Rhinitis Subtypes, Endotypes, and Definitions

Papadopoulos, Nikolaos G.; Guibas, George V.

doi:10.1016/j.iac.2015.12.001

Cited by 69 publications

(112 citation statements)

References 114 publications

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“…The condition is often classified as allergic rhinitis (AR) and non‐allergic rhinitis (NAR) . AR constitutes a relatively homogenous phenotype resulting from IgE‐sensitisation to environmental allergens . Conversely, NAR comprises a heterogeneous group of diseases where immune‐mediated inflammation is not always apparent .…”

Section: Introductionmentioning

confidence: 99%

“…AR constitutes a relatively homogenous phenotype resulting from IgE‐sensitisation to environmental allergens . Conversely, NAR comprises a heterogeneous group of diseases where immune‐mediated inflammation is not always apparent . AR patients are by definition positive for skin prick test (SPT) and/or serum specific (s)IgE .…”

Section: Introductionmentioning

confidence: 99%

“…1 Conversely, NAR comprises a heterogeneous group of diseases where immune-mediated inflammation is not always apparent. 1,3 AR patients are by definition positive for skin prick test (SPT) and/or serum specific (s)IgE. 4 Nevertheless a significant proportion of healthy subjects also display positivity for either test, demonstrating the need for a correlation between symptoms and allergen exposure.…”

Section: Introductionmentioning

confidence: 99%

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Local allergic rhinitis: Implications for management

Campo

Eguiluz‐Gracia

Bogas

et al. 2018

Clin Experimental Allergy

101

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A significant proportion of rhinitis patients without systemic IgE-sensitisation tested by skin prick test and serum allergen-specific IgE (sIgE) display nasal reactivity upon nasal allergen provocation test (NAPT). This disease phenotype has been termed local allergic rhinitis (LAR). LAR is an underdiagnosed entity affecting children and adults from different parts of the world, with moderate-to-severe symptoms, impairment of quality of life and rapid progression to symptom worsening. LAR is a stable phenotype and not merely an initial state of AR. Allergic rhinitis and LAR share many clinical features including a positive NAPT response, markers of type 2 nasal inflammation including sIgE in nasal secretions and a significant rate of asthma development. LAR should be considered as a differential diagnosis in those subjects of any age with symptoms suggestive of AR but no evidence of systemic atopy. Although LAR pathophysiology is partially unknown, in some patients sIgE can be demonstrated directly in the nasal secretions and/or indirectly via positive responses in basophil activation test (BAT). LAR can coexist with other rhinitis phenotypes, especially AR. The diagnosis currently relies on the positivity of NAPT to a single or multiple allergens. NAPT has high sensitivity, specificity and reproducibility, and it is considered the gold standard. BAT and the measurement of nasal sIgE can also contribute to LAR diagnosis. LAR patients benefit from the same therapeutic strategies than AR individuals, including the avoidance of allergen exposure and the pharmacotherapy. Moreover, several recent studies support the effectiveness and safety of allergen immunotherapy for LAR, which opens a window of treatment opportunity in these patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Local allergic rhinitis: Implications for management

Campo

Eguiluz‐Gracia

Bogas

et al. 2018

Clin Experimental Allergy

101

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“…We hypothesised that Biyeom‐go may alleviate nasal symptoms associated with rhinitis based on our prior experiences; therefore, this study included all rhinitis patients regardless of rhinitis phenotypes and endotypes. Rhinitis phenotypes and endotypes are numerous and diverse and encompass many different pathologic and treatment mechanisms; thus, treatment effects may differ in patients with different rhinitis phenotypes. Therefore, future studies and clinical trials will need to incorporate differentiation between rhinitis phenotypes and endotypes into their designs.…”

Section: Discussionmentioning

confidence: 99%

Treating nasal symptoms associated with rhinitis using the intranasal herbal ointment Biyeom‐go: A prospective observational study

