THE LINK BETWEEN ALLERGIC RHINITIS AND RHEUMATIC DISORDERS: FROM AVICENNA’S VIEW TO RECENT FINDINGS

Allergic rhinitis (AR) is one of the most prevalent allergic disorder across the globe which has significant socioeconomic costs. In addition to direct and indirect costs, the disease also has hidden direct costs related to comorbid conditions. AR can result in several complications such as pharyngitis, sinusitis, asthma, otitis media, eczema and lymphoid hypertrophy. Although associations between AR and other airway disorders have been investigated for years, less attention has been focused on the association of this disease with non-respiratory disorders. Cosidering the fact that AR is rarely found in isolation and reprts of traditional Persian medical literatures on the relationship between rhinitis and joint disorders, this study aimed to investigate the link between AR and rheumatic disorders. In this regard, Avicenna's Canon of Medicine which was a well known medical textbook until 17th century was reviewed. Modern medical databases were searched as well. The results of this study showed that as mentioned in the teachings of Avicenna, allergic rhinitis may have association with some rheumatic disorders such as rheumatoid arthritis, low back pain and gout. Findings that support this hypothesis include the wide range of symptoms and complications of allergic rhinitis, emphasizing the association by prominent medical scholars of the past like Rhazes and Avicenna, studies found an association between AR or chronic rhnosinusitis with rheumatic diseases and common cytokines and inflammatory biomarkers that serve similar roles in both allergic rhinitis and rheumatic diseases like IL-4, IL-6, IL-8, IL-17 and TNF-alpha. It is suggested that studies be conducted with the main aim of investigating the relationship between these diseases and evaluating underlying mechanisms. The result of such research can be helpful in finding new treatment modalities in both groups. Keywords: allergic rhinitis; rheumatic disorder; comorbidity, traditional medicine; Persian medicine; Avicenna