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http://doi.org/10.5281/zenodo.1069785
Please cite this article in press as Ali Reza Derakhshan et al., The Link between Allergic Rhinitis and Rheumatic
Disorders: from Avicennas View to Recent Findings, Indo Am. J. P. Sci, 2017; 4(12).
Th1- and Th2-mediated diseases are significantly and gout(29, 33, 34). It has also been proven that
associated in a large general practice population(17). patients with chronic low back pain due to disc
Besides, two studies show that history of AR and low herniation have higher levels of IL-6 and TNF-
back pain are linked together(18, 19). (35). Besides, TNF-, IL-6 and IL-17 are known
as major contributor in intervertebral disc
As we already know AR and chronic degeneration and related radicular pain(36). Taken
rhinosinusitis(CRS) are associated together and may these facts together, it seems that AR may share a
represent a spectrum of the same disease entity through similar mechanism in its inflammatory actions
the concept of united allergic airways(20). On the other with these rheumatic disorders. Also, positive
hand, despite the lack of research on the association of therapeutic effects of some drugs like quercetin
AR and gout, relation between CRS and gout have which have been proven in RA and gout as well as
been disscussed in two studies. Fu et al. in a study AR, are consistent with this theory.
which was conducted in China to evaluate the effect of
CRS on health-related quality of life indicated that CONCLUSION:
individuals suffering from CRS showed an increased Based on systemic symtoms of AR and several
prevalence of AR, asthma and gout compared to comordities associated with this disease and literature
individuals without CRS(21). Another study included a and articles which showed the association between AR
total of 10636 respondents indicated that individuals and some rheumatic disorders, the authors of current
with history of COPD or gout were more susceptible to study concluded that untreated AR may play a role as a
development of CRS compared to those without such predisposing factor for these rheumatic disorders.
history(22). Avicenna has highlighted this relationship many
centuries ago. Exploring the ideas of complementary
DISCUSSION: and alternative medical systems especially eastern
Several studies found the relationship between some traditional systems of medicine which provide holistic
rheumatic disorders and AR or CRS. In this regard, it view to human body in order to implementing these
can be expected that untreated AR may play a causal ideas in future clinical researches around the link
role in development of these rheumatoid disorders. The between AR and non-respiratory disorders. From this
evidence supporting this hypothesis is as follows: perpective, the researchers of this study suggest
AR is not just a runny nose. It can lead to fatigue, conducting future studies on this topic with the main
headache, cognitive impairment, sleep disturbance, goal of identifying the exact relationship between AR
and other systemic symptoms(23). and rheumatic disorders and underlying mechanisms.
AR is rarely found in isolation. It has several Also we suggest additional studies for exploring the
comorbidites such as asthma, sinusitis, otitis other non-respiratory complications of AR.
media, lymphoid hypertropy, eczema, atopic
dermatitis, migraine and some psychiatric ACKNOWLEDGEMENTS:
disorders. These comorbid condition are not This article is based on PhD thesis in School of
limited to respiratory system and can affect other Traditional Medicine, Shahid Beheshti University of
systems such as skin, skeletal and nervous system Medical Sciences, Tehran, Iran. The authors would like
too(24-27). to acknowledge Shahid Beheshti center for research
Several studies showed an association between AR cooperation and financial support.
and some rheumatic disorders such as arthritis,
back pain and gout(14-22). Conflict of Interest:
Historical and traditional medicine literatures from The authors declare that they have no conflict of
prominent scholars of Persia like Rhazes and interest.
Avicenna have emphasized the relationship
between rhinitis or sinusitis and some rheumatic Ethical approval:
disorders. The treatment plan of this disorders This article does not contain any studies with human
covers the treatment of rhinitis/sinusitis too(11, participants or animals performed by any of the
28). authors.
Some biomarkers play the same role in AR and
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