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Allergic rhinitis is a common immune-mediated disease that affects a large part of the global population. Its symptoms may not be life-threatening but nonetheless have a strong impact on quality of life and productivity. Current therapeutic options are manifold and include intranasal glucocorticoids, antihistamines and leukotriene receptor antagonists. The current guidelines recommend intranasal glucocorticoids and antihistamines as effective and safe first-line therapies. However, some patients remain uncontrolled with the current treatment options. Therefore, it is necessary to develop new treatment strategies and/or improve current therapy options. Over the last years a few new agents have been developed which may have an impact on the way allergic rhinitis is treated in the nearest future. These include new compounds such as SYK-inhibitors, which inhibit the signalling pathway of the allergic reaction, new antihistamines targeting not only the H,-receptor but also the H3-receptor, new improved glucocorticoids in the form of prodrugs as well as a novel formulation (MP29-02) combining the administration of a nasal antihistamine and glucocorticoid. In allergen-specific immunotherapy, new promising approaches such as intralympha- Tic and epicutaneous immunotherapy are currently being investigated. Source


Klimek L.,Zentrum fur Rhinologie und Allergologie
Haut | Year: 2012

Food allergies are immunological reactions. In adults, fruits, vegetables and nuts are among the most common triggers. Symptoms may be caused by minimal to moderate amounts of the respective food. Complete elimination of the respective allergens from nutrition results in a complete remission of the symptoms. The spectrum of symptoms comprises both relatively harmless oral allergy syndrom as well as life-threatening anaphylaxis. Source


Currently, preparations containing native allergens or allergoids are used predominantly in allergen-specific immunotherapy (SIT) of inhaled allergies. The safety and efficacy of these preparations has been demonstrated. However, their reproducible production and standardisation requires substantial effort. Besides this, improved efficacy is often associated with higher doses and an increase in adverse events. The production of recombinant allergens could make SIT preparations more precisely definable, purer, more reproducible, safer and more efficacious. Furthermore, a more specific and individually tailored therapy would be conceivable. These effects could be further amplified by modification to hypoallergenic variants and peptides, or by the addition of adjuvants. Results of clinical trials with recombinant grass, birch and ragweed pollen, as well as with cat hair allergens have already been published. Particularly broad clinical experience exists for recombinant birch and grass pollen preparations, and results are promising for commercial application. Taken as a whole, this new technology can both improve the therapy of allergic diseases and deepen the understanding of the molecular mechanisms of SIT. © 2013 Springer-Verlag Berlin Heidelberg. Source


Klimek L.,Zentrum fur Rhinologie und Allergologie | Bousquet J.,Montpellier University | Price D.,University of Aberdeen
Expert Opinion on Drug Safety | Year: 2016

Introduction: As a chronic disease, allergic rhinitis (AR) requires regular use of allergy medications for the effective management of symptoms. It is therefore imperative that AR treatments not only provide adequate symptom control but are also well tolerated.Areas covered: MP29-02 (Dymista, Meda, Solna, Sweden) is the first new class of AR medication (WHO ATC R01AD58) since the introduction of intranasal corticosteroids (INS) almost 50 years ago. It is a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate delivered in a single spray. Here we review all the safety information relevant to MP29-02, from the initial phase I bioavailability and disposition data, to the phase III 14-day and 52-week data and finally to phase IV safety data collected during MP29-02 use in routine clinical practice.Expert opinion: MP29-02 is the first real therapeutic advance in AR since the introduction of INS and has the potential to change the way this disease is managed, simplifying AR treatment regimens to a single puff in each nostril twice a day. Patients will benefit from superior symptom relief MP29-02 compared to INS with the added assurance that the safety of MP29-02 has been confirmed in the short term and long term as well as in real life. © 2015 Taylor & Francis. Source


In a subgroup of patients with symptoms of allergic rhinitis (AR), no systemic sensitization can be detected in skin tests or serum. These patients are considered to be afflicted with so-called “local allergic rhinitis” (LAR) with IgE-production exclusively at the site of the nasal mucosa. Patients without any positive allergy test results but seasonal (intermittent) or perennial (persistent) allergic symptoms were often misdiagnosed as having “non-allergic rhinitis” (NAR) in the past. However, there is evidence for a specific IgE-production in the nasal mucosa in these patients without systemic sensitization. The diagnosis of LAR is confirmed by clinical symptoms, the detection of specific IgE production in the nasal mucosa and/or nasal provocation tests. We report on two cases of LAR to Alternaria alternata with symptoms of persistent allergic rhinitis that have been diagnosed by positive allergenspecific nasal challenge tests and specific IgE determinations in nasal secretions. According to an actual literature research, this is the second report published on LAR caused by Alternaria alternata. © 2015, Springer-Verlag Berlin Heidelberg. Source

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