Алгоритм диагностического поиска при IgE-независимом аллергическом рините

Abstract

Allergic rhinitis is a widespread disease located at the junction of two specialties: otorhinolaryngology and allergology. Currently, it is characterized by an early onset, often continuously recurring course and refractory to traditional methods of treatment. Unstable remissions, a tendency to complications, and the lack of effectiveness of the therapy suggest that allergic rhinitis occurs against the background of secondary immunodeficiency, a favorable factor for the development of bacterial superinfection on the damaged mucous membrane of the nasal cavity. In conditions of impaired immune homeostasis, the microbial landscape of the nasal mucosa is characterized by polymorphism, bacterial agents can act as an infectious antigen. The article is devoted to a current problem – chronic IgE-independent allergic rhinitis due to allergen-specific lymphocytes or IgG antibodies with the formation of immune complexes. The article reveals the content of the concept of “chronic infectious-dependent allergic rhinitis”, its characteristic features are highlighted and described, the key stages of diagnosis are considered. The importance of knowledge about mediators of chronic eosinophilic inflammation for practitioners is reflected. The work is interdisciplinary in nature, written at the intersection of otorhinolaryngology, allergology and immunology and will be interesting to doctors of various specialties. Keywords: chronic rhinitis, allergic rhinitis, microbial landscape, immunity, diagnostic algorithm.