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01.11.2020 | Rhinosinusitis (J Mullol, Section Editor)

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

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

Erschienen in: Current Allergy and Asthma Reports | Ausgabe 11/2020

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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.

Summary

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.

Meltzer EO, Hamilos DL. Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines. Mayo Clin Proc. 2011;86(5):427–43. https://doi.org/10.4065/mcp.2010.0392.CrossRefPubMedPubMedCentral

Wood RA. Pediatric asthma. JAMA. 2002;288(6):745–7. https://doi.org/10.1001/jama.288.6.745.CrossRefPubMed

Bousquet J, Van Cauwenberge P, Khaltaev N, et al. Allergic rhinitis and its impact on asthma. JAMA. 2001;108(5):S147–334. https://doi.org/10.1034/j.1398-9995.2002.23625.CrossRef

Borish L. Allergic rhinitis: systemic inflammation and implications for management. J Allergy Clin Immunol. 2003;112(6):1021–31. https://doi.org/10.1016/j.jaci.2003.09.015.CrossRefPubMed

Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020;58(Supplement 29):1–464. https://doi.org/10.4193/Rhin20.600.CrossRef

Tan YSL, Hong CY, Chong PN, Tan ESL, Lew YJ, Lin RTP. Knowledge that upper respiratory tract infection resolves on its own is associated with more appropriate health-seeking behavior and antibiotic cognition. Singap Med J. 2006;47(6):518–24.

Garcia ML, Rey CC, Del Rosal Rabes T. Pediatric asthma and viral infection. Arch Bronconeumol. 2016;52(5):269–73. https://doi.org/10.1016/j.arbr.2016.03.010.CrossRef

Larsen JM, Brix S, Thysen AH, Birch S, Rasmussen MA, Bisgaard H. Children with asthma by school age display aberrant immune responses to pathogenic airway bacteria as infants. J Allergy Clin Immunol. 2014;133(4):1008–13. https://doi.org/10.1016/j.jaci.2014.01.010.CrossRefPubMed

Parker D, Prince A. Innate immunity in the respiratory epithelium. Am J Respir Cell Mol Biol. 2011;45(2):189–201. https://doi.org/10.1165/rcmb.2011-0011RT.CrossRefPubMedPubMedCentral

10.

Waltl EE, Selb R, Eckl-Dorna J, Mueller CA, Cabauatan CR, Eiwegger T, et al. Betamethasone prevents human rhinovirus-and cigarette smoke-induced loss of respiratory epithelial barrier function. Sci Rep. 2018;8(1):1–10. https://doi.org/10.1038/s41598-018-27022.CrossRef

11.

Steelant B, Farré R, Wawrzyniak P, Belmans J, Dekimpe E, Vanheel H, et al. Impaired barrier function in patients with house dust mite–induced allergic rhinitis is accompanied by decreased occludin and zonula occludens-1 expression. J Allergy Clin Immunol. 2016;137(4):1043–53. https://doi.org/10.1016/j.jaci.2015.10.050.CrossRefPubMed

12.

Steelant B, Seys SF, Van Gerven L, Van Woensel M, Farré R, Wawrzyniak P, et al. Histamine and T helper cytokine–driven epithelial barrier dysfunction in allergic rhinitis. J Allergy Clin Immunol. 2018;141(3):951–63. https://doi.org/10.1016/j.jaci.2017.08.039.CrossRefPubMed

13.

Ciprandi G, Buscaglia S, Pesce G, Villaggio B, Bagnasco M, Canonica GW. Allergic subjects express intercellular adhesion molecule—1 (ICAMA or CD54) on epithelial cells of conjunctiva after allergen challenge. J Allergy Clin Immunol. 1993;91(3):783–92. https://doi.org/10.1016/0091-6749(93)90198.CrossRefPubMed

14.

Fasce L, Ciprandi G, Pronzato C, Cozzani S, Tosca MA, Grimaldi I, et al. Cetirizine reduces ICAM-I on epithelial cells during nasal minimal persistent inflammation in asymptomatic children with mite-allergic asthma. Int Arch Allergy Immunol. 1996;109(3):272–6. https://doi.org/10.1159/000237249.CrossRefPubMed

15.

Baraldo S, Contoli M, Bazzan E, Turato G, Padovani A, Marku B, et al. Deficient antiviral immune responses in childhood: distinct roles of atopy and asthma. J Allergy Clin Immunol. 2012;130(6):1307–14. https://doi.org/10.1016/j.jaci.2012.08.005.CrossRefPubMed

16.

