Impact Of Allergic Rhinitis Research Articles

Impact of Allergic Rhinitis on Academic Performance in Adolescents and Adults: a Bayesian Analysis of MASK-air® Real-world Direct Patient Data.

Impact of Allergic Rhinitis on Academic Performance in Adolescents and Adults: a Bayesian Analysis of MASK-air® Real-world Direct Patient Data.

The impact of allergic rhinitis on bronchial asthma: What therapy?

Childhood asthma constitutes a significant healthcare burden due to its chronic nature and prevalence, affecting approximately 5–10 % of the pediatric population. Asthma is often heterogeneous and characterized by chronic airway inflammation. It is classified into two main phenotypes based on airway inflammation: T2-high (eosinophilic) and T2-low (neutrophilic/pauci-granulocytic) phenotype. Allergic sensitization is commonly associated with T2-high asthma, involving T helper 2 and innate immunity cells and type 2-associated cytokines, including interleuikin-4 (IL-4), IL-5, and IL-13. Type 2 inflammation is characterized by eosinophilic infiltrate. Asthma and allergic rhinitis share common mechanisms, and their association, known as united airways disease, highlights the close interconnection between upper and lower airways. Effective allergic rhinitis control positively impacts asthma, emphasizing the importance of early identification and personalized therapeutic strategies. One is allergen immunotherapy, a disease-modifying approach demonstrating preventive and therapeutic efficacy in children. However, more research is needed to optimize pediatric allergic rhinitis management.

The Impact of Allergic Rhinitis on Asthma and Its Effect on the Quality of Life of Asthmatic Patients.

Background Allergic rhinitis (AR) and asthma are one of the most common diseases in the Kingdom of Saudi Arabia. Asthma and AR patients report significant reductions in their daily activities due to this condition. Therefore, measuring health-related quality of life (HRQOL) in adult asthmatic and AR patients and evaluating the use of allergic rhinitis treatment modalities to improve asthma control may help prevent future respiratory complications, improve patient quality of life, and reduce morbidity. Methods This cross-sectional observational study was conducted through an online self-administrated questionnaire distributed electronically on social media through "Survey Monkey" (http://www.surveymonkey.com) from April 2 to September 18, 2021. The study targeted adult patients with asthma and/or allergic rhinitis residing in the Riyadh region of Saudi Arabia. The study compared and evaluated HRQOL between three groups: asthmatic patients with concomitant AR, patients with asthma only, and patients with AR only. Results A total of 811 questionnaires were analyzed. Of those, 23.1%were diagnosed with asthma and 64% were diagnosed with allergic rhinitis; from those who were diagnosed with AR,27.2%were asthmatics.A statistically significant association was observed between receiving AR medications and asthma controlin respondents with intermittent AR(P < 0.001).However, no association was observed between asthma control and receiving medications for AR in respondents with persistent AR (P = 0.589).The average scores for all eight-itemshort-form (SF-8) QOL dimensions were lower in patients with combined asthma and AR than in patients with AR only and asthma only (P < 0.001). Conclusions This study suggested that AR was associated with more severe asthma and quality of life impairment.

The Prevalence and Impact of Allergic Rhinitis on Asthma Exacerbations in Asthmatic Adult Patients in the Riyadh Region of Saudi Arabia: A Cross-Sectional Study.

Allergic rhinitis (AR) and asthma are highly prevalent conditions known to occur concomitantly. However, observational, cross-sectional studies in Saudi Arabia assessing the frequency and severity of rhinitis in asthmatics adults using questionnaires based on guidelines are unavailable. Therefore, this study attempted to investigate this side and evaluate the role of triggers, symptoms, andfamily history or history of AR on asthma control levels. From April 2nd to September 18th, 2021, this observational cross-sectional study was conducted through an online self-administrated questionnaire that was distributedelectronically on social media through the SurveyMonkey website (Momentive Inc., Waterford, NY). The study targeted asthmatic adult patientsresiding in Riyadh city in Saudi Arabia. Overall, 187 questionnaires were analyzed. In this study, the frequency of AR in asthmatic patients was 75.5%(95% CI: 74.87-75.4%). Of those, AR was intermittent mild for 15.0%, intermittent moderate to severe for 43.9%, mild persistent for 2.14%, persistent moderate to severe for 14.4%, and 24.6%of patients were without AR. A significant association was observed between asthma control level and the severity of AR (P < 0.001). Moderate to severe persistent AR was more prevalent in patients with uncontrolled asthma (40.6%) than patients with partially controlled (25%) or controlled asthma (2.7%). This study suggested that AR was related to more severe asthma and more difficulty in controlling asthma. The frequency significantly increased with the severity of asthma.

