Introduction.The increasing prevalence of allergic diseases throughout the world has been established by the publication of more than 10 national and multinational epidemiologic studies during the past 10 years. (1) The prevalence for allergic rhinitis Allergic Rhinitis Definition
Allergic rhinitis, more commonly referred to as hay fever, is an inflammation of the nasal passages caused by allergic reaction to airborne substances. ranges from 3 to 40% of the population, depending on the geographic area and the age of the patients. Allergic rhinitis and asthma, as common respiratory diseases, affect school performance, work productivity, and the social life of patients, and the cost to society is substantial. For instance, total direct medical costs of allergic rhinitis are estimated to be $3.4 billion per year in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. alone. (2) This cost is divided equally between prescription medications and outpatient visits.
A better understanding of immunoglobulin E-mediated, mast cell-dependent allergic inflammation has resulted in the development of new therapies for allergic respiratory disease. (3) The newest of these are antileukotriene drugs and anti-immunoglobulin E monoclonal antibodies. Many more are in the pipeline. How T-cell subpopulations facilitate the genetic propensity to develop allergic diseases and their role in control of the inflammatory response is rapidly being elucidated. Meanwhile, the roles of allergens, pollution, and childhood infections in allergic sensitization sensitization /sen·si·ti·za·tion/ (sen?si-ti-za´shun)
1. administration of an antigen to induce a primary immune response.
2. exposure to allergen that results in the development of hypersensitivity. are under careful study. (4) Our new understanding of the basic mechanisms of allergic inflammation, present throughout the upper and lower airways in both symptomatic and some asymptomatic allergic individuals, may ultimately lead to technologies that prevent allergic disease altogether.
Since the translation of science to the bedside now occurs at lightning speed, we thought it useful to provide an update on allergic diseases focused on our new understanding of their pathophysiology pathophysiology /patho·phys·i·ol·o·gy/ (-fiz?e-ol´ah-je) the physiology of disordered function.
1. . Thus, the first article in our symposium focuses on basic mechanisms of allergic disease. As you read the articles on allergic rhinosinusitis, asthma, and atopic dermatitis Atopic Dermatitis Definition
Eczema is a general term used to describe a variety of conditions that cause an itchy, inflamed skin rash. Atopic dermatitis, a form of eczema, is a non-contagious disorder characterized by chronically inflamed skin and , you will see how recent scientific discoveries have focused treatment on control of allergic inflammation. Because insect allergy and drug allergy drug allergy An immune response to a therapeutic. See Allergy. are such common allergic problems, we have also included updates on these topics. Our group hopes you find these articles interesting and useful in the care of your patients.
My colleagues and I thank Dawn Chism, who provided editorial assistance in the preparation of this series of CME CME
See: Chicago Mercantile Exchange
See Chicago Mercantile Exchange (CME). articles.
1. Bachert C, van Cauwenberge P, Khaltaev N, et al; World Health Organization. Allergic rhinitis and its impact on asthma: Executive summary of the workshop report 7-10 December 1999, Geneva Geneva, canton and city, Switzerland
Geneva (jənē`və), Fr. Genève, canton (1990 pop. 373,019), 109 sq mi (282 sq km), SW Switzerland, surrounding the southwest tip of the Lake of Geneva. , Switzerland. Allergy 2002;57:841-855.
2. Law AW, Reed SD, Sundy JS, et al. Direct costs of allergic rhinitis in the United States: Estimates from the 1996 Medical Expenditure Panel Survey. J Allergy Clin Immunol 2003;111:296-300.
3. Larche M, Robinson DS, Kay AB. The role of T lymphocytes in the pathogenesis of asthma. J Allergy Clin Immunol 2003;111:450-464.
4. Liu AH, Murphy JR. Hygiene hypothesis hygiene hypothesis,
n the theory that excessive prevention of early childhood exposure to dirt and pathogens can stunt the development of the immune system. : Fact or fiction? J Allergy Clin Immunol 2003;111:471-478.
Richard D. deShazo, MD