Application of nasal sprays for treatment of allergic rhinitis and changes in local gene expression

INTERVENTION: Allocation to one of three nasal sprays. Twice daily application (one spray per nostril) for 7 days. The nasal sprays include: (A) an intranasal antihistamine (Azep; Azelastine hydrochloride 125 mcg/spray) (B) an intranasal steriod (Flixonase; Fluticasone proprionate 50mcg/spray) (C) an intranasal antihistamine and steriod combination (Dymista: Azelastine hydrochloride and Fluticasone proprionate 125/50 mcg per spray). Compliance will be monitored with return and weighing of spray bottle and self‐report in daily symptom and medication diaries CONDITION: allergic rhinitis PRIMARY OUTCOME: Gene expression profiles in nasal mucosal cells following nasal spray administration. This will be assessed using the Nanostring ncounter platform using the PanCancer immune profiling kit (770 genes involved in immune and inflammatory pathways). SECONDARY OUTCOME: Gene expression profiles in blood following nasal spray administration.. This will be assessed using the Nanostring ncounter platform using the PanCancer immune profiling kit (770 genes involved in immune and inflammatory pathways). INCLUSION CRITERIA: For inclusion into the study participants will: have a more than 2 year history of allergic rhinitis, have moderate/severe persistent allergic rhinitis based on ARIA classification, score 5 cm or greater on a visual analogue scale of symptom severity, score 6 or greater on a total nasal symptom score survey, have a positive skin prick test and/or radio‐allergosorbent test to Dermatophahoides pteronyssinus or D. farnae.