Pathophysiology and therapy for allergic and nonallergic rhinitis: an updated review.

Symptoms from rhinitis can be assessed to be more troubling to the patient than symptoms from asthma. Further, the array of bioactive mediators, cytokines, and cells in nasal mucosa suggests that rhinitis is a much more complex condition than formerly thought. The presence of allergic rhinitis is a risk factor for emergence of asthma. Topical nasal corticosteroids have a relatively flat dose-response curve and have onset of action within 1 to 2 days for some patients. Allergen immunotherapy remains the only immunomodulator for patients with allergic rhinitis, with the possible exception of long-term administration of nasal corticosteroids.