Jaimin Patel DO Larry Borish MD José Gurrola II MD Ann Allergy Asthma Immunol August 20211272161162 Refractory Nasal Obstruction in Allergic Rhinitis Patel et al Ann Allergy Asthma Immunol ID: 935730
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Slide1
Slide2When
Medical Treatments Fail
Jaimin Patel, DO
Larry Borish, MD
José Gurrola II, MD
Ann Allergy Asthma Immunol.
August 2021;127(2):161-162
Slide3Refractory
Nasal Obstruction
in
Allergic Rhinitis
Patel,
et al.
Ann
Allergy Asthma Immunol.
August 2021;127(2):161-162
Slide4Comparing the
Nasal Allergen Challenge
and
Environmental Exposure Unit Models
of Allergic RhinitisRashi Ramchandani, BHSc(c)Sophia Linton, BScLubnaa Hossenbaccus, BScH
Anne K. Ellis, MD, MSc, FRCP(C),
FAAAAI
Ann Allergy Asthma Immunol.
August 2021;127(2):163-164
Slide5Overview of the NAC
Model
Ramchandani, et al. Ann
Allergy Asthma Immunol.
August 2021;127(2):163-164
Slide6Recent
Development
on the
Use
of Sublingual Immunotherapy Tablets for Allergic RhinitisSusan Waserman, MSc, MDCM, FRCPC Anita Shah, HBSc
Ernie Avilla, MBA
Ann Allergy Asthma Immunol.
August 2021;127(2):165-175.e1
Slide7Recent Development on the Use of Sublingual Immunotherapy Tablets for Allergic
Rhinitis
Key
Messages
Sublingual immunotherapy (SLIT) is generally safe with minor adverse events, making it safe for home administration.SLIT is associated with improvement in symptom and medication scores and quality of life scores vs placebo.SLIT is effective and safe to use with children and adults.There is lack of consistency on how allergen immunotherapy efficacy is defined and measured.
Prescribing SLIT should be limited to physicians with adequate training and experience in the treatment of allergic respiratory diseases.
Waserman, et al. Ann
Allergy Asthma Immunol.
August 2021;127(2):165-175.e1
Slide8The
Impact
of AR on
Patients
’
Daily Lives
Waserman, et al. Ann
Allergy Asthma Immunol.
August 2021;127(2):165-175.e1
Slide9Recommendations on the
Pharmacotherapeutic
Treatment
of AR
Based
on ARIA
Guidelines
Waserman, et al. Ann
Allergy Asthma Immunol.
August 2021;127(2):165-175.e1
Slide10Study
Extraction Process
Waserman, et al. Ann
Allergy Asthma Immunol.
August 2021;127(2):165-175.e1
Slide11It
Is
No Skin Off My Nose
Jessica S.S. Ho, MSc
Carmen H. Li, BScHAmi Wang, MDYuka Asai, MD, PhD, FRCPC,
DABD
Ann Allergy Asthma Immunol.
August 2021;127(2):176-182
Slide12It
Is
No Skin Off My
Nose
Key MessagesSkin barrier defects are related to the atopic march; this may be a starting point for the development of other atopic diseases such as allergic rhinitis, asthma, food allergy, and eosinophilic esophagitis.The epidermis shares histopathologic features with the sinonasal epithelial barrier; these may explain some commonalities across atopic conditions.Understanding the role of epithelial disruption in atopy may lead to new insights in the pathogenesis of atopic diseases.
As we better understand the mechanisms of sensitization by the skin, it may be a target for innovative therapies and treatments for allergic rhinitis.
Ho, et
al.
Ann
Allergy Asthma Immunol.
August 2021;127(2):176-182
Slide13The Atopic March
Ho, et
al.
Ann
Allergy Asthma Immunol.
August 2021;127(2):176-182
Slide14Normal
Skin
at × 400
Magnification
with HPS
Stain
Ho, et
al.
Ann
Allergy Asthma Immunol.
August 2021;127(2):176-182
Slide15Atopic
Dermatitis
at × 400
Magnification
with HPS
Stain
Ho, et
al.
Ann
Allergy Asthma Immunol.
August 2021;127(2):176-182
Slide16Normal
Nasal Vestibule Epithelium
at
×
100
Magnification
with HPS
Stain
Ho, et
al.
Ann
Allergy Asthma Immunol.
August 2021;127(2):176-182
Slide17Normal
Respiratory Epithelium
in the
Nasal Cavity
at
× 400
Magnification
with HPS
Stain
Ho, et
al.
Ann
Allergy Asthma Immunol.
August 2021;127(2):176-182
Slide18Chronic
Rhinosinusitis
at × 400
Magnification
with HPS
Stain
Ho, et
al.
Ann
Allergy Asthma Immunol.
August 2021;127(2):176-182
Slide19Suggested
Interactions
in the
Pathogenesis
of
Atopic Disease
Ho, et
al.
Ann
Allergy Asthma Immunol.
August 2021;127(2):176-182
Slide20Future of
Allergic Rhinitis Management
Sophia Linton, BSc
Alyssa G. Burrows, BHSc
Lubnaa Hossenbaccus, BScHAnne K. Ellis, MD,
MSc
Ann Allergy Asthma Immunol.
August 2021;127(2):183-190
Slide21Future of Allergic Rhinitis Management
Key
Messages
Social media, telemedicine, and
mHealth are useful tools that allergists can take advantage of to better connect with patients. An integrated, multidisciplinary approach to patient care, featuring collaborative involvement of allergists, pharmacists, and primary care physicians, is beneficial for optimal management of allergic rhinitis (AR).Azelastine hydrochloride and fluticasone propionate and other drug combinations represent the future of AR management beyond traditional pharmacotherapy.Intralymphatic immunotherapy and peptide immunotherapy are more time- and cost-effective than subcutaneous immunotherapy and sublingual immunotherapy and have revealed positive biological results in several clinical trials across several different seasonal and perennial allergens.
Many clinical trials of targeted biologics are ongoing
.
Probiotics, especially
Bifidobacterium
spp
, may be clinically beneficial for patients with AR
.Probiotic as an add-on therapy to allergen immunotherapy has proven very effective in AR.
Linton, et al. Ann
Allergy Asthma Immunol.
August 2021;127(2):183-190
Slide22Integrated
Care
for AR M
anagement
Linton, et al. Ann
Allergy Asthma Immunol.
August 2021;127(2):183-190
Slide23Therapeutic
Combinations
for AR
Linton, et al. Ann
Allergy Asthma Immunol.
August 2021;127(2):183-190