Testera-Montes, AlmudenaSalas, MariaPalomares, FranciscaAriza, AdrianaTorres, María J.Rondón, CarmenEguiluz-Gracia, Ibon2022-09-272022-09-272021-06-02Testera-Montes A, Salas M, Palomares F, Ariza A, Torres MJ, Rondón C, et al. Local Respiratory Allergy: From Rhinitis Phenotype to Disease Spectrum. Front Immunol. 2021 Jun 2;12:691964http://hdl.handle.net/10668/4159Local respiratory allergy (LRA) is defined by the negativity of atopy tests, a clinical history suggestive of airway allergy and a positive response to the nasal and/or bronchial allergen challenge. The clinical spectrum of LRA is comprised of three conditions: local allergic rhinitis (LAR) and local allergic asthma in non-atopic patients, and dual allergic rhinitis (coexistence of allergic rhinitis and LAR) in atopic individuals. LRA is an independent disease phenotype not progressing to atopy over time, but naturally evolving to the clinical worsening and the onset of comorbidities. Published data suggests that LRA is mediated through the mucosal synthesis of allergen-specific (s)IgE, which binds to FcϵRI on resident mast cells, and in >50% of cases traffics to the blood stream to sensitize circulating basophils. To date, 4 clinical trials have demonstrated the capacity of allergen immunotherapy (AIT) to decrease nasal, conjunctival and bronchial symptoms, to improve quality of life, to increase the threshold dose of allergen eliciting respiratory symptoms, and to induce serum sIgG4 in LRA individuals. Collectively, these data indicate that local allergy is a relevant disease mechanisms in both atopic and non-atopic patients with airway diseases.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Allergic rhinitisDual allergic rhinitisLocal allergic rhinitisLocal allergic asthmaLocal respiratory allergyMucosal immunologyIgE synthesisRinitis alérgicaEnfermedad localAsmaAlergia e inmunologíaInmunidad mucosaInmunoglobulina EMedical Subject Headings::Organisms::Eukaryota::AnimalsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Biological Therapy::Immunomodulation::Immunotherapy::Immunosuppression::Desensitization, ImmunologicMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Phenomena and Processes::Genetic Phenomena::PhenotypeMedical Subject Headings::Diseases::Respiratory Tract Diseases::Respiratory HypersensitivityMedical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Globulins::Serum Globulins::Immunoglobulins::Antibodies::Immunoglobulin Isotypes::Immunoglobulin EMedical Subject Headings::Chemicals and Drugs::Biological Factors::Antigens::AllergensMedical Subject Headings::Diseases::Respiratory Tract Diseases::Nose Diseases::RhinitisMedical Subject Headings::Diseases::Respiratory Tract Diseases::Bronchial Diseases::AsthmaMedical Subject Headings::Phenomena and Processes::Genetic Phenomena::Phenotypereview article34149736open access10.3389/fimmu.2021.6919641664-3224PMC8206788