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Nasal hyperreactivity in rhinitis: A diagnostic and therapeutic challenge

机译:鼻炎中的鼻过度反应性:诊断和治疗挑战

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摘要

Abstract Although nasal hyperreactivity ( NHR ) is a common feature in patients suffering from allergic and nonallergic rhinitis, it is widely neglected during history taking, underdiagnosed in the majority of patients with rhinitis and rhinosinusitis, not considered as an outcome parameter in clinical trials on novel treatments for rhinitis and rhinosinusitis, and no target for routine treatment. In contrast to the simple nature of diagnosing NHR by a history of nasal symptoms induced by nonspecific exogenous and/or endogenous triggers, quantification is hardly performed in routine clinic given the lack of a simple tool for its diagnosis. So far, limited efforts have been invested into gaining better insight in the underlying pathophysiology of NHR , helping us to explain why some patients with inflammation develop NHR and others not. Of note, environmental and microbial factors have been reported to influence NHR , contributing to the complex nature of understanding the development of NHR . As a consequence of the neglect of NHR as a key clinical feature of rhinitis and chronic rhinosinusitis ( CRS ), patients with NHR might be suboptimally controlled and/or dissatisfied with current treatment. We here aim to provide a comprehensive overview of current knowledge on the pathophysiology, and the available tools to diagnose and treat NHR .
机译:摘要虽然鼻过血(NHR)是患有过敏性和非过敏性鼻炎的患者的常见特征,但在历史上被广泛忽视,在大多数鼻炎和鼻窦炎的大多数患者中都被视为小说临床试验中的结果参数鼻炎和鼻窦炎的治疗,没有常规治疗的目标。相反,由于非特异性外源和/或内源性触发器诱导的鼻腔症状历史诊断NHR的简单性,鉴于缺乏诊断工具缺乏简单的工具,在常规诊断中难以进行定量。到目前为止,有限的努力已经进入NHR的潜在病理生理学的更好的洞察力,帮助我们解释为什么一些炎症患者产生NHR等。据报道,据报道,环境和微生物因子会影响NHR,有助于了解NHR发展的复杂性。由于疏忽NHR作为鼻炎和慢性鼻窦炎(CRS)的关键临床特征,NHR的患者可能依赖于目前的治疗次偏见控制和/或不满意。我们在这里旨在全面概述当前关于病理物理学的知识,以及诊断和治疗NHR的可用工具。

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