Infection with the human immunodeficiency virus (HIV) has been known to render persons more susceptible to allergic, as well as infectious disorders. As the number of HIV-infected persons increases, it has been noted by many practitioners that chronic nasal symptoms, sinusitis, and otitis are quite common problems.<sup>16Koutsonikolis A., Nelson R.P., Caldor E., e al. Serum total and specific IgE levels in children infected with human immunodeficiency virus J Allergy Clin Immunol 1996 ;  97 : 692 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> It is a matter of debate which percentage of these nasal symptoms are truly allergic in nature.

The etiology of rhinitis is broadly classified into allergic or nonallergic forms, including chronic infectious rhinitis, mucociliary disturbances such as cystic fibrosis,<sup>9Guida L.E., Frieri M. Cytokines and inflammatory mediators in cystic fibrosis Pediatr Asthma Allergy Immunol 1994 ;  8 : 1-5 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> and immune deficiency, predisposing to chronic infection.<sup>23Mathews K.P. Allergic and non-allergic rhinitis, nasal polyposis and sinusitis Pediatric Allergy New York: Churchill Livingstone (1985).  331-366

Cliccare qui per andare alla sezione Riferimenti</sup> Seasonal or perennial allergic rhinitis may be caused by different pollens, mold spores, animal dander, dust mite, and other allergens.

The pathophysiology of allergic rhinitis results from the development of both humoral and cellular immune reactions to airborne allergens, with symptoms of sneezing, rhinorrhea, nasal blockage, and itching, owing to IgE-dependent mast cell activation in the nasal mucosa with the release of numerous inflammatory mediators.<sup>12Kaliner M., Lemanske R. Rhinitis and asthma JAMA 1992 ;  268 : 2807-2829

Cliccare qui per andare alla sezione Riferimenti</sup> An increase in vascular permeability, glandular secretion, and secretion of cytokines results, leading to chronic inflammation.<sup>13Kaliner M.A. Human respiratory secretions and host defense Am Rev Respir Dis 1991 ;  144 (Suppl) : 52-66

Cliccare qui per andare alla sezione Riferimenti</sup> Additional mediators from an influx of inflammatory cells are chemoattractants for neutrophils, eosinophils, T lymphocytes, and basophils,<sup>12Kaliner M., Lemanske R. Rhinitis and asthma JAMA 1992 ;  268 : 2807-2829

Cliccare qui per andare alla sezione Riferimenti</sup> which have been shown to induce the release of histamine from mononuclear cells from patients with allergic rhinitis.<sup>5Frieri M., Madden J., Nolte H. Spontaneous basophil histamine release in atopic patients with food hypersensitivity J Allergy Clin Immunol 1992 ;  89 : 204

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An increase in the basal levels of ⍺ interleukin (IL)-1 in mononuclear cells obtained from allergic rhinitis patients have been demonstrated in the laboratory of these authors. Nasal ⍺IL-1 levels in allergic rhinitis patients following grass and ragweed in vivo nasal provocation were demonstrated to diminish during the late-phase inflammatory reaction after 1 month of antihistamine treatment.<sup>6Frieri M., Madden J., Zitt M., e al. Late-phase inflammation during nasal grass and ragweed challenges in a double-blind placebo controlled trial with astemizole Am J Rhinol 1995 ;  9 : 1-5

Cliccare qui per andare alla sezione Riferimenti</sup> We have also reported the release of soluble intercellular adhesion molecules by cytokine-activated human tracheal epithelial cells.<sup>24Matin AFM, Grant MM, Frieri M, et al: Release of soluble intercellular adhesion molecule-1 by cytokine-activated human tracheal epithelial cells. Presented at the American College of Physicians Meeting, San Francisco, CA, 1996

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Activation of allergen-specific Th2 lymphocytes can induce a cascade of events with secretion of IL-4, IL-5, IL-13. An increase in nasal IL-8 levels during the late-phase inflammatory reaction after grass and ragweed nasal provocation has been reported in patients with allergic rhinitis from our center.<sup>14Knapik M., Chavarria V., Karnik A., e al. A preliminary study on interleukin-8 detection during grass or ragweed nasal provocation Pediatr Asthma Allergy Immunol 1995 ;  9 : 63-70 [cross-ref]

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