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Current Allergy and Asthma Reports
Erschienen in: Current Allergy and Asthma Reports 2/2010

01.03.2010

Vasomotor Rhinitis

verfasst von: Debendra Pattanaik, Phillip Lieberman

Erschienen in: Current Allergy and Asthma Reports | Ausgabe 2/2010

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Abstract

Vasomotor rhinitis is a common disorder that is seen routinely in allergy practice. It affects millions of Americans and results in significant morbidity. The pathophysiology of this complex heterogeneous disorder is unknown, but we are making advances in this regard. Symptoms and signs can closely resemble those of allergic rhinitis and can be difficult to differentiate from those resulting from allergy. A careful history, physical examination, and diagnostic testing help clinicians arrive at a definitive diagnosis, but treatment can be challenging. Therapy should be based on the presenting symptoms of vasomotor rhinitis. Combination therapy with topical corticosteroids and azelastine is useful. However, in patients whose predominant symptom is rhinorrhea, use of atopical anticholinergic agents can be quite useful. Up-to-date pathogenesis, epidemiology, diagnosis, and treatment approaches are discussed in this review.
Literatur
1.
•• Kaliner MA, Farrar JR: Consensus review and definition of nonallergic rhinitis with a focus on vasomotor rhinitis, proposed to be known henceforth as non allergic rhinopathy: part 1. Introduction. World Allergy Organ J 2009, 2:155. A complete and comprehensive review of chronic nonallergic rhinitis consisting of several articles published online in this journal begins with this article.CrossRef
2.
•• Wallace DV, Dykewicz MS: The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol 2008, 122:S1–S84. This is a consensus, evidence-based document published as a guideline and prepared as a joint effort of the American Academy of Allergy, Asthma, and Immunology and American College of Allergy, Asthma, and Immunology.CrossRefPubMed
3.
Blom HM, Godthelp T, Fokkens WJ, et al.: Mast cells, eosinophils and IgE-positive cellsin nasal mucosa of patients with vasomotor rhinitis. An immunohistochemical study. Eur Arch Otorhinolaryngol 1995, 252(Suppl 1):S33–S39.CrossRefPubMed
4.
Powe DG, Huskisson RS, Carney AS, et al.: Evidence for an inflammatory pathophysiology in idiopathic rhinitis. Clin Exp Allergy 2001, 31:864–872.CrossRefPubMed
5.
Zeiger RS: Differential diagnosis and classification in rhinosinusitis. In Nasal Manifestations of Systemic Diseases. Edited by Schatz M, Zeiger RS. Providence, RI: Oceanside Publications; 1991:3–20.
6.
Kaliner MA: Classification of non-allergic rhinitis syndromes with a focus on vasomotor rhinitis, proposed to be known henceforth as nonallergic rhinopathy. World Allergy Organ J 2009, 2:98–101.CrossRef
7.
8.
Dykewicz MS, Fineman S, Skoner DP: Diagnosis and management of rhinitis: complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. American Academy of Allergy, Asthma, and Immunology. Ann Allergy Asthma Immunol 1998, 81:478–518.CrossRefPubMed
9.
Mullarkey MF, Hill JS, Webb DR: Allergic and nonallergic rhinitis: their characterization with attention to the meaning of nasal eosinophilia. J Allergy Clin Immunol 1980, 65:122–126.CrossRefPubMed
10.
Enberg RN: Perennial nonallergic rhinitis: a retrospective review. Ann Allergy 1989, 63:513–516.PubMed
11.
