Patients with allergic rhinitis

KeY wOrds: s ensitization to inhalant allergens is a specific feature of allergic rhinitis. An association between atopy and bronchial hyper-responsiveness was found in patients with allergic rhinitis: namely, exposure to multiple foreign substances increases BHR1 in atopic patients. Recently, interleukin 17A-producing T helper cells have challenged the classic Th1/Th22 paradigm, and have been implicated in a growing number of inflammatory conditions. Recent data have provided new insights into the pathogenesis of atopic diseases [1]. Current data suggest a central role of Th17 in orchestrating adaptive immune responses. Furthermore, there is growing evidence that IL-17A3 plays an important role in autoimmune diseases [2,3]. Consistent with the broad expression pattern of its receptor, IL-17A acts on a variety of cells that respond by up-regulating the expression of pro-inflammatory cytokines, chemokines and metalloproteinases (MMP14, MMP3, MMP13). Emerging evidence suggests active involvement of IL-17A in a range of pathologic conditions in humans, ranging from common asthma and allergic rhinitis to certain autoimmune diseases [2]. Indeed, one of the major questions in immunology remains: Why does an individual develop an autoimmune disease or allergy [3]. The number of studies on molecular mechanisms of the most prevalent allergic diseases – allergic rhinitis and bronchial asthma – are increasing. Over the past decades, the clinical symptoms in patients with allergic respiratory diseases tend to overlap those of upper and lower airways. Although the concept of combined upper and lower respiratory diseases is unanimously accepted, the border between clinical conditions relating to allergy of upper airways and those of latent immune inflammation of lower airways is not the focus of the latest research. Bronchial hyper-responsiveness to methacholine in AR5 is a risk factor for the development of asthma [4]. Among rhinitis BHR = bronchial hyper-responsiveness Th = T helper cells IL-17A = interleukin-17A MMP = metalloproteinase AR = allergic rhinitis