Review of Rhinitis: Classification, Types, Pathophysiology

Abstract

Rhinitis describes a pattern of symptoms as a result of nasal inflammation and/or dysfunction of the nasal mucosa. It is an umbrella entity that includes many different subtypes, several of which escape of complete characterization. Rhinitis is considered as a pathologic condition with considerable morbidity and financial burden on health care systems worldwide. Its economic impact is further emphasized by the fact that it represents a risk factor for other conditions such as sinusitis, asthma, learning disabilities, behavioral changes, and psychological impairment. Rhinitis may be associated with many etiologic triggers such as infections, immediate-type allergic responses, inhaled irritants, medications, hormonal disturbances, and neural system dysfunction. It is basically classified into three major clinical phenotypes: allergic rhinitis (AR), infectious rhinitis, and non-allergic, non-infectious rhinitis (NAR). However, this subdivision may be considered as an oversimplification because a combined (mixed) phenotype exists in many individuals and different endotypes of rhinitis subgroups are overlapping. Due to the variety of pathophysiologic mechanisms (endotypes) and clinical symptoms (phenotypes), it is difficult to develop clear guidelines for diagnosis and treatment. This study aims to review the types of allergic and non-allergic rhinitis, providing a thorough analysis of the pathophysiological background, diagnostic approach, and main treatment options.

Ameliorative Effect of a Neoteric Regimen of Catechin plus Cetirizine on Ovalbumin-Induced Allergic Rhinitis in Rats

“…The pathophysiology of AR involves the activation of an inflammation cascade that is initiated by mast cell activation succeeding IgE cross-linking by an allergen. This action triggers the degranulation of mast cells and the release of preformed mediators such as histamine [ 5 , 6 ]. Histamine is a vital mediator that is released during the immediate allergic response from cytoplasmic granules in tissue mast cells and during the late phase response chiefly from recruited basophils.…”

“…Histamine is a vital mediator that is released during the immediate allergic response from cytoplasmic granules in tissue mast cells and during the late phase response chiefly from recruited basophils. The rapidly synthesized mediators trigger the early symptoms of AR: sneezing, pruritus, and rhinorrhea [ 4 , 5 , 6 , 7 , 8 ].…”

Identification of Some Promising Heterocycles Useful in Treatment of Allergic Rhinitis: Virtual Screening, Pharmacophore Mapping, Molecular Docking, and Molecular Dynamics

“…It is classified into many subtypes according to the causative agent such as viral or bacterial infections and allergies [ 1 ]. However, many cases illustrate the interchanging properties of these subtypes as displayed by conversion of a type into another in addition to the presence of multiple subtypes in a single case [ 2 , 3 ]. The key factor in tackling rhinitis is identifying the type(s) and severity which in turn will vary the treatment.…”

Plant-Derived Lactobacillus paracasei IJH-SONE68 Improves Chronic Allergy Status: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

“…Allergic diseases are immunoglobulin E (IgE)-mediated type I inflammatory disorders, including allergic rhinitis [1,2]. The major symptoms of allergic rhinitis are sneezing, nasal congestion, and lacrimation caused by complex allergen-driven mucosal inflammations, and the increased inflammatory mediators lead to sensory nerve activation, plasma leakage, and congestion [3,4].…”

“…The major symptoms of allergic rhinitis are sneezing, nasal congestion, and lacrimation caused by complex allergen-driven mucosal inflammations, and the increased inflammatory mediators lead to sensory nerve activation, plasma leakage, and congestion [3,4]. The prevalence of these diseases in the USA ranges from 9 to 42%, and in the UK, it reaches 26% in adults [1,5]. An epidemiological study in Japan revealed that the prevalence of allergic rhinitis markedly increased from 29.8 to 39.4%, between 1998 and 2008 [6].…”