Allergic rhinitis : natural treatment and causes
Definition of allergic rhinitis
Allergic rhinitis is a common condition whose incidence has increased significantly in recent years; it is estimated that between 10-20% of the population of the developed world is affected.
Although its symptoms may appear trivial, the condition can cause severe distress and affect productivity at some considerable cost to society, and to the quality of life of sufferers. There is also evidence suggesting that allergic rhinitis, if untreated, may lead to asthma.
The following are all associated with allergic rhinitis:
- Repeated sneezing
- Runny and/or itchy nose
- Nasal congestion
- Watery, itchy or swollen eyes
Causes of allergic rhinitis
Allergic rhinitis is caused by inhaled substances (allergens) which the body has become sensitised to. Common allergens are tree and grass pollen, which cause hay fever to many sufferers in particularly in the spring and early summer.
- dust mites - present in bedding and other home furnishing textiles, the excretions of these microscopic animals are known allergens,
- fungal spores - from outdoor or indoor plants, or in damp poorly ventilated houses,
- household pets - the dander of many pets, in particular cats and dogs, are frequent causes of allergies
Allergic Reaction Phases
The allergic reaction has two phases :
- hypersensitivity phase, and
- clinical phase.
During the “sensitization” phase, Ig-E immunoglobulins are produced by a type I reaction, with antigen presenting cell / Th2 lymphocytes / B lymphocytes - Plasmocytes. Ig-Es bind to mastocytes via FcΣRI receptor. Mastocytes are then “activated”.
Once the sensitization is effective, the contact with the allergen will lead to a clinical phase divided in 3 consecutive phases :
- Chronic phase with modification of the nasal mucosa.
In the acute phase, the mastocyte is the principal mediator of the allergic reaction. It is considered as a hub in allergy. It has a double role : its degranulation leads to histamine and leukotrienes release, and it is responsible for the symptoms (sneezing, runny nose and nasal occlusion).
At the same time, mastocytes produce cytokines and chemokines (IL-3, IL-5, IL-8, TNF-a and IL-6) that will attract other cell populations, leading to allergy in the late reaction.
In the late phase of allergy, 3 to 12 hours after the combination antigen-antibody, mastocytes and Th2 lymphocytes produce interleukines IL-3, IL-4, IL-5, IL-8 and IL-13. Other factors will be produced, less specific of allergy, as IL-6, IL-1 and TNF-a, that constitute a non significant inflammatory signal . These factors will allow the recruiting of eosinophils principally, and in less quantities basophils, macrophages and neutrophils. These inflammatory cells will migrate through the vascular endothelium and infiltrate the nasal mucosa; a persistent oedema will occur that will be responsible for long term nasal occlusion.
During the chronic phase, mucosa infiltration by different cell types may occur (often polynuclear neutrophils, macrophages but also polynuclear eosinophils and mastocytes in some cases). Then white blood cells produce cytokines that auto-support the inflammatory reaction and lead to a medium to long term chronic state (indeed very long term), with a persistent residual inflammation . The different white cells release proteins and inflammatory mediators, as MMP-9 and PLAII enzymes, lipid derivates (arachidonic acid derivatives: prostaglandins, leukotrienes, …). The oedema, as well as the oxidative and inflammatory cascades, keep degrading the nasal mucosa ; the epithelial cells are then impaired and destroyed, leading to a tissue remodeling of the nasal mucosa . The patient consequently suffers bleeding, itching and nasal congestion.
Treatments and natural remedies for allergic rhinitis
bioXtract had developed Nasaler® as a natural remedy for allergic rhinitis.
Anti-histamines are traditionnaly the first line of treatment for the acute stage, and are effective in stopping irritating symptoms such as sneezing, runny nose and eyes.
Treatments for the late stage nasal congestion and inflammation is often in the form of nasal sprays; corticosteroids which have an anti-inflammatory effect, and decongestants which can give short term relief for nasal congestion.
 Bachert C. Allergic inflammation in the nose: mediators and adhesion molecules. Allergy. 1999; 54: 21-22.
 Lei F, Cui YN, Jiang YP, Kong H, Zhu DD, Dong Z. Effects of minimal persistent inflammation on nasal mucosa of experimental allergic rhinitis in guinea pigs. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008; 43: 499-503.
 Nagai H, Teramachi H, Tuchiya T. Recent Advances in the development of Anti-allergic Drugs. Allergol. Int. 2006; 55: 35-42.