosis has long been based on clinical history, skin prick tests and in vitro measurement of specific IgE, but the innovative approach of precision medicine has made diagnostic tools of much greater accuracy available.
This review covers the advances in the treatment of seasonal AR concerning the drugs to be used according to the grade of disease and the characteristics of the patients, and the role of allergen immunotherapy (AIT), which is the only treatment capable of acting, in addition to the symptoms, on the cause of AR and therefore to modify its natural history.
Drug treatment of AR include a large number of agents, the choice of which depends on the severity of the disease. AIT has high evidence of efficacy demonstrated by meta-analyses, and further improvement is currently apparent, as for diagnosis, applying the means of precision medicine. However, when AIT is performed in current practice, without the strict rules of controlled trials, long-term low adherence is a major problem to be solved.
变应性鼻炎（AR）通常由花粉引起。AR的症状包括打喷嚏、鼻塞、流涕、鼻痒和气流阻塞。长期以来，诊断一直基于临床病史、皮肤点刺试验和特异性IgE的体外检测，但精准医学的创新方法提供了准确性更高的诊断工具。
本综述涵盖季节性AR治疗方面的进展，涉及根据疾病分级和患者特征使用的药物，以及变应原免疫疗法（AIT）的作用，AIT是唯一除了能缓解症状外，还能作用于AR病因并因此改变其自然病程的治疗方法。
AR的药物治疗包括大量药物，药物的选择取决于疾病的严重程度。荟萃分析表明AIT具有很高的疗效证据，并且目前在诊断方面，如同应用精准医学手段一样，进一步的改善也很明显。然而，在当前实践中进行AIT时，由于缺乏对照试验的严格规则，长期低依从性是一个亟待解决的主要问题。
