Persistent allergic rhinitis includes different pathophysiologic types

BACKGROUND: Allergy rhinitis is typically classified as seasonal allergy rhinitis (SAR) and perennial allergy rhinitis (PAR). More recently, the Allergic Rhinitis and its Impact on Asthma document proposed the intermittent (ITR) and persistent forms (PER). However, it has been previously reported that each single allergen may induce different clinical and pathophysiologic features. OBJECTIVE: The aim of the study was to test the hypothesis that the type of causal allergen might characterize pathophysiologic differences in a cohort of patients with PER. METHODS: Three hundred nineteen patients, sailors of the Italian Navy, with moderate-severe PER were prospectively and consecutively evaluated with clinical evaluation, skin prick test, rhinomanometry, and nasal decongestion test. RESULTS: Patients with pollen allergy showed significantly more severe symptoms, lower nasal airflow, and higher response to decongestion test than patients with allergy to perennial allergens (P <.0001). CONCLUSION: This study provides evidence that patients with PER may show different pathophysiologic patterns depending on the type of causal allergen.