Głobińska A, Pawełczyk M, Piechota-Polańczyk A, Olszewska-Ziąber A, Moskwa S, Mikołajczyk A, et al. Impaired virus replication and decreased innate immune responses to viral infections in nasal epithelial cells from patients with allergic rhinitis. Clin Exp Immunol. 2017;187(1):100–12. https://doi.org/10.1111/cei.12869.CrossRefPubMed

17.

Fenoglio D, Ferrera A, Ferrera F, Sormani MP, Di Gioacchino M, Ciprandi G. Patients with allergic rhinitis show an allergen-specific interferon-gamma defect. Eur J Inflamm. 2008;6(2):87–91. https://doi.org/10.1177/1721727X0800600206.CrossRef

18.

Teach SJ, Gill MA, Togias A, Sorkness CA, Arbes SJ Jr, Calatroni A, et al. Preseasonal treatment with either omalizumab or an inhaled corticosteroid boost to prevent fall asthma exacerbations. J Allergy Clin Immunol. 2015;136(6):1476–85. https://doi.org/10.1016/j.jaci.2015.09.008.CrossRefPubMedPubMedCentral

19.

Karevold G, Kvestad E, Nafstad P, Kvaerner KJ. Respiratory infections in schoolchildren: co-morbidity and risk factors. Arch Dis Child. 2006;91(5):391–5. https://doi.org/10.1136/adc.2005.083881.CrossRefPubMedPubMedCentral

20.

Ciprandi G, Tosca MA, Fasce L. Allergic children have more numerous and severe respiratory infections than non-allergic children. Pediatr Allergy Immunol. 2006;17(5):389–91. https://doi.org/10.1111/j.1399-3038.2006.00413.CrossRefPubMed

21.

Kværner KJ, Tambs K, Harris JR, Mair IW, Magnus P. Otitis media: relationship to tonsillitis, sinusitis and atopic diseases. Int J Pediatr Otorhinolaryngol. 1996;35(2):127–41. https://doi.org/10.1016/0165-5876(95)01299-0.CrossRefPubMed

22.

Sütçü M, Acar M, Aktürk H, Hançerli-Törün S, Salman N, Somer A. Recognizing immunodeficiency in children with recurrent infections: What are the predictive factors? The Turk J Pediatr. 2016;58(6):609–15. https://doi.org/10.24953/turkjped.2016.06.006.CrossRefPubMed

23.

Ciprandi G, Tosca M, Passalacqua G, Canonica GW, Ricca V, Landi M. Continuous antihistamine treatment controls allergic inflammation and reduces respiratory morbidity in children with mite allergy. Allergy. 1999;54(4):358–65. https://doi.org/10.1034/j.1398-9995.1999.00920.x.CrossRefPubMed

24.

•• Barberi S, Bernardo L, D'Auria E, Ferrara F, Tosi S, Incorvaia C, et al. Allergen immunotherapy and respiratory infections in children: an encouraging experience. Minerva Pediatr. 2018;70(1):1–4. https://doi.org/10.23736/s0026-4946.16.04394-2The authors demonstrated that 3 year high-dose HDM-SLIT significantly reduced respiratory infections in children with allergic rhinitis.CrossRefPubMed

25.

Barberi S, Ciprandi G, Verduci E. Effect of high-dose sublingual immunotherapy on respiratory infections in children allergic to house dust mite. Asia Pac Allergy. 2015;5(3):163–9. https://doi.org/10.5415/apallergy.2015.5.3.163.CrossRefPubMedPubMedCentral

26.

Chow AW, Benninger MS, Brook I, Brozek JL, Goldstein EJ, Hicks LA, et al. Infectious Diseases Society of America. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012;54(8):72–112. https://doi.org/10.1093/cid/cis370.CrossRef

27.

Lin SW, Wang YH, Lee MY, Ku MS, Sun HL, Lu KH, et al. Clinical spectrum of acute rhinosinusitis among atopic and nonatopic children in Taiwan. Int J Pediatr Otorhinolaryngol. 2012;76(1):70–5. https://doi.org/10.1016/j.ijporl.2011.10.002.CrossRefPubMed

28.

Holzmann D, Willi U, Nadal D. Allergic rhinitis as a risk factor for orbital complication of acute rhinosinusitis in children. Am J Rhinol. 2001;15(6):387–90. https://doi.org/10.1177/194589240101500606.CrossRefPubMed

29.