Togias A: Age relationships and clinical features of nonallergic rhinitis. J Allergy Clin Immunol 1990, 85:182.
12.
Settipane RA, Lieberman P: Update on nonallergic rhinitis. Ann Allergy Asthma Immunol 2001, 86:494–507.CrossRefPubMed
13.
Leynaert B, Bousquet J, Neukirch C, et al.: Perennial rhinitis: an independent risk factor for asthma in nonatopic subjects. Results from the European Community Respiratory Health Survey. J Allergy Clin Immunol 1999, 104:301–304.CrossRefPubMed
14.
Mercer MJ, van der Linde GP, Joubert G: Rhinitis (allergic and nonallergic) in an atopic pediatric referral population in the grasslands of inland South Africa. Ann Allergy Asthma Immunol 1002, 89:503–512.CrossRef
15.
Bachert C, van Cauwenberge P, Olbrecht J, van Schoor J: Prevalence, classification and perception of allergic and nonallergic rhinitis in Belgium. Allergy 2006, 61:693–698.CrossRefPubMed
16.
Molgaard E, Thomsen SF, Lund T, et al.: Difference between allergic and nonallergic rhinitis in a large sample of adolescents and adults. Allergy 2007, 62:1033–1037.CrossRefPubMed
17.
• Schatz M, Zeiger RS, Chen W, et al.: The burden of rhinitis in a managed care organization. Ann Allergy Asthma Immunol 2008, 101:240–247. This was an excellent review of the epidemiology of rhinitis and its burden on society.CrossRefPubMed
18.
Berger WE, Schonfeld JE: Nonallergic rhinitis in children. Curr Allergy Asthma Rep 2007, 7:112–116.CrossRefPubMed
19.
Settipane GA, Klein DE: Nonallergic rhinitis: demography of eosinophils in nasal smear, blood total eosinophil counts and IgE levels. N Engl Reg Allergy Proc 1985, 6:363–366.CrossRefPubMed
20.
Settipane RA: Epidemiology of vasomotor rhinitis. World Allergy Organ J 2009, 2:115–118.CrossRef
21.
Baraniuk JN: Pathogenic mechanisms of idiopathic nonallergic rhinitis. World Allergy Organ J 2009, 2:106–114.CrossRef
22.
Powe DG, Jagger C, Kleinjian A, et al.: ‘Entopy’ localized mucosal allergic disease in the absence of systemic responses for atopy. Clin Exp Allergy 2003, 33:1374–1379.CrossRefPubMed
23.
van Rijswisk JB, Blom HM, Kleinjan A, et al.: Inflammatory cells seems not to be involved in idiopathic inflammatory rhinitis. Rhinology 2003, 41:25–30.
24.
Rondon C, Romero JJ, Lopez S, et al.: Local IgE production and positive nasal provocation test in patients with persistent nonallergic rhinitis. J Allergy Clin Immunol 2007, 119:899–905.CrossRefPubMed
25.
Powe DG, Huskisson RS, Carney AS, et al.: Evidence for an inflammatory pathophysiology in idiopathic rhinitis. Clin Exp Allergy 2001, 31:864–872.CrossRefPubMed
26.
Smurthwaite L, Walker SN, Wilson DR, et al.: Persistent IgE synthesis in the nasal mucosa of hay fever patients. Eur J Immunol 2001, 31:3422–3431.CrossRefPubMed
27.
Smurthwaite L, Durham SR: Local IgE synthesis in allergic rhinitis and asthma. Curr Allergy Asthma Rep 2002, 2:231–238.CrossRefPubMed
28.
Wierzbicki DA, Majumdar AR, Schull DE, Khan DA: Multiallergen nasal challenges in nonallergic rhinitis. Ann Allergy Asthma Immunol 2008, 100:533–537.CrossRefPubMed
29.
• Khan DA: Allergic rhinitis with negative skin tests: does it exist? Allergy Asthma Proc 2009, 30:465–469. This is a critical look at the concept of entopy as it applies to the pathogenesis of nonallergic rhinitis.CrossRefPubMed
30.
Dray A, Urban L, Dickenson A: Pharmacology of chronic pain. Curr Opin Allergy Clin Immunol 2002, 2:11–19.CrossRef
31.
Belmonte C, Viana F: Molecular and cellular limits to somatosensory specificity. Mol Pain 2008, 4:14.CrossRefPubMed
