Abstract
BACKGROUND: Characterization of disease endotypes will open a new window
for the treatment of allergic rhinitis (AR). Herein we provide the first
attempt to identify specific AR phenotypes/endotypes and/or any
biomarker/predictor for specific treatment response based on local
biological parameters. METHODS: This observational study was carried out
in 142 patients with seasonal AR and 20 non-allergic controls. Total IgE
levels, specific IgE to 112 allergenic molecules and 92 proinflammatory
and immunologic proteins were measured in both serum and nasal
secretions (NS). RESULTS: We found increased values of MCPs and MMPs in
adults both in NS and serum when compared with pediatric patients
(p<.05). MCPs and MMPs might represent two effective
predictors of chronic inflammation. CXCL9, CXCL10, CXCL11, MCPs and MMP1
showed an upward trend both in serum and NS for patients with ≥ 3
comorbidities vs non-allergic controls(p<.05). These data
suggest the involvement of these chemokines in the late phase of chronic
allergic inflammation in the nose. Serum levels of IL-6, IL-8 and IL-10
(p<.05) were significantly higher in patients with AR+asthma
compared to patients with different comorbidities. Conversely, serum
levels of neurotrophin-3 values (p<.05) were significantly
higher in those with AR+eczema vs other comorbidities groups. A subgroup
of patients with a nasal hypersecretory state,called “hypersecreter
endotype” was characterized by paediatric age, male gender, grass
pollen sensitization and distributed among persistent, mild or moderate
to severe cases of AR. CONCLUSIONS: Our study sets the groundwork for an
AR endotypization at molecular level, which is highly desirable to
deliver a patient-tailored approach.