A Precision Medicine Approach to Rhinitis Evaluation and Management

Abstract

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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Clinical Evidence of Type 2 Inflammation in Non-allergic Rhinitis with Eosinophilia Syndrome: a Systematic Review

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Nėščiųjų Rinitas

“…Vienas dažniausių yra alerginis rinitas, kuriam būdingas sekreto tekėjimas iš nosies ir čiaudulys, o tai nėra dominuojantys simptomai nėščiųjų rinito metu [2,4,13]. Rinitas gali komplikuotis rinosinusitu dėl nosį ir sinusus siejančių kraujagyslinių, nervinių ir anatominių kelių [14] ir yra astmos bei kitų rinitų rizikos veiksnys [2,9,15]. Įtariant rinosinusitą, radiologinio ištyrimo reikėtų vengti, ypač pirmajame trimestre, nes radiacija gali paveikti vaisiaus nervų sistemą [11].…”

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