32.
Blom HM, Van Rijswijk JB, Garrelds IM, et al.: Intranasal capsaicin is efficacious in nonallergic noninfectious perennial rhinitis. A placebo controlled study. Clin Exp Allergy 1997, 27:796–801.CrossRefPubMed
33.
Baraniuk JN, Peterie KN, Le U, et al.: Neuropathology in rhinosinusitis. Am J Respir Crit Care Med 2005, 171:5–11.CrossRefPubMed
34.
Naranch K, Park YJ, Repka-Ramirez MS, et al.: A tender sinus does not always mean sinusitis. Otolaryngol Head Neck Surg 2002, 127:387–397.CrossRefPubMed
35.
Braat JP, Mulder PG, Fokkens WJ, et al.: Intranasal cold dry air is superior to histamine challenge in determining the presence and degree of nasal hyperreactivity to nonallergic noninfectious perennial rhinitis. Am J Respir Crit Care Med 1998, 157:1748–1755.PubMed
36.
van Rijswijk JB, Blom HM, Fokkens WJ: Idiopathic rhinitis, the ongoing quest. Allergy 2005, 60:1471–1481.CrossRefPubMed
37.
Silvers WS: The skier‘s nose: a model of cold induced rhinorrhea. Ann Allergy 1991, 67:32–36.PubMed
38.
Waibel KH, Chang C: Prevalence and food avoidance behaviors for gustatory rhinitis. Ann Allergy Asthma Immunol 2008, 100:200–205.CrossRefPubMed
39.
Jaradeh SS, Smith TL, Torrico L, et al.: Autonomic nervous system evaluation of patients with vasomotor rhinitis. Laryngoscope 2000, 110:1828–1831.CrossRefPubMed
40.
Segal S, Shlamkovitch N, Eviatar E, et al.: Vasomotor rhinitis following trauma to the nose. Ann Otol Rhinol Laryngol 1999, 108:208–210.PubMed
41.
Jones NS: Midfacial segment pain: implications for rhinitis and sinusitis. Curr Allergy Asthma Rep 2004, 4:187–192.CrossRefPubMed
42.
Lindberg S, Malm L: Comparison of allergic rhinitis and vasomotor rhinitis patients on the basis of a computer questionnaire. Allergy 1993, 48:602–607.CrossRefPubMed
43.
Wedback A, Enbom H, Eriksson NE, et al.: Seasonal nonallergic rhinitis (SNAR)—a new disease entity? A clinical and immunological comparison between SNAR, seasonal allergic rhinitis and persistent nonallergic rhinitis. Rhinology 2005, 43:86–92.PubMed
44.
Brandt A, Bernstein JA: Questionnaire evaluation and risk factor identification for nonallergic vasomotor rhinitis. Ann Allergy Asthma Immunol 2006, 96:526–532.CrossRefPubMed
45.
Kaliner MA, Baraniuk JN, Benninger M, et al.: Consensus definition of nonallergic rhinopathy, previously referred to as vasomotor rhinitis, nonallergic rhinitis, and/or idiopathic rhinitis. World Allergy Organ J 2009, 2:119–120.CrossRef
46.
Bernstein IL, Li JT, Bernstein DI, et al.: Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol 2008, 100(Suppl 3):S1–S148.
47.
Blom HM, Godthelp T, Fokkens WJ, et al.: The effect of nasal steroid aqueous spray on nasal complaint scores and cellular infiltrates in the nasal mucosa of patients with nonallergic and noninfectious perennial rhinitis. J Allergy Clin Immunol 1997, 100:739–747.CrossRefPubMed
48.
Philip G, Togias AG: Nonallergic rhinitis. Pathophysiology and models for study. Eur Arch Otorhinolaryngol 1995, 252(Suppl 1):S27–S32.CrossRef
49.
Wight RG, Jones AS, Beckingham E, et al.: A double blind comparison of intranasal budesonide 400 micrograms and 800 micrograms in perennial rhinitis. Clin Otolaryngol 1992, 17:354–358.CrossRefPubMed
50.
Small P, Black M, Frenkiel S: Effects of treatment with beclomethasone dipropionate in subpopulations of perennial rhinitis patients. J Allergy Clin Immunol 1982, 70:178–182.CrossRefPubMed
51.
