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.
Highlights
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
Skin prick testing involves introducing controlled amounts of allergen and control substances into the skin. Skin testing provokes both types of responses, early and late; the main goal is detecting the immediate allergic response caused by the release of mast cell or basophil immunoglobulin E (IgE)-specific mediators, which create the classic wheal-and-flare reaction within fifteen minutes [25]
Neutrophilic Non-Allergic Rhinitis (NAR) is defined by infiltration of equal to or more than 20%
Summary
Rhinitis is an entity that includes many different subtypes and is mainly used to describe a pattern of nasal symptoms such as nasal congestion/obstruction, rhinorrhea, sneezing and pruritus that appear as a result of inflammation and/or dysfunction of the nasal mucosa [1,2,3,4]. Various criteria may be used, including the severity of disease (mild, moderate/severe), pattern of symptoms (seasonal/perennial or intermittent/persistent), predominant symptom (runners/blockers), possible triggering factor (allergens, infectious agents, etc.) and response to treatment (controlled/uncontrolled) [7,8,9,10]. Another disease categorization has been proposed based on endotype, and grouping rhinitis depending on the specific pathophysiological pathway [1,5]. All of the above constitute the indirect costs of rhinitis, but there exist direct costs such as physician office visits, lab tests and medication [1,4]
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