The purpose of this prospective experimental study is to determine the effect of two different treatments for patients with perennial allergic rhinitis on immunologic and behavioral measures over the first three months of treatment. Twenty subjects, diagnosed with perennial allergies through in vitro RAST testing, will be randomly assigned to either a pharmacotherapy group, to be managed with antihistamines, or an immunotherapy group, which involves systematic desensitization to the allergens. The biological measures will consist of serum and nasal levels of several interleukins (L-4, L-5, IL-13) and serum specific IgE and IgG4 antibody levels to the specific allergens. These measures will be assessed three times during the study, prior to initiation of treatment and at six weeks and three months following the beginning of treatment. Subjects in both treatment groups will also complete several questionnaires assessing their allergy and sinus-related quality of life scores and nasal and sinus symptoms three times during the study, prior to the onset of treatment, at six weeks and at three months following treatment. The close interaction of the physiological consequences of allergic rhinitis to the individual?s functional, emotional, and psychological status necessitates the incorporation of not only biological indicators of outcomes but clinical and behavioral measurements of the multifaceted dimensions comprising quality of life. As a result of treatment with immunotherapy for three months versus pharmacotherapy over the same period of time, a significant alteration in immune function may be observed and is expected to correlate with improvement in behavioral measures. The group receiving pharmacotherapy is also expected to demonstrate improvement in behavioral measures with no accompanying changes in immune function, thus achieving temporary relief with medication. It is believed that administration of immunotherapy may significantly alter the immune response and over time permanently alter immune function thereby creating longstanding improvements in nasal and sinus symptoms and quality of life for patients with perennial allergic rhinitis.
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