Nonallergic rhinitis and lower airway disease
Open accessAbstract
In the past years, several investigators have demonstrated the existence of local nasal responses in some patients with typical allergic rhinitis symptoms but without atopy and have defined a new phenotype called local allergic rhinitis (LAR) or 'entopy'. In a percentage of LAR subjects, the upper airway disease is also associated with lower airway symptoms. After the description of this phenotype, the differential diagnosis between LAR and nonallergic rhinitis (NAR) has become a challenge for the clinician. To correctly identify LAR patients is of high importance for treatment and management of these patients, and for an appropriate inclusion of patients in clinical trials and genetics studies. The treatment of LAR patients, in contrast with NAR, is oriented to allergen avoidance and specific treatment. Allergen immunotherapy, the aetiological treatment for allergic respiratory diseases, has demonstrated to be an effective and safe treatment in LAR, increasing immunological tolerance, and reducing the clinical symptoms and the use of medication. In this article, the important and novel aspects of LAR in terms of mechanisms, diagnosis and treatment will be discussed. Also, the involvement of the lower airway and the potential role of IgE in the bronchial disease will be also reviewed.
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In the local allergic rhinitis population, early studies suggest that AIT can decrease symptoms and medication usage, and improve quality of life.
“In this LAR population, early studies suggest that AIT can decrease symptoms and medication usage, and improve QOL.288,957”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [288]
The “AIT in local AR with/without asthma” section reports that immunotherapy reduced symptoms and rescue-medication use in patients with local allergic rhinitis. It says these patients can have impaired quality of life, but does not report that immunotherapy improved it. No page number is available for these passages. (LLM, conf=0.88)
Experimental — accuracy not yet measuredProduction of nasal mast cells, eosinophils, and specific IgE rapidly increases after allergen-specific stimulation in the nasal mucosa.
“The production of nasal mast cells, eosinophils, and sIgE rapidly increases after allergen-specific stimulation in the nasal mucosa.288,294,307”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [288]
The “Local IgE in rhinitis” section reports that nasal sIgE increases rapidly after allergen-specific stimulation. It also reports mast-cell and eosinophil activation, not a rapid increase in the production of those cells. (LLM, conf=0.90)
Experimental — accuracy not yet measuredA positive allergy skin or in vitro test may lack clinical relevance, and a negative test does not exclude regional IgE-mediated sensitivity as in LAR.
“While it is possible for a positive allergy skin or in vitro test result to lack clinical relevance, the opposite is also true, as a negative allergy skin or in vitro test result does not exclude regional IgE-mediated sensitivity, as in the case of LAR.194,288-290”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [288]
LAR is a regional inflammatory condition defined by local symptoms and sIgE-mediated inflammation without evidence of systemic hypersensitivity.
“LAR is a regional inflammatory condition defined by local symptoms and sIgE-mediated inflammation without evidence of systemic hypersensitivity.107,194,284,288”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [288]
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- Rond on et al. Local IgE in rhinitis and asthma 13989995, 2017, 1, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/all.12988, Wiley Online Library on [17/08/2026]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
- John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Rond on et al. Local IgE in rhinitis and asthma 13989995, 2017, 1, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/all.12988, Wiley Online Library on [17/08/2026]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
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- Authors
- Rondón, C., Bogas, G., Barrionuevo, E., Blanca, M., Torres, M. J., & Campo, P.
- Affiliations
- Hospital Regional Universitario de Málaga (ES)
- Allergy Unit; IBIMA-Regional University Hospital of Málaga; UMA; Malaga Spain
- Corresponding author
- Rondón, C.
- Venue
- Allergy
- Publisher
- Wiley
- Published
- 2016-09-12
- Volume
- 72
- Issue
- 1
- Pages
- 24-34
- ISSN
- 0105-4538 (ISSN-L)
- OpenAlex
- W2502719427
- Cited by
- 74
- References
- 105
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 4 · 2020: 12 · 2019: 8 · 2018: 19 · 2017: 11 · 2016: 1
- FWCI
- 1.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Allergy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Instituto de Salud Carlos III
- Ministerio de Economía y Competitividad (PI11/02519, PI12/00900, PI14/00864)
- Red de Reaccopmes Adversas a Alergenos y Farmacos (RD12/0013/0001)
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- non-allergic rhinitis, local allergic rhinitis, lower airway disease, differential diagnosis, allergen immunotherapy, allergen avoidance, immune tolerance, IgE, bronchial diseases, atopy
- MeSH terms
- Asthma, Basophils, Diagnosis, Differential, Humans, Immunoglobulin E, Nasal Mucosa, Phenotype, Respiratory Tract Diseases, Rhinitis, Biomarkers, Cell Adhesion Molecules
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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