摘要
变应性鼻炎（allergic rhinitis,AR）是一个全球性的健康问题,近年来不断出现一些与AR发病机制、流行病学特征及与诊疗相关的新观点和新证据,本文将从以上几个方面介绍AR近期的研究进展。1 AR的发病机制AR的经典发病过程为：树突状细胞（dendritic cell,DC）在接触并摄取变应原后即被活化,并在迁移至局部鼻黏膜组织的过程中逐渐成熟。成熟的DC表达MHCⅡ类分子,加工处理后的变应原与MHCⅡ类分子结合形成复合物提呈给初始T细胞。初始T细胞可在IL-4存在下分化为2型辅助。
Summary Allergic rhinitis（AR） clinically expressed by sneezing, rhinorrhea, nasal itching and congestion is an allergen-driven mucosal inflammatory disease which is modulated by immunoglobulin E. Epidemiological studies have indicated that prevalence of AR continues to increase, and it has been a worldwide health problem that places a significant healthcare burden on individuals and society. Given the evolving understanding of the process by which an allergen is recognized and the roles of mediators which account for AR progress, the pathogenesis of AR has become clearer. Current studies have demonstrated local allergic rhinitis （LAR） that patients with both sug- gestive symptoms of AR and a negative diagnostic test for atopy may have local allergic inflammation is a prevalent entity in patients evaluated with rhinitis, but further research remains needed. Management of AR includes aller- gen avoidance, pharmacological treatment and allergen-specific immunotherapy. Recently montelukast has exhibi- ted previously undocumented anti-inflammatory properties, leukotriene receptor antagonists therefore may serve a more important role in the treatment of AR. Not only has immunotherapy proved its efficacy, but also been able to alter disease course and thereby mitigate progression to asthma. Thus immunotherapy can be initiated while receiv- ing pharmacotherapy, especially in children with AR. As clinical guidelines, the ARIA （Allergic Rhinitis and its Impact on Asthma） provides basic principles of effective treatment of AR. Besides, choosing an appropriate treat- ment strategy should be based on the severity and chronicity of patient＇s symptom. The aim of this review was to provide an update mainly on the pathophysiology, epidemiology, and management of AR.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2015年第3期202-206,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
鼻炎
变应性
发病机制
流行病学
rhinitis, allergic
pathogenesis
epidemiology
