Allergic Rhinitis can be a condition resistant to treatment

Submitted by Dr. Cory Hewko

Allergic Rhinitis (AR) represents a frustrating condition that is often resistant to treatment. It is the sixth most common chronic illness which has a significant impact on patients’ quality of life. The actual cost of AR is staggering, approximately $5.6 billion is being spent in direct and indirect medical costs per year.

AR is the result of an antibody reaction that results in inflammation with many of the symptoms likely due to changes in the permeability of blood vessels. The most common approaches for treatment include avoiding triggers, using antihistamine medications and desensitization injection, none of which are ideal. Far-infrared (FIR) is an invisible electromagnetic wave with a longer wavelength than that of visible light. Numerous studies have found that FIR can be used to treat vascular diseases and may increase blood flow.

Studies have shown that the symptoms of eye itching, nasal itching, nasal stuffiness, rhinorrhea and sneezing were all significantly improved during the period of FIR therapy.

In addition, the levels of a type of white blood cell, the Eosinophil, have been found to decrease significantly after sauna while other leukocyte counts tended to increase. Eosinophils along with basophils and mast cells, are important mediators of allergic responses and asthma pathogenesis and are associated with disease severity.

It appears that warming of the nasal passages might enhance a person’s natural defenses against the different factors leading to the symptoms of Allergic Rhinitis. FIRS has been observed to improve clinical symptoms during a course of the therapy. The effect that raising the body temperature has on the immune system suggests that sauna may have the the potential to improve immune function. FIR appears to improve the symptoms of AR and might serve as a novel modality in the treatment of AR.

AR can be triggered by perennial or seasonal allergens, the most common of which are house dust, animal dander, mold spores, and pollen. Sneezing, nasal itch, runny nose, and nasal stuffiness, are symptoms that arise from the stimulation of nerves, increased production of mucous from the glands in the nose, increased blood vessel permeability, and the movement of inflammatory cells into the area coming into contact with the allergen. Nitric oxide (NO) is an interesting signal molecule that cause increase blood flow by dilating blood vessels. It is produced in higher concentrations by the lining of the nasal passages of untreated AR patients compared with normal individuals . It is produced by a reaction between an amino acid, L-arginine, and an enzyme called NO synthase. This enzyme is produced by the cells lining the blood vessels (the endothelium) and a host of white blood cells, (macrophages, neutrophils, mast cells, fibroblasts). The evidence demonstrated that these substances are involved in the immediate allergic response, and together they are considered to induce the characteristic symptoms.

Akasaki et al. reported that repeated FIR therapy could upregulate the expression of endothelial NO synthase (eNOS) . How this directly results in improvement of symptoms is unknown. However, Yu et al. considered that FIR therapy promoted skin blood flow through a mechanism closely related to L-arginine/NO pathway which suggest that there these substances and enzymes may be involved. Therefore, in addition to the thermal effects, the improvement of nasal symptoms may result from non-thermal effects of FIR.