Scadding GK, Lund VJ, Jacques LA, Richards DH: A placebo controlled study of fluticasone propionate aqueous nasal spray and beclomethasone dipropionate in perennial rhinitis: efficacy in allergic and nonallergic perennial rhinitis. Clin Exp Allergy 1995, 25:737–743.CrossRefPubMed
52.
Webb DR, Meltzer EO, Finn AF Jr, et al.: Intranasal fluticasone propionate is effective for perennial nonallergic rhinitis with or without eosinophilia. Ann Allergy Asthma Immunol 2002, 88:385–390.CrossRefPubMed
53.
Banov CH, Lieberman P: Efficacy of azelastine nasal spray in the treatment of vasomotor rhinitis (perennial nonallergic rhinitis). Ann Allergy Asthma Immunol 2001, 86:28–35.CrossRefPubMed
54.
Lieberman P, Kaliner MA, Wheeler WJ: Open label evaluation of azelastine nasal spray in patients with seasonal allergic rhinitis and nonallergic vasomotor rhinitis. Curr Med Res Opin 2005, 21:611–618.CrossRefPubMed
55.
Ciprandi G, Pronzato C, Passalacqua G, et al.: Topical azelastine reduces eosinophil activation and intercellular adhesion molecule-1 expression on nasal epithelial cells: an antiallergic activity. J Allergy Clin Immunol 1996, 98:1088–1096.CrossRefPubMed
56.
Yoneda K, Yamamoto T, Ueta E, Osaki T: Suppression by azelastine hydrochloride of NF-kappa B activation involved in generation of cytokines and nitric oxides. Jpn J Pharmacol 1997, 73:145–153.CrossRefPubMed
57.
Grossman J, Banov C, Boggs P, et al.: Use of ipratropium bromide nasal spray in chronic treatment of nonallergic perennial nonallergic rhinitis, alone and in combination with other perennial rhinitis medications. J Allergy Clin Immunol 1995, 95:1123–1127.CrossRefPubMed
58.
Bronsky EA, Druce H, Findlay SR, et al.: A clinical trial of ipratropium bromide nasal spray in patients with perennial nonallergic rhinitis. J Allergy Clin Immunol 1995, 95:1117–1122.CrossRefPubMed
59.
• Horak F, Zieglmayer P, Zieglmayer R, et al.: A placebo controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna challenge chamber. Ann Allergy Asthma 2009, 102:116–120. This was an objective investigation of the effects of nasal decongestants.CrossRef
60.
Harvey R, Hannan SA, Badia L, et al.: Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database Syst Rev 2007, 3:CD006394.
61.
Tomooka LT, Murphy C, Davidson TM: Clinical study and literature review of nasal irrigation. Laryngoscope 2000, 110:1189–1193.CrossRefPubMed
62.
Pynnonen MA, Mukerji, SS, Kim HM, et al.: Nasal saline for chronic sinonasal symptoms: a randomized controlled trial. Arch Otolaryngol Head Neck Surg 2007, 133:1115–1120.CrossRefPubMed
63.
Mladina R, Risavi R, Subaric M: CO2 laser anterior turbinectomy in the treatment of nonallergic vasomotor rhinopathy. A prospective study upon 78 patients. Rhinology 1991, 29:267–271.PubMed
64.
el-Guindy A: Endoscopic transseptal vidian neurectomy. Arch Otolaryngol Head Neck Surg 1994, 120:1347–1351.
65.
Fernades CM: Bilateral transnasal vidian neurectomy in the management of chronic rhinitis. J Laryngol Otol 1994, 108:569–573.
66.
Prasanna A, Murthy PS: Vasomotor rhinitis and sphenopalatine ganglion block. J Pain Symptom Manage 1997, 13:332–338.CrossRefPubMed
Metadaten
Titel
Vasomotor Rhinitis
verfasst von
Debendra Pattanaik
Phillip Lieberman
Publikationsdatum
01.03.2010
Verlag
Current Science Inc.
Erschienen in
Current Allergy and Asthma Reports / Ausgabe 2/2010
Print ISSN: 1529-7322
Elektronische ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-010-0089-z

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