Allergic rhinitis and its impact on airways disease

Allergic rhinitis is linked to an increased risk of asthma development. Laia Castro Salvador et al discuss the impact of allergic rhinitis and how it can be managed Allergic rhinitis is characterised by symptoms including rhinorrhoea, sneezing, nasal obstruction and itching, which have a great impact on the patient's quality of life. Allergic rhinitis can be classified depending on the frequency and severity of symptoms, and can be sub-divided into seasonal and perennial. Allergic rhinitis is linked to an increased risk of asthma development and both diseases are believed to be different expressions of the same inflammatory process. The aim of the treatment is improving the patient's quality of life by relieving symptoms. Management of allergic rhinitis will encompass a combination of allergen avoidance, pharmacological therapies and patient education and adherence.

Impact of Allergic Rhinitis and Asthma on COVID-19 Infection, Hospitalization, and Mortality

BackgroundIt remains unclear if patients with allergic rhinitis (AR) and/or asthma are susceptible to corona virus disease 2019 (COVID-19) infection, severity, and mortality.ObjectiveTo investigate the role of AR and/or asthma in COVID-19 infection, severity, and mortality, and assess whether long-term AR and/or asthma medications affected the outcomes of COVID-19.MethodsDemographic and clinical data of 70,557 adult participants completed SARS-CoV-2 testing between March 16 and December 31, 2020, in the UK Biobank were analyzed. The rates of COVID-19 infection, hospitalization, and mortality in relation to pre-existing AR and/or asthma were assessed based on adjusted generalized linear models. We further analyzed the impact of long-term AR and/or asthma medications on the risk of COVID-19 hospitalization and mortality.ResultsPatients with AR of all ages had lower positive rates of SARS-CoV-2 tests (relative risk [RR]: 0.75, 95% confidence interval [CI]: 0.69-0.81, P < .001), with lower susceptibility in males (RR: 0.74, 95% CI: 0.65-0.85, P < .001) than females (RR: 0.8, 95% CI: 0.72-0.9, P < .001). However, similar effects of asthma against COVID-19 hospitalization were only major in participants aged <65 (RR: 0.93, 95% CI: 0.86-1, P = .044) instead of elderlies. In contrast, patients with asthma tested positively had higher risk of hospitalization (RR: 1.42, 95% CI: 1.32-1.54, P < .001). Neither AR nor asthma had an impact on COVID-19 mortality. None of conventional medications for AR or asthma, for example, antihistamines, corticosteroids, or β2 adrenoceptor agonists, showed association with COVID-19 infection or severity.ConclusionAR (all ages) and asthma (aged <65) act as protective factors against COVID-19 infection, whereas asthma increases risk for COVID-19 hospitalization. None of the long-term medications had a significant association with infection, severity, and mortality of COVID-19 among patients with AR and/or asthma.

Supporting people to self-manage their allergic rhinitis

Allergic rhinitis is common in the UK and can cause significant symptoms and reductions in quality of life. Viv Marsh considers how health professionals can support self-management of these patients Many of us look forward to the spring and summer months with warmer weather, longer days and more opportunity to spend time outdoors. But for hay fever sufferers these months can be truly miserable. For others, the winter months can be equally challenging as, with more time spent indoors, exposure to indoor allergens is greater. Hay fever is the term commonly used to describe seasonal nasal allergy triggered by pollen. It affects many children and adults in the UK, causing significant symptoms and reduction in quality of life. Often, people with allergic rhinitis try to manage the condition themselves using home or over-the-counter remedies to reduce and control symptoms. However, effective management may not be straightforward and guidance from knowledgeable and experienced health professionals can lead to improved outcomes. Taking an evidence-based approach, this article will explore the impact of allergic rhinitis on those who experience it, and will consider how health professionals can support self-management to enable people with the condition to manage their symptoms and minimise its impact on their lives.

