Rhinitis Phenotypes Based on Multimorbidities.

Area of Science:

• Upper airway diseases
• Immunology
• Allergology

Background:

• Chronic rhinitis, encompassing allergic and nonallergic types, is prevalent and often co-occurs with asthma.
• Current understanding suggests rhinitis and asthma may represent distinct disease entities rather than a single airway condition.
• Associated conditions like atopic dermatitis, food allergy, and allergic conjunctivitis complicate the disease concept, suggesting a
• multimorbid allergic disease
• framework is more fitting than
• one-airway-one-disease
• .

Purpose of the Study:

• To differentiate between rhinitis alone and the combined condition of rhinitis plus asthma.
• To investigate the relationship between rhinitis, asthma, and other atopic conditions.
• To characterize distinct disease phenotypes within upper airway disorders.

Main Methods:

• Analysis of clinical data and epidemiological studies.
• Utilizing mobile health (mHealth) applications, such as MASK-air, for data collection across multiple countries.
• Genomic approaches and meta-analysis of existing research.

Main Results:

• Evidence supports the existence of two distinct diseases: rhinitis alone and rhinitis plus asthma (allergic or nonallergic).
• Atopic dermatitis showed a strong association with rhinitis but not with the combination of rhinitis and asthma.
• The distinction between rhinitis alone and rhinitis plus asthma was consistent across 12 countries, independent of allergen exposure.

Conclusions:

• Rhinitis alone and rhinitis plus asthma are distinct upper airway diseases.
• The concept of
• multimorbid allergic disease
• better reflects the complexity of these conditions.
• Disease classification should consider these distinct phenotypes for accurate diagnosis and management.