The Immunological Aspect Of The Nasal Mucosa And Its Response To Immunotherapy In Patients With Allergic Rhinitis

The nasal cavity is lined by a stratified squamous and columnar non ciliated and ciliated epithelium and its mucosa acts as an immunologic barrier by different mechanisms. Allergic rhinitis (AR) is a common global health problem and is increasing in prevalence. Although several modes of treatment are present, only allergen-specific immunotherapy (ASIT) has the ability to change the course of the disease and make future prevention. Date Palm(DP) pollen allergenicity is well-established and it can cause different allergies including AR.AIM OF THE WORK: Evaluation of the efficacy of ASIT as a method of treatment of patients with AR.MATERIALS AND METHODS: Our present study included 10 patients with persistent AR due to DP pollen and 10 healthy control. Our patients were treated by injection ASIT for one year and were evaluated clinically by applying the total nasal symptom score (TNSS) and laboratorily by measuring total IgE, interferon-gamma (IFN-), tumor necrosis factor (TNF) and albumin in sera and nasal secretions at baseline(BL) and one year(OY).RESULTS: Maximum [BL] TNSS=7 while [OY] TNSS=3 that denotes clinical improvement with minimal side effects (mild erythema and swelling once in 2%) and well-toleration. Decreased serum and nasal TNF(p 0.03,0.018 respectively), decreased nasal total IgE level(p 0.03), insignificant serum total IgE response and a tendency to decrease, insignificant serum IFN- and albumin response and a tendency to increase, insignificant nasal albumin response and a tendency to decrease.CONCLUSION: DP pollen is a cause of AR. ASIT is successful in treating AR patients, has minimal side effects and is well-tolerated by patients. Serum and nasal TNF and total nasal IgE are good evaluation markers of ASIT.