《耳鼻喉科学 Otolaryngology》课程教学课件（PPT讲稿）nose_5 allergic rhinitis and nasal polyp

Allergic rhinitis

Allergic rhinitis

AllergicrhinitisItis an IgE mediated immunologic response of nasalmucosato air-bone allergens and is characterized bywaterynasaldischarge,nasalobstruction,sneezingand itching in the nose. This may also be associatedwithsymptomsof intheeyes,plateandpharynx.Twoclinical types have been rescognized:1.Seasonal. Symptoms appears in or around a particularseason when the pollens of particular plant, to whichthe patients is sensitive, are present in the air.2. Perennial. Symptoms are present throughout the year

Allergic rhinitis • It is an IgE mediated immunologic response of nasal mucosa to air-bone allergens and is characterized by watery nasal discharge, nasal obstruction , sneezing and itching in the nose. This may also be associated with symptoms of in the eyes, plate and pharynx. Two clinical types have been rescognized: 1. Seasonal. Symptoms appears in or around a particular season when the pollens of particular plant, to which the patients is sensitive, are present in the air. 2. Perennial. Symptoms are present throughout the year

Allergicrhinitis:AetiologyInhalant allergens are oftenthecausePollenfromthetrees and grasses,mouldspores,house dust,debrisfrominsectsorhouse miteare common offenders.Foodallergy is rarely an important cause.Geneticpredispositionplays an importantpart

Allergic rhinitis • Aetiology Inhalant allergens are often the cause. Pollen from the trees and grasses, mould spores, house dust, debris from insects or house mite are common offenders. Food allergy is rarely an important cause. Genetic predisposition plays an important part

Commen allergens·SpecificPollenfoodsDustmitesmilkFurryanimalseggsMoldspeanuts15KV30003wheatCockroachessoy·Stingingfish/shellfishinsectstreenuts

Commen allergens • Pollen • Dust mites • Furry animals • Molds • Cockroaches • Stinging insects • Specific foods ➢ milk ➢ eggs ➢ peanuts ➢ wheat ➢ soy ➢ fish/shellfish ➢ tree nuts 30003 30003 15KV 15KV 50U50U

Allergicrhinitis·Pathogenesis1.lnhaled allergens produce an important partspecificIgE antibody inthegeneticallypredisposed individuals. This antibody becomesfixed to thebloodbasophils ortissues mastcells.2.On subsequent exposure.Antigen combines withIgEantibody.This reactionproducesdegranulation of the mast of the cells withrelease ofseveralchemical mediators

Allergic rhinitis • Pathogenesis 1.Inhaled allergens produce an important part specific IgE antibody in the genetically predisposed individuals. This antibody becomes fixed to the blood basophils or tissues mast cells . 2.On subsequent exposure. Antigen combines with IgE antibody. This reaction produces degranulation of the mast of the cells with release of several chemical mediators

Allergic rhinitis·Pathogenesis00Mast-cellMastcellReleaseofmediators ofstimulationacuteand chronic inflammationFCeRIAllergenCUptakeof2allergenbyIgEdendriticcellsIL-4,IL-5andIL-10PrecursorExpansionofThelper cellTH2-typecellsTCR国MHCclass llProductionofIgE-DendriticcellNatureReviewslmmunology

Allergic rhinitis • Pathogenesis

Allergicrhinitis·PathogenesisThesemediatorare responsibleforsymptomatologyofallergicdiseaseDepending on the tissues involved,theremay be vasodilation,mucosaloedema,Infiltrationwitheosinophils,excessivesecretionfrom nasal gland or smoothmusclecontraction

Allergic rhinitis • Pathogenesis These mediator are responsible for symptomatology of allergic disease. Depending on the tissues involved, there may be vasodilation , mucosal oedema, Infiltration with eosinophils, excessive secretion from nasal gland or smooth muscle contraction

Allergic rhinitis·Pathogenesisit is also gets“primed"to other non-specificantigens to which patient was not exposedAllergicrespondoccurs in2phase:1.Acuteorearlyphase.2.Lateordelayedphase

Allergic rhinitis • Pathogenesis it is also gets “primed” to other non-specific antigens to which patient was not exposed. Allergic respond occurs in 2 phase: 1. Acute or early phase. 2. Late or delayed phase

AllergicrhinitisClinicalfeaturesThere are no age or sex predilection. It may startin infants as young as 6months or older peopleUsually the onset is at 12-16 years of age.The cardinal symptoms of season nasal allergyinclude paroxysmal sneezing. 10-20 sneezes ata time, nasal obstruction, watery nasaldischarge and itching in the nose

Allergic rhinitis • Clinical features There are no age or sex predilection. It may start in infants as young as 6 months or older people. Usually the onset is at 12-16 years of age. The cardinal symptoms of season nasal allergy include paroxysmal sneezing. 10-20 sneezes at a time, nasal obstruction, watery nasal discharge and itching in the nose

Allergic rhinitis·Clinicalfeatures过敏性鼻炎症状主要症状：流递、鼻塞、鼻痒、喷嚏

Allergic rhinitis • Clinical features