Son

Jung

Kim

et al. 2019

Clinical Otolaryngology

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ObjectivesThe aim of the current study was to investigate the effectiveness and clinical feasibility of Biyeom‐go for the treatment of nasal symptoms associated with rhinitis.DesignProspective observational study.SettingThis study was conducted at the Woosuk Korean Medicine Medical Center in South Korea.ParticipantsFifty‐eight patients with rhinitis participated in this study. All patients received Biyeom‐go treatment >3 times daily for a total of 4 weeks.Main outcome measuresThe primary outcome was the total nasal symptom score. Mini‐rhinoconjunctivitis quality of life questionnaire, nasal endoscopy index, total serum immunoglobulin E levels and immunologic factors in nasal lavage fluid were also measured.ResultsBiyeom‐go administration was associated with significant improvements in total nasal symptoms scores (P < .0001) and mini‐rhinoconjunctivitis quality of life questionnaire scores (P < .0001) in a time‐dependent manner. The nasal endoscopy index also significantly improved at weeks 2 (P = .0049), 3 (P < .0001) and 4 (P = .0001) after Biyeom‐go treatment. Significantly, increased interleukin‐2 levels (P = .005) and decreased interleukin‐8, chemokine (C‐C motif) ligand (CCL) 5, chemokine (C‐X‐C motif) ligand (CXCL) 9, CCL2 and CXCL10 levels were observed in the nasal lavage fluid.ConclusionsThe present findings suggest that Biyeom‐go may be beneficial for the management of rhinitis symptoms and rhinitis‐associated quality of life. Further well‐designed randomised controlled trials are needed to evaluate the effectiveness of Biyeom‐go for rhinitis.

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“…Idiopathic rhinitis (IR) is the most prevalent subtype of the NAR group, and is also a diagnosis requiring exclusion of AR, nasal eosinophilia, structural defects, or underlying systemic disease [46]. In the absence of any cellular inflammatory pattern, the pathophysiologic mechanism in IR is likely to be neurogenically mediated [37]. Most common triggers of symptoms include chemical irritants, as tobacco smoke, perfumes, and cleaning agents, but also changes in temperature, humidity, and barometric pressure, as well as alcohol ingestion.…”

Section: Idiopathic Rhinitis/vasomotor Rhinitismentioning

confidence: 99%

A Precision Medicine Approach to Rhinitis Evaluation and Management

Crisci

Ardusso

2020

Curr Treat Options Allergy

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Purpose of Review Precision medicine (PM) represents a new paradigm in disease diagnosis, prevention, and treatment. The PM approach focuses on the characterization of different phenotypes and pathogenic pathways in order to allow the selection of specific biomarkers that will be useful in disease management. Rhinitis is a highly prevalent and heterogeneous disease, both in terms of underlying endotypes and clinical presentations. Therefore, to apply the PM principles to the various rhinitis subtypes rise as a meaningful strategy to improve evaluation and treatment. Recent Findings The technology of recombinant allergens has allowed molecular characterization of IgE reactivity of specific individual components of allergenic extracts. Recently published and ongoing clinical trials based on component resolved diagnosis (CRD) bring more precision to allergen immunotherapy for allergic rhinitis. Monoclonal antibodies against various cytokines involved in inflammatory allergic and nonallergic rhinitis endotypes show promissory results. Summary Better understanding of pathogenic pathways together with an accurate phenotype classification of patients presented with rhinitis symptoms contributes to point out clinical usefulness of biomarkers and other diagnostic tools, which leads to more accurate environmental control measures, personalized pharmacologic options, and new biological therapy developments.

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Rhinitis Subtypes, Endotypes, and Definitions

Cited by 69 publications

References 114 publications

Local allergic rhinitis: Implications for management

Local allergic rhinitis: Implications for management

Treating nasal symptoms associated with rhinitis using the intranasal herbal ointment Biyeom‐go: A prospective observational study

A Precision Medicine Approach to Rhinitis Evaluation and Management

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