Alho OP, Karttunen TJ, Karttunen R, Tuokko H, Koskela M, Suramo I, et al. Subjects with allergic rhinitis show signs of more severely impaired paranasal sinus functioning during viral colds than nonallergic subjects. Allergy. 2003;58(8):767–71. https://doi.org/10.1034/j.1398-9995.2003.00252.CrossRefPubMed

30.

Lin SW, Wang SK, Lu MC, Wang CL, Koo M. Acute rhinosinusitis among pediatric patients with allergic rhinitis: A nationwide, population-based cohort study. PLoS One. 2019;14(2). https://doi.org/10.1371/journal.pone.0211547.

31.

Leo G, Incorvaia C, Cazzavillan A, Consonni D, Zuccotti GV. Could seasonal allergy be a risk factor for acute rhinosinusitis in children? J Laryngol Otol. 2018;132(2):150–3. https://doi.org/10.1017/S0022215118000038.CrossRefPubMed

32.

Choi SH, Han MY, Ahn YM, Park YM, Kim CK, Kim HH, et al. Predisposing factors associated with chronic and recurrent rhinosinusitis in childhood. Allergy, Asthma Immunol Res. 2012;4(2):80–4. https://doi.org/10.4168/aair.2012.4.2.80.CrossRef

33.

Veskitkul J, Vichyanond P, Pacharn P, Visitsunthorn N, Jirapongsananuruk O. Clinical characteristics of recurrent acute rhinosinusitis in children. Asian Pac J Allergy Immunol. 2015;33(4):276–80. https://doi.org/10.12932/AP0591.33.4.2015.CrossRefPubMed

34.

Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines—2016 revision. J Allergy Clin Immunol. 2017;140(4):950–8. https://doi.org/10.1016/j.jaci.2017.03.050.CrossRefPubMed

35.

Veling MC. The role of allergy in pediatric rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2013;21(3):271–6. https://doi.org/10.1097/MOO.0b013e32835fb399.CrossRefPubMed

36.

Chan KH, Abzug MJ, Coffinet L, Simoes EA, Cool C, Liu AH. Chronic rhinosinusitis in young children differs from adults: a histopathology study. J Pediatr. 2004;144(2):206–12. https://doi.org/10.1016/j.jpeds.2003.11.009.CrossRefPubMed

37.

Berger G, Kogan T, Paker M, Berger-Achituv S, Ebner Y. Pediatric chronic rhinosinusitis histopathology: differences and similarities with the adult form. Otolaryngol Head Neck Surg. 2011;144(1):85–90. https://doi.org/10.1177/0194599810390443.CrossRefPubMed

38.

De Corso E, Baroni S, Lucidi D, Battista M, Romanello M, Autilio C, et al. Nasal lavage levels of granulocyte-macrophage colony-stimulating factor and chronic nasal hypereosinophilia. Int Forum Allergy Rhinol. 2015;5(6):557–62. https://doi.org/10.1002/alr.21519.CrossRefPubMed

39.

De Corso E, Baroni S, Romitelli F, Luca L, Di Nardo W, Passali GC, et al. Nasal lavage CCL24 levels correlate with eosinophils trafficking and symptoms in chronic sino-nasal eosinophilic inflammation. Rhinology. 2011;49(2):174–9. https://doi.org/10.4193/rhino10.133.CrossRefPubMed

40.

De Corso E, Lucidi D, Battista M, Romanello M, De Vita C, Baroni S, et al. Prognostic value of nasal cytology and clinical factors in nasal polyps development in patients at risk: can the beginning predict the end? Int Forum Allergy Rhinol. 2017;7(9):861–7. https://doi.org/10.1002/alr.21979.CrossRefPubMed

41.

De Corso E, Baroni S, Battista M, Romanello M, Penitente R, Di Nardo W, et al. Nasal fluid release of eotaxin-3 and eotaxin-2 in persistent sinonasal eosinophilic inflammation. Int Forum Allergy Rhinol. 2014;4:617–24. https://doi.org/10.1002/alr.21348.CrossRefPubMed

42.

De Corso E, Anzivino R, Galli J, Baroni S, Di Nardo W, De Vita C, et al. Antileukotrienes improve naso-ocular symptoms and biomarkers in patients with NARES and asthma. Laryngoscope. 2019;129(3):551–7. https://doi.org/10.1002/lary.27576.CrossRefPubMed

43.

Chawes BL. Upper and lower airway pathology in young children with allergic and non-allergic rhinitis. Dan Med Bull. 2011;58(5):B4278.PubMed

44.

