Roles of Metabolomics in Allergic Rhinitis: From Cell to Bedside Investigations

Alterations in various metabolic pathways observed in patients with allergies suggest that metabolomics offer a precise and comprehensive approach for the diagnosis of allergic diseases and the monitoring of the efficacy of allergen immunotherapy. The purpose of this review is to provide a comprehensive assessment of the existing evidence regarding metabolomic changes in allergic rhinitis and allergen immunotherapy. The PubMed database search was conducted from inception to December 2025. A narrative synthesis was performed. A total of 16 studies were included. Several metabolic pathways are affected in allergic rhinitis, including amino acid metabolism, fatty acid oxidation, and phospholipid metabolism. Additionally, fatty acids, diacylglycerols, and lysophosphatidylcholines have emerged as potential diagnostic and severity biomarkers for allergic rhinitis. Allergen immunotherapy has also been shown to modulate these metabolic disturbances. Notably, arachidonic acid, linolenic acid, and sphingosine may serve as indicators of therapeutic efficacy. In conclusion, AR is characterized by distinct metabolic alterations and mainly associated with alterations in lipid metabolism. AIT has been shown to modulate metabolic disturbances in AR. Future research should focus on integrating metabolomics with clinical and other molecular approaches to enhance clinical applicability in AR.