CLINICAL AND LABORATORY EVIDENCE LINKING ALLERGY AND ACUTE OR CHRONIC
RHINOSINUSITIS IN CHILDREN.
Abstract
Background: allergic rhinitis is a common childhood disease in
industrialized countries that is responsible for a major impact on
quality of life and health care resources. The objective of this review
was to provide a systemic review of experimental and clinical evidence
linking allergy to rhinosinusitis in children including common cold.
Furthermore, we questioned if anti-allergy treatment may prevent the
occurrence of rhinosinusitis or improve outcomes of its specific
management. Methods: This systematic review was conducted in accordance
with the Preferred Reporting Items for Systematic Review and
Meta-Analysis (PRISMA) process to identify experimental and clinical
articles about allergy and acute or chronic rhinosinusitis in children
published since January 2000. The research was performed in April 2020
including only English-language peer-reviewed papers. Our search yielded
7103 that were finally screened. This resulted in 30 publications of
which the full texts were assessed and included in a qualitative
analysis per different phenotypes of rhinosinusitis. Results: 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. We found interesting data linking
allergy to chronic rhinosinusitis: although there is no definitive proof
of causation studies lead to suppose that anti-allergy treatment may
improve outcomes of specific CRS treatments. Conclusion: We summarized
conclusions in a practical algorithm taking into account different
phenotypes of rhinosinusitis in order to elucidate when prompt and
accurate diagnosis of allergy is recommended. We lastly focused
attention on the needs for future research.