Impact of allergic rhinitis on quality of life and main risk factor: a study in Jazan region

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Allergic rhinitis is a common inflammatory disorder that affects the upper respiratory tract. It affects about one-third of the world’s population. The prevalence of rhinitis varies greatly in various countries and also in various parts of the same country. With this disease, the quality of life which includes sleep disturbances, fatigue, diminished memory, depression is decreased because of the direct impact on the life of the patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The present cross-sectional study was conducted on patients over the age of 18 years old who suffered from symptoms of allergic rhinitis between 1 March 2021 to 30 March 2021 in Jizan region&lt;/p&gt;&lt;p&gt;Patients were answered for questionnaires that sent for them online through social media.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 37 participants enrolled. According to the ARIA guidelines, patients were divided into four groups: a moderate to severe intermittent group that comprised the majority of the patients 38%, a mild intermittent group 19%, a moderate to severe permanent group 27%, and a mild permanent group 15%. Among the total of 37 patients, the quality of life was mildly affected in 35% and severely influenced in 65% patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In the patients studied in Saudi Arabia's southern area, allergic rhinitis can have a negative impact on sleep quality, mood, and daily activities.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Prevalence and impact of allergic rhinitis in school going children

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Allergic rhinitis (AR) is a chronic inflammatory disorder affecting the nasal mucosa. There is negative impact of AR on several aspects of day to day living and quality of life (QoL), which include: daily functioning, sleep, absenteeism, school productivity and academic performance. Almost 40% of children are being affected by AR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method:&lt;/strong&gt; An observational study was conducted on randomly selected 100 parents of school going children aging 2 to 15 years, attending OPD in community health center, Chenani, district Udhampur, J and K, for a period of one year from June 2018 to Nov 2018. Children having frequent episodes of allergic rhinitis were enquired about their history of sneezing, runner itchy nose and eyes, thick mucus, nasal blockage or breathless with associated symptoms were selected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; 81% of subjects had a worse problem during specific months of the year; and 67% had itchy-watery eyes. In 15% of subjects, AR impacted daily activities. A prevalence of 28% for nasal symptoms and 14% for allergic rhino-conjunctivitis was found. Study also showed significantly higher proportion of blockers (61%) than sneeze runners (39%). 56% children had one or more co morbidity, whereas 44% had ‘nil’ co-morbidities. The most common allergens were: pollens (grass, trees and weeds), house dust mites, pets, molds, fungi and food.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; AR adversely affects quality of life of patients and furthermore studies should be conducted for more clarity on the subject, besides a timely medical intervention and treatment could possibly avoid the rising morbidity associated with the disease.&lt;/p&gt;

Impact of Allergic Rhinitis on Voice in Children

Introduction: The purpose of the present study was to determine the possible effect of allergic rhinitis (AR) on voice change in children with acoustic analysis and Turkish children’s voice handicap index-10 (TR-CVHI-10). Methods: This is a case-control study. Forty-one children with AR, and a positive skin prick test, as well as 39 children of controls who had produced a negative skin prick test and lacked a history of allergic disease, were selected for the study. Each assessment included recordings for the purposes of acoustic voice analysis (fundamental frequency [f0], jitter %, shimmer %, and harmonics-to-noise ratio (HNR)), and aerodynamic analysis (maximum phonation time (MPT) and s/z ratio). All participants completed TR-CVHI-10. Results: The mean TR-CVHI-10 score of the AR group was significantly higher than the control group (p = 0.013). No difference was observed between the AR and control groups in terms of jitter, shimmer, HNR, and MPT values and s/z ratio (p > 0.05). Conversely, the f0 value was more pronounced in controls (270.9 ± 60.3 Hz) than in the AR group (237.7 ± 54.3 Hz) (p = 0.012). Conclusion: The study’s results revealed that AR can have an effect on fundamental frequency and voice quality in children. The diagnostic process should include AR as a potential cause of voice disorders in children.