Blair C, Nelson M, Thompson K, Boonlayangoor S, Haney L, Gabr U, et al. Allergic inflammation enhances bacterial sinusitis in mice. J Allergy Clin Immunol. 2001;108(3):424–9. https://doi.org/10.1067/mai.2001.117793.CrossRefPubMed

45.

Shin YH, Kim HS, Lee EK, Kim YJ, Lee HS, Jang PS, et al. Eosinophil related markers and total immunoglobulin E as a predictive marker for antibiotics response in chronic rhinosinusitis: a case-control study. Ann Saudi Med. 2015;35(4):312–7. https://doi.org/10.5144/0256-4947.2015.312.CrossRefPubMedPubMedCentral

46.

•• Mikolajczyk M, Janukowicz K, Majewska E, Baj Z. Impact of Allergic Rhinitis on Nasal Mucociliary Clearance Time in Children. Int Arch Allergy Immunol. 2019;179(4):297–303. https://doi.org/10.1159/000499740This is a case control study on a large series demonstrating that percentage of eosinophils in nasal smear was significantly higher in patients than controls. Accordingly muco-ciliary transport was significantly longer in allergic rhinitis patients than non-allergic ones.CrossRefPubMed

47.

Brożek-Mądry E, Chmielik LP, Gałązka A, Rogulska J, Frąckiewicz M, Biejat A. Chronic rhinosinusitis in children—bacteriological analysis in terms of cytological examination. Int J Pediatr Otorhinolaryngol. 2012;76(4):512–22. https://doi.org/10.1016/j.ijporl.2012.01.008.CrossRefPubMed

48.

Bachert C, Gevaert P, Van Cauwenberge P. Staphylococcus aureus enterotoxins: a key in airway disease? Allergy. 2002;57(6):480–7. https://doi.org/10.1034/j.1398-9995.2002.02156.x.CrossRefPubMed

49.

Philpott CM, Erskine S, Hopkins C, Kumar N, Anari S, Kara N, et al. Prevalence of asthma, aspirin sensitivity and allergy in chronic rhinosinusitis: data from the UK National Chronic Rhinosinusitis Epidemiology Study. Respir Res. 2018;19(1):129. https://doi.org/10.1186/s12931-018-0823-y.CrossRefPubMedPubMedCentral

50.

Del Gaudio JM, Loftus PA, Hamizan AW, Harvey RJ, Wise SK. Central compartment atopic disease. Am J Rhinol Allergy. 2017;31(4):228–34. https://doi.org/10.2500/ajra.2017.31.4443.CrossRef

51.

Sedaghat AR, Phipatanakul W, Cunningham MJ. Atopy and the development of chronic rhinosinusitis in children with allergic rhinitis. J Allergy Clin Immunol Pract. 2013;6(1):689–691.e2.CrossRef

52.

Tantimongkolsuk C, Pornrattanarungsee S, Chiewvit P, Visitsunthorn N, Ungkanont K, Vichyanond P. Pediatric sinusitis: symptom profiles with associated atopic conditions. J Med Assoc Thail. 2005;88(Suppl 8):S149–55.

53.

Chandy Z, Ference E, Lee JT. Clinical Guidelines on Chronic Rhinosinusitis in Children. Curr Allergy Asthma Rep. 2019;19(2):14. https://doi.org/10.1007/s11882-019-0845-7.CrossRefPubMed

54.

Brietzke SE, Shin JJ, Choi S, Lee JT, Parikh SR, Pena M, et al. Clinical consensus statement: pediatric chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2014;151(4):542–53. https://doi.org/10.1177/0194599814549302.CrossRefPubMed

55.

Sedaghat AR, Phipatanakul W, Cunningham MJ. Prevalence of and associations with allergic rhinitis in children with chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2014;78(2):343–7. https://doi.org/10.1016/j.ijporl.2013.12.006.CrossRefPubMed

56.

• Anamika A, Chakravarti A, Kumar R. Atopy and quality of life in pediatric chronic rhinosinusitis. Am J Rhinol Allergy. 2019;33(5):586–90. https://doi.org/10.1177/1945892419854266The authors demonstrated that atopic children with chronic rhinosinusitis had a significant higher mean Lund-Mackay endoscopic score and symptoms scores than non-atopic ones.CrossRefPubMed

57.

Huang SW. The risk of sinusitis in children with allergic rhinitis. Allergy Asthma Proc. 2000;21:85–8. https://doi.org/10.2500/108854100778250905.CrossRefPubMed

58.

