Frontiers in immunology · 2026
Local immune and inflammatory endotypes of the nasal mucosa in allergic and non-allergic chronic rhinitis.
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Ma Zhancheng, Wu Cuiling
Аннотация
BACKGROUND: Allergic rhinitis (AR) and non-allergic rhinitis (NAR) are the main forms of chronic rhinitis with distinct pathogenesis. Endotype analysis based on nasal mucosal immune markers may facilitate precision medicine.
OBJECTIVE: To compare inflammatory profiles and identify endotypes in AR and NAR through local immune marker detection and correlation analysis.
METHODS: This retrospective study enrolled chronic rhinitis patients (January 2023-June 2025) divided into three groups: AR group [ARG, n=40, positive skin prick test and/or serum specific IgE (sIgE)], NAR group (NARG, n=40, negative allergy tests), and control group (CG, n=20). Primary measures: nasal eosinophil (EOS) and neutrophil (NEU) counts, sIgE and eosinophil cationic protein (ECP), Th2 cytokines, NEU-related mediators, and immune cell subsets.
RESULTS: ARG showed significantly higher EOS count, sIgE, ECP, interleukin-5 (IL-5), interleukin-13 (IL-13), and EOS% than NARG and CG. NARG exhibited significantly higher NEU count, interleukin-8 (IL-8), interleukin-1β (IL-1β), and NEU% (P < 0.01). Correlation analysis revealed moderate to strong positive correlations among Th2 markers in ARG and among NEU markers in NARG, with ECP also correlated to EOS in NARG (all P < 0.05).
CONCLUSION: AR exhibits a Th2-dominant inflammatory network involving eosinophils, IgE, and Th2 cytokines rather than eosinophils alone, while NAR displays a NEU-mediated pattern with a subset showing eosinophilic activation. Multi-marker detection in nasal secretions effectively differentiates inflammatory endotypes in chronic rhinitis.
SIGNIFICANCE & INNOVATION: This study identified a synergistic Th2 network in AR and a NEU-dominant pattern in NAR via nasal secretion analysis, providing evidence for endotype identification and precision therapy.
OBJECTIVE: To compare inflammatory profiles and identify endotypes in AR and NAR through local immune marker detection and correlation analysis.
METHODS: This retrospective study enrolled chronic rhinitis patients (January 2023-June 2025) divided into three groups: AR group [ARG, n=40, positive skin prick test and/or serum specific IgE (sIgE)], NAR group (NARG, n=40, negative allergy tests), and control group (CG, n=20). Primary measures: nasal eosinophil (EOS) and neutrophil (NEU) counts, sIgE and eosinophil cationic protein (ECP), Th2 cytokines, NEU-related mediators, and immune cell subsets.
RESULTS: ARG showed significantly higher EOS count, sIgE, ECP, interleukin-5 (IL-5), interleukin-13 (IL-13), and EOS% than NARG and CG. NARG exhibited significantly higher NEU count, interleukin-8 (IL-8), interleukin-1β (IL-1β), and NEU% (P < 0.01). Correlation analysis revealed moderate to strong positive correlations among Th2 markers in ARG and among NEU markers in NARG, with ECP also correlated to EOS in NARG (all P < 0.05).
CONCLUSION: AR exhibits a Th2-dominant inflammatory network involving eosinophils, IgE, and Th2 cytokines rather than eosinophils alone, while NAR displays a NEU-mediated pattern with a subset showing eosinophilic activation. Multi-marker detection in nasal secretions effectively differentiates inflammatory endotypes in chronic rhinitis.
SIGNIFICANCE & INNOVATION: This study identified a synergistic Th2 network in AR and a NEU-dominant pattern in NAR via nasal secretion analysis, providing evidence for endotype identification and precision therapy.