ARIA 2019: An Integrated Care Pathway for Allergic Rhinitis in Portugal

The Allergic Rhinitis and Its Impact on Asthma (ARIA) initiative started more than 20 years ago and has developed and disseminated evidence-based guidelines and projects in the field of allergic rhinitis. This initiative is currently focused on providing patient-centred guidelines that contribute to an integrated care pathway between the various levels of care and take advantage of digital solutions, and the introduction of integrated care pathways in clinical practice has been recommended. In this article we describe the adaptation for Portugal of the ARIA Integrated Care Pathways document. After a brief review of the epidemiology and impact of allergic rhinitis in Portugal and the activities carried out in Portugal within the ARIA initiative, we describe the broad knowledge base used for the development of recommendations for the pharmacological treatment of allergic rhinitis, and these recommendations are based on the GRADE methodology, real world evidence acquired by mobile technology (mHealth) and resulting from allergenic exposure chamber studies. What follows is a summary of integrated care pathways for allergen immunotherapy produced in 2019. Allergen immunotherapy is considered an example of precision medicine where the use of mHealth technologies will improve stratification for patient selection and response monitoring. These recommendations were considered as best practices of integrated patient-centred care supported by digital systems from Directorate General for Health and Food Safety of the European Union (DG Santé) and represent the ARIA Phase 4 Change Management strategy.

Quality of life of patients with allergic rhinitis at a South African referral hospital: a prospective cross-sectional study.

Allergic rhinitis causes nasal as well as extranasal symptoms, and may adversely affect quality of life. The aims of this study were to determine the impact of allergic rhinitis on the health-related quality of life of adult patients attending the Ear Nose and Throat clinic at Universitas Academic Hospital, a public referral hospital, in Bloemfontein, South Africa, and to determine the change in the health-related quality of life of patients with allergic rhinitis after one month of treatment. This was a prospective cross-sectional study of adult patients who were newly diagnosed with allergic rhinitis. Patients completed the Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) at initial presentation and at follow-up after one month of appropriate treatment. Eighty-five (85) patients were included. At the initial visit, patients were most troubled by activity limitations and nasal symptoms, with a blocked nose being the most troublesome nasal symptom. There was a statistically significant improvement in scores of all domains after one month of treatment, with the mean total symptom score improving from 2.05±0.73 to 0.94±0.49. Allergic rhinitis had a negative impact on quality of life of patients. Appropriate treatment resulted in an improvement in quality of life.

Allergic rhinitis characterization in community pharmacy customers: a cross-sectional study.

Background Allergic rhinitis represents a public health problem that is significantly prevalent in the global population and has been associated with asthma, a strong desire to sleep and a low quality of life. Objective This study aims to evaluate the prevalence, symptoms, control strategies and treatment, as well as the control of this condition and its impact on the quality of life of customers of community pharmacies with allergic rhinitis. Setting A questionnaire survey was carried out in nine community pharmacies in the city of Guarda, Portugal. Method In this cross-sectional study, data was collected by an interview between May 2014 and December 2014. The control of the illness and the impact of allergic rhinitis on the quality of life were assessed through a CARAT10 test and a WHOQOL-BREF instrument, respectively. Main outcome measure The impact of allergic rhinitis on the patient's quality of life. Results The estimated prevalence of allergic rhinitis was between 10.8% and 15.4%, from which 63 and 42 individuals were medically and symptomatically diagnosed, respectively, from a study population of 804 respondents. The majority of participants (57.1%) suffered from the symptoms more than twice a year. The symptoms, such as difficulty in falling asleep, repeated and continuous sneezing and bilateral nasal obstruction, were severe. There were patients with uncontrolled allergic rhinitis symptoms after the CARAT10 test, even when the individual's perception of the quality of life was good according to the WHOQOL-BREF score, with gender differences in the psychological domain. It should also be emphasized that there was a significant association between higher education levels with better control of the illness/quality of life. Additionally, most participants used pharmacological treatment (not alternative therapies) and the adoption of self-management measures to relieve their symptoms. Conclusions The findings of this study showed that the estimated prevalence of allergic rhinitis seems to be apparently lower in Guarda than that found in the general Portuguese population. From the data, some patients showed uncontrolled allergic rhinitis symptoms, strengthening the importance of the role of intervention by a health professional.