Leo G, Piacentini E, Incorvaia C, Consonni D, Frati F. Chronic rhinosinusitis and allergy. Pediatr Allergy Immunol. 2007;18:19–21. https://doi.org/10.1111/j.1399-3038.2007.00626.x|.CrossRefPubMed

59.

Gelardi M, Marchisio P, Caimmi D, Incorvaia C, Albertario G, Bianchini S, et al. Pathophysiology, favoring factors, and associated disorders in otorhinosinusology. Pediatr Allergy Immunol. 2012;23:5–16. https://doi.org/10.1111/j.1399-3038.2012.01323.CrossRefPubMed

60.

Sedaghat AR, Phipatanakul W, Cunningham MJ. Characterization of aeroallergen sensitivities in children with allergic rhinitis and chronic rhinosinusitis. Allergy Rhinol (Providence). 2014;5(3) ar-2014. https://doi.org/10.2500/ar.2014.5.0102.

61.

Ramadan HH, Hinerman RA. Outcome of endoscopic sinus surgery in children with allergic rhinitis. Am J Rhinol. 2006;20(4):438–40. https://doi.org/10.2500/ajr.2006.20.2879.CrossRefPubMed

62.

Nathan RA, Santilli J, Rockwell W, Glassheim J. Effectiveness of immunotherapy for recurring sinusitis associated with allergic rhinitis as assessed by the Sinusitis Outcomes Questionnaire. Ann Allergy Asthma Immunol. 2004;92(6):668–72. https://doi.org/10.1016/S1081-1206(10)61435-4.CrossRefPubMed

63.

Kim HY, Dhong HJ, Chung SK, Chung YJ, Min JY. Prognostic factors of pediatric endoscopic sinus surgery. Int J Pediatr Otorhinolaryngol. 2005;69(11):1535–9. https://doi.org/10.1016/j.ijporl.2005.04.010.CrossRefPubMed

64.

El Sharkawy AA, Elmorsy SM, Eladl HM. Functional endoscopic sinus surgery in children: predictive factors of outcome. Eur Arch Otorhinolaryngol. 2012;269(1):107–11. https://doi.org/10.1007/s00405-011-1680-1.CrossRefPubMed

65.

Robinson S, Douglas R, Wormald PJ. The relationship between atopy and chronic rhinosinusitis. Am J Rhinol. 2006;20(6):625–8. https://doi.org/10.2500/ajr.2006.20.2907.CrossRefPubMed

66.

Lee TJ, Liang CW, Chang PH, Huang CC. Risk factors for protracted sinusitis in pediatrics after endoscopic sinus surgery. Auris Nasus Larynx. 2009;36(6):655–60. https://doi.org/10.1016/j.anl.2009.02.008.CrossRefPubMed

67.

• Wu PW, Huang CC, Yang SW, Huang Y, Huang CC, Chang PH, et al. Endoscopic sinus surgery for pediatric patients: prognostic factors related to revision surgery. Laryngoscope. 2020;130(4):1051–5. https://doi.org/10.1002/lary.28106The authors demonstrated that pediatric patients with positive aeroallergen tests had higher rates of CRS recurrence after ESS and required revision surgery.CrossRefPubMed

68.

Thorp BD, McKinney KA, Rose AS, Ebert CS. Allergic fungal sinusitis in children. Otolaryngol Clin N Am. 2012;45(3):631–42. https://doi.org/10.1016/j.otc.2012.03.003.CrossRef

69.

Patro SK, Verma RK, Panda NK, Chakrabarti A. Understanding paediatric allergic fungal sinusitis: is it more aggressive? Int J Pediatr Otorhinolaryngol. 2015;79(11):1876–80. https://doi.org/10.1016/j.ijporl.2015.08.032.CrossRefPubMed

Titel: Clinical Evidence and Biomarkers Linking Allergy and Acute or Chronic Rhinosinusitis in Children: a Systematic Review
verfasst von: Eugenio De Corso
Daniela Lucidi
Elena Cantone
Giancarlo Ottaviano
Tiziana Di Cesare
Veronica Seccia
Gaetano Paludetti
Jacopo Galli
Publikationsdatum: 01.11.2020
Verlag: Springer US
Erschienen in: Current Allergy and Asthma Reports / Ausgabe 11/2020
Print ISSN: 1529-7322
Elektronische ISSN: 1534-6315
DOI: https://doi.org/10.1007/s11882-020-00967-9

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

Abstract

Purpose of the Review

Recent Findings

Summary

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Purpose of the Review

Recent Findings

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