Clinical Evidence and Biomarkers Linking Allergy and Acute or Chronic Rhinosinusitis in Children: a Systematic Review

Eugenio De Corso, Daniela Lucidi, Elena Cantone, Giancarlo Ottaviano, Tiziana Di Cesare, Veronica Seccia, Gaetano Paludetti, Jacopo Galli, Eugenio De Corso, Daniela Lucidi, Elena Cantone, Giancarlo Ottaviano, Tiziana Di Cesare, Veronica Seccia, Gaetano Paludetti, Jacopo Galli

Abstract

Purpose of the review: We provide a systematic review of experimental and clinical evidences linking allergy to acute, including common cold, and chronic rhinosinusitis in children. Furthermore, we questioned if anti-allergy treatment may prevent the occurrence of rhinosinusitis or improve outcomes of its specific management.

Recent findings: Allergic rhinitis is a common childhood disease in industrialized countries that is responsible for a major impact on quality of life and healthcare resources. Over the years many authors tried to correlate allergy with comorbidities and in particular to the onset of rhinosinusitis including common cold, even though conflicting results are frequently reached. We performed a systematic review in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process. Our search yielded 7103 that were finally screened. This resulted in 25 publications of which the full texts were assessed and included in a qualitative analysis per different phenotypes of rhinosinusitis. The evidence suggests that allergy may lead to overall impairment of mechanical and immunological defense function of the nasal mucosa against viruses and that anti-allergy treatment may significantly decrease the number and severity of upper respiratory tract infections including common colds in children. It was not possible to perform the analysis for allergy and post-viral acute rhinosinusitis, bacterial acute rhinosinusitis, and recurrent acute rhinosinusitis because of paucity and heterogeneity of data. Although there is no definitive proof of causation linking allergy to chronic rhinosinusitis, studies lead to suppose that anti-allergy treatment may improve outcomes of specific CRS treatments.

Keywords: Acute rhinosinusitis; Allergy; Children; Chronic rhinosinusitis; Common cold; Coronavirus; Rhinovirus.

Conflict of interest statement

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors do not have any conflicts of interests to declare.

Figures

Fig. 1
Fig. 1
Flowchart of article search and selection
Fig. 2
Fig. 2
Practical algorithm based on different phenotypes of rhinosinusitis in children. Abbreviations: ARS: acute rhinosinusitis; CRS chronic rhinosinusitis; URTI: upper respiratory tract infections; ABRS: acute bacterial rhinosinusitis; RARS: recurrent acute rhinosinusitis; AFRS allergic fungal rhinosinusitis

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