The Impact of Allergic Rhinitis on Asthma Outcomes in Urban Adolescents

The Impact of Allergic Rhinitis on Asthma Outcomes in Urban Adolescents

The impact of allergic rhinitis in clinical practice: an Italian Survey.

Allergic rhinitis (AR) is a very common disorder. The current Survey was conducted on a sample of about 5,000 adult subjects in 5 Italian cities. A questionnaire, containing 15 questions, was administered on the road. AR affects about 20% of the general population. The most common diagnostic test was the skin prick test, but only 12% of patients performed an allergy test to confirm the diagnosis. About 50% of patients did not take any medicine. Even about 40% of treatments were suggested by friends or pharmacists. In conclusion, the current Survey demonstrated that AR is a common disorder in Italy, the diagnostic work-up is still incorrect, and the therapeutic approach does not adhere to the guidelines. Therefore, there is a need to implement adequate information on this topic in Italy. (www.actabiomedica.it)

A study on prevalence and effects of allergic rhinitis and asthma on quality of life among secondary school’s student in Kinta District, Perak

Allergic rhinitis (AR) and bronchial asthma (BA) are common inflammatory chronic respiratory diseases, and they are significant public health challenges on a global scale. The prevalence of these diseases are on the rise in all regions of the world, affecting all ages but more commonly among children and adolescences. Both AR and BA affect patients to a different extent with variable restrictions in the physical, emotional, and social aspects of the patient's life. They may be seen as two presentations of the same disease by sharing common epidemiologic, histologic, physiologic, and immunopathologic linkages. To determine the prevalence and impact of allergic rhinitis, asthma and allergic rhinitis with asthma on quality of life among secondary school students in Kinta District, Perak. A cross-sectional study was done among secondary school students from randomly selected three schools in Kinta District, Ipoh, Perak. A well-vetted and validated questionnaire was used to collect the data, and statistical analysis was done to determine the prevalence and impact of AR, BA, or both. A total of 250 secondary school students were involved in this study. Malays were the majority among the participants. The prevalence of AR alone, BA alone, and disease co-occurance were 27.2%, 9.2%, and 8%, respectively. Nearly 20% of the participants were troublesome but low scale in terms of quality of life followed by disturbed sleep, restricted participation in school, and daily activities. Only 6% of the participants experienced sleep disturbance due to asthma, but daily anti-asthmatic medication was essential in only 1.2%. This study showed that although a relatively high prevalence of allergic rhinitis and bronchial asthma. There was no significant low quality of life among sufferers.

Impact of Allergic Rhinitis on Nasal Mucociliary Clearance Time in Children

Background: Mucociliary clearance is one of the most important protective functions of the airway. Previous studies, checking the influence of allergic rhinitis (AR) on mucociliary clearance time (MCT), were made on small patient groups and brought contradictive results. Objectives: The aim of the study is to confirm whether AR in children influences MCT. Methods: The examined group consisted of 842 AR children. A total of 96 children with no history of allergy rhinitis served as a comparative group. All patients underwent saccharin and skin prick tests and tests for blood eosinophilia, nasal eosinophilia, vitamin D3 serum concentration, total and specific IgE serum concentration. Results: Nasal MCT was significantly longer in AR patients (mean ± SD: 10.5 ± 5.65 min) compared to controls (mean ± SD: 7.25 ± 4.3 min). Percentage of eosinophils in nasal smears in patients was significantly higher compared to controls and a weak, but significant positive correlation was observed between the percentage and MCT (r > 0.10, p < 0.008). Patients with intermittent and persistent moderate/ severe AR had significantly longer MCT and higher eosinophilia in nasal smears compared both to patients with intermittent and persistent mild RA and controls. No correlation was observed between MCT and: participant’s age, total serum IgE, vitamin D3 serum concentration, absolute number or percentage of eosinophils in blood, prick test results or duration of illness. Conclusions: AR affects the mucociliary clearance in children, and its deterioration is related to more severe rhinitis with higher intensity of local nasal inflammation, reflected in nasal smear eosinophilia.

The impact of allergic rhinitis on gastrointestinal disorders among young adults.

