Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr;280(4):1775-1784.
doi: 10.1007/s00405-022-07704-0. Epub 2022 Oct 22.

Nasal eosinophilia as a preliminary discriminative biomarker of non-allergic rhinitis in every day clinical pediatric practice

Athina Papadopoulou  1   2 , Stavroula Lambidi  3 , Theano Lagousi  4 , Maria Syrrou  5 , Fani Giannoula  4 , Efstathia Staikou  5 , Stavroula Kostaridou  6 , Despoina-Zoe T Mermiri  4
Affiliations

Nasal eosinophilia as a preliminary discriminative biomarker of non-allergic rhinitis in every day clinical pediatric practice

Athina Papadopoulou et al. Eur Arch Otorhinolaryngol. 2023 Apr.

Abstract

Background: Non-allergic rhinitis (NAR) in children, named local allergic rhinitis (LAR) and non-allergic rhinitis with eosinophilia syndrome (NARES), are recently termed entities in childhood characterized by symptoms suggestive of allergic rhinitis in the absence of systemic atopy. Nasal eosinophils (nEo) are the principal cells involved in the allergy inflammation and nasal allergen provocation test is the gold standard method for the diagnosis, albeit with several limitations. The aim of this study was to validate the presence of nEo in combination with the therapeutic response to nasal steroids, as a preliminary discriminator of NAR in real life data.

Methods: In a prospective cohort study, 128 children (63.3% male, aged 72 ± 42 m) with history of NAR were enrolled and followed up for 52 ± 32 m. Nasal cytology was performed and nasal steroids trial was recommended initially in all and repeatedly in relapsing cases. Response to therapy was clinically evaluated using 10-VAS.

Results: Significant nEo was found in 59.3% of the cases and was related to reported dyspnea episodes. 23.4% had no response to therapy, whereas 51.5% were constantly good responders. Response to therapy was related to nEo and a cutoff point of 20% was defined as the most reliable biological marker with 94% sensitivity and 77% specificity.

Conclusions: In children with symptoms of NAR, the presence of nEo > 20% constantly responding to nasal steroid therapy, is a clear indicator of atopy. In an everyday clinical setting, it emerged as an easy, preliminary, cell biomarker suggestive of further investigation such as NAPT, to discriminate LAR from NARES.

Keywords: Biomarker; Children; Nasal eosinophils; Nasal steroids; Non-allergic rhinitis.

PubMed Disclaimer

References

    1. Yum HY, Ha EK, Shin YH, Han MY (2021) Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis. Clin Exp Pediatr 64:373–383. https://doi.org/10.3345/cep.2020.00822 - DOI - PubMed
    1. Testera-Montes A, Salas M, Palomares F et al (2021) Local respiratory allergy: from rhinitis phenotype to disease spectrum. Front Immunol 12:691964. https://doi.org/10.3389/fimmu.2021.691964 - DOI - PubMed - PMC
    1. Rondón C, Campo P, Togias A et al (2012) Local allergic rhinitis: concept, pathophysiology, and management. J Allergy Clin Immunol 129:1460–1467. https://doi.org/10.1016/j.jaci.2012.02.032 - DOI - PubMed
    1. Campo P, Rondón C, Gould HJ et al (2015) Local IgE in non-allergic rhinitis. Clin Exp Allergy 45:872–881. https://doi.org/10.1111/cea.12476 - DOI - PubMed
    1. Rondón C, Romero JJ, López S et al (2007) Local IgE production and positive nasal provocation test in patients with persistent nonallergic rhinitis. J Allergy Clin Immunol 119:899–905. https://doi.org/10.1016/j.jaci.2007.01.006 - DOI - PubMed

LinkOut - more resources