Perspective - (2021) Volume 9, Issue 11
Nasal Hyper Reactivity (NHR) is a common feature in patients with allergic and non-allergic rhinitis; it is commonly overlooked during in the majority of patients with rhinitis and rhino sinusitis, not considered as an outcome parameter in clinical trials on novel rhinitis and rhino sinusitis treatments, and has no possibility for routine treatment. In contrast to the ease with which treatment of nasal symptoms caused by nonspecific external and endogenous triggers can be used to diagnose NHR, quantification is rarely used in routine clinic due to the lack of a simple method for diagnosis. So far, only a little amount of research has gone into better understanding the underlying pathophysiology of NHR, which could help us understand why some individuals with inflammation develop NHR while others do not. Environmental and microbiological factors have been identified to influence the development of NHR, adding to the complexity of understanding the disease. Patients with NHR may be treated and unsatisfied with current treatment as a result of the neglect of NHR as a critical clinical characteristic of rhinitis and Chronic Rhino Sinusitis (CRS). It is to provide a comprehensive summary of current pathophysiology information as well as diagnostic and treatment options for NHR. Despite the fact that NHR is common in all subgroups of rhinitis, it is frequently observed in clinical practice due to a lack of an effective diagnostic tool. Despite the fact that several nasal provocation tests have been described over the years, none of them has been successfully used in clinical practice. The fundamental reason for this is that none of the provocative tests has high enough sensitivity and specificity when combined with a patient and investigator-friendly procedure. It refers to situations in which patients are asked to cooperate minimally and are not subjected to unpleasant exams such as nasal lavages or irritating stimuli such as capsaicin. It is extremely simple to use without the need for specialized equipment. Nasal hyper reactivity in non-allergic rhinitis, a clinical entity encompassing a diverse range of disorders, is substantially more difficult. There are several methods for determining nasal hyper reactivity. In several causes, the diverse patient groups, and the lack of consistency in tests, it's not unexpected that nasal hyper reactivity assessment isn't part of the clinician's diagnostic treatment. Patients with NHR may be treated with current treatment as a result of the neglect of NHR as a critical clinical characteristic of rhinitis and Chronic Rhino Sinusitis (CRS). MP-AzeFlu (1 spray/nostril bd) or placebo was given to severe persistent AR and NHR (i.e. reduced peak nasal inspiratory flow (PNIF)>20% upon CDA provocation). The effect of MP-AzeFlu on NHR was examined using the PNIF drop in response to CDA, as well as the severity of nasal symptoms from 7 to 28 days for following treatment. Nasal symptom severity was measured using a total of five symptom scores (T5SS; congestion, nasal itching, rhinorrhea, sneezing, and ocular itching) and a visual analogue scale (0 cm-10 cm). AR control test was used to evaluate AR control. The effect of MP-AzeFlu on substance P and hexosaminidase concentrations in human nasal secretions was examined to investigate the mechanism(s) behind any reported reduction in NHR. In a mouse model of house dust mite-induced NHR, the MP-effect of AzeFlu's on mucosal barrier integrity, mast cell degranulation, and airway inflammation, as well as its influence on murine sensory neurons from the trigeminal ganglia, were studied. These findings should transform the way AR is treated in the real world by encouraging open and honest communication with patients, as well as pharmaceutical prescriptions that take into consideration patient preferences, illness phenotypes, and treatment behavior. It is a valuable approach to take a more pragmatic to AR management in order to give individualized medication that is centered on the patient and to acknowledge that patients do not behave the same way in real life as they do in RCTs. The patient should be fitted to the AR treatment rather than the treatment fitted to the patient. It has the quickest onset of action and clinically significant effect of any currently approved AR drug. MP-AzeFlu is an AR medication that is personalized to the patient, as well as having proven efficacy in the treatment of NHR.
Citation: Mustafa R (2021) A Short Note on Nasal Hyper Reactivity. Gen Med (Los Angeles). 9: 377
Received: 08-Nov-2021 Published: 29-Nov-2021
Copyright: © 2021 Mustafa R. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