An association between allergic rhinitis (AR) and digestive diseases (DDs) has been reported; however, studies have only focused on the prevalence of DDs in populations of patients with AR. In individuals with specific DDs, the impact of AR on the frequency of clinical visits for each DD has not been studied. Moreover, the association between topical steroid usage for AR and DDs has not been investigated. Data from 16526 men and 18438 women, aged 21 to 30years, were collected from a national database. Individuals were separated into the AR and non-AR groups. Eight common DDs were studied: (1) gastroesophageal reflux disease (GERD), (2) gastritis and duodenitis, (3) peptic ulcers, (4) irritable bowel syndrome, (5) gastric functional disease, (6) intestinal functional disease, (7) gastroenteritis and colitis, and (8) constipation. The rate of each DD was compared between groups. In individuals with specific DDs, the frequency of clinical visits for each DD was also compared between groups. Between users and nonusers of topical steroids in the AR group, the rate of DDs was compared. Significant associations were observed between all eight DDs and AR in both sexes. In comparison to the non-AR group, women with AR visited clinics more frequently for gastritis/duodenitis, gastric and intestinal functional disease, gastroenteritis/colitis, and constipation, while men with AR visited clinics more frequently for gastritis/duodenitis, gastric functional disease, gastroenteritis/colitis, and constipation. Female topical-steroid users with AR had higher rates of GERD, irritable bowel syndrome, gastric or intestinal functional disease, and gastritis/colitis. Male topical-steroid users with AR had higher rates of GERD and peptic ulcers. AR was associated with DDs in both sexes. However, the influence of AR on clinical visit frequency varied among specific DD groups. Topical steroid usage for AR was associated with some DDs, but the association requires future evaluation.

Impact of allergic rhinitis on quality of life after powered intracapsular tonsillectomy and adenoidectomy.

Allergic rhinitis (AR) has been reported to worsen quality of life (QoL) after adenotonsillectomy. Although powered intracapsular tonsillectomy and adenoidectomy (PITA) has been widely performed, it is not clear whether comorbid AR may worsen QoL in patients who undergo PITA. To evaluate QoL after PITA in relation to AR. Children undergoing PITA for sleep-disordered breathing were enrolled and divided into AR and non-AR groups. QoL was evaluated using serial applications of the Obstructive Sleep Apnea-18 (OSA-18) questionnaire and compared between the two groups. Of 151 enrolled patients, 73 were categorized into the AR and 78 into non-AR groups. After surgery, patients exhibited marked improvement in OSA-18 scores in both groups, with similar results at each follow-up. The degree of improvement in OSA-18 scores was less in the AR group 3 months after surgery; however, this difference was not significant 6 months after surgery. Although comorbid AR may initially appear to impede improvement in QoL after PITA, QoL was improved similarly 6 months after PITA, irrespective of AR status. In children with comorbid AR, PITA could be safely performed to treat sleep-disordered breathing without concerns regarding worsening of QoL.

Nettle Allergy: a Review and Clinical Perspective

Stinging nettle (Urtica dioica) is a common cause of contact urticaria worldwide; however, its clinical relevance in allergic rhinitis and aeroallergen immunotherapy has not been well established. This presents a clinical conundrum to the physician and can potentially impact the effectiveness of treatment of allergic rhinitis in nettle sensitized patients. The objectives of this article are to review the available literature regarding the geographic distribution of nettle, allergen(s) involved, cross-reactivity, role in allergic rhinitis, immunotherapy efficacy, and provide a clinical perspective on the evaluation and treatment of nettle sensitized patients. Stinging nettle (Urtica dioica) is a bi-annual pollinator with worldwide distribution and wide use in homeopathy. Limited data suggest that nettle pollen allergens may be considered clinically relevant and that nettle pollen allergy may be underestimated. More recent allergomic analysis of nettle pollen has revealed protein allergens including an osmotin and a pectin esterase which may implicate cross-reactivity with other pollens and foods. One study describes in vivo nettle immunotherapy. Overall, there is a paucity of medical literature evaluating the role of nettle in allergic rhinitis with even fewer studies assessing the clinical efficacy of nettle immunotherapy. Cross-reactivity patterns with other pollens and foods remains to be fully elucidated. Given the immense medical and economic impact of allergic rhinitis and the worldwide distribution of nettle, prospective randomized controlled trials are needed to evaluate the possible contribution of nettle allergy and efficacy of nettle immunotherapy.