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      Chinese Society of Allergy Guidelines for Diagnosis and Treatment of Allergic Rhinitis

      review-article
      1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 6 , 4 , 4 , 9 , 10 , 6 , 10 , 11 , 12 , 13 , 14 , 14 , 15 , 16 , 1 , 9 , 11 , 14 , 10 , 6 , 12 , 10 , 6 , 12 , 14 , 1 , 12 , 9 , 4 , 1 , 14 , 12 , 7 , 12 , 13 , 14 , 17 , 18 , 11 , 14 , 1 , 19 , 12 , 13 , 14 ,
      Allergy, Asthma & Immunology Research
      The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease
      Allergic rhinitis, China, diagnosis, treatment

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          Abstract

          Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.

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          The development of allergic inflammation.

          Allergic disorders, such as anaphylaxis, hay fever, eczema and asthma, now afflict roughly 25% of people in the developed world. In allergic subjects, persistent or repetitive exposure to allergens, which typically are intrinsically innocuous substances common in the environment, results in chronic allergic inflammation. This in turn produces long-term changes in the structure of the affected organs and substantial abnormalities in their function. It is therefore important to understand the characteristics and consequences of acute and chronic allergic inflammation, and in particular to explore how mast cells can contribute to several features of this maladaptive pattern of immunological reactivity.
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            European Position Paper on Rhinosinusitis and Nasal Polyps 2012.

            The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007.The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps and chronic rhinosinusitis with nasal polyps are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed.
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              The aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized methodology and facilitating international collaboration. Its specific aims are: 1) to describe the prevalence and severity of asthma, rhinitis and eczema in children living in different centres, and to make comparisons within and between countries; 2) to obtain baseline measures for assessment of future trends in the prevalence and severity of these diseases; and 3) to provide a framework for further aetiological research into genetic, lifestyle, environmental, and medical care factors affecting these diseases. The ISAAC design comprises three phases. Phase 1 uses core questionnaires designed to assess the prevalence and severity of asthma and allergic disease in defined populations. Phase 2 will investigate possible aetiological factors, particularly those suggested by the findings of Phase 1. Phase 3 will be a repetition of Phase 1 to assess trends in prevalence.
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                Author and article information

                Journal
                Allergy Asthma Immunol Res
                Allergy Asthma Immunol Res
                AAIR
                Allergy, Asthma & Immunology Research
                The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease
                2092-7355
                2092-7363
                July 2018
                18 June 2018
                : 10
                : 4
                : 300-353
                Affiliations
                [1 ]Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
                [2 ]International Centre for Allergy Research, Nanjing Medical University, Nanjing, China.
                [3 ]Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
                [4 ]Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
                [5 ]Allergy and Clinical Immunology Research Centre, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China.
                [6 ]Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China.
                [7 ]Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
                [8 ]Department of Otolaryngology Head Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, China.
                [9 ]Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan, China.
                [10 ]Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
                [11 ]Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital, Fudan University, Shanghai, China.
                [12 ]Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
                [13 ]Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
                [14 ]Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
                [15 ]Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.
                [16 ]Department of Traditional Chinese Medicine, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
                [17 ]Department of Otorhinolaryngology, Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
                [18 ]Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji University, Shanghai, China.
                [19 ]Department of Otorhinolaryngology, The Second Affiliated Hospital, Nanjing Medical University, Nanjing, China.
                Author notes
                Correspondence to: Luo Zhang, MD, Beijing Institute of Otolaryngology, No. 17, HouGouHuTong, DongCheng District, Beijing 100005, China. Tel: +8610-65141136; Fax: +8610-85115988; dr.luozhang@ 123456139.com

                These authors contributed equally to the study.

                Article
                10.4168/aair.2018.10.4.300
                6021586
                29949830
                54174c11-1092-41f4-9466-9f91a2c24a14
                Copyright © 2018 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 June 2017
                : 17 September 2017
                : 05 October 2017
                Funding
                Funded by: National Key R & D Program of China;
                Award ID: 2016YFC20160905200
                Funded by: National Natural Science Foundation of China, CrossRef http://dx.doi.org/10.13039/501100001809;
                Award ID: 81630023
                Award ID: 81100704
                Award ID: 81441029
                Award ID: 81441031
                Award ID: 8157089481630023
                Award ID: 81100704
                Award ID: 81441029
                Award ID: 81441031
                Award ID: 8157089481630023
                Award ID: 81100704
                Award ID: 81441029
                Award ID: 81441031
                Award ID: 81570894
                Award ID: 81420108009
                Funded by: program for Changjiang scholars and innovative research team;
                Award ID: IRT13082
                Funded by: Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support, CrossRef http://dx.doi.org/10.13039/501100009331;
                Award ID: ZYLX201310
                Funded by: Beijing health bureau program for high level talents;
                Award ID: 2014-3-017
                Funded by: Beijing Municipal Administration of Hospitals, CrossRef http://dx.doi.org/10.13039/501100009601;
                Award ID: SML20150203
                Categories
                Review

                Immunology
                allergic rhinitis,china,diagnosis,treatment
                Immunology
                allergic rhinitis, china, diagnosis, treatment

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