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Gelardi M, Fiore V, Giancaspro R, Di Canio FM, Fiorentino C, Patruno S, Ruzza A, Cassano M. General classification of rhinopaties: the need for standardization according to etiology and nasal cytology. Eur Arch Otorhinolaryngol 2023; 280:4751-4758. [PMID: 37462742 PMCID: PMC10562500 DOI: 10.1007/s00405-023-08117-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/05/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Rhinitis is as an inflammation of the nasal mucosa, characterized by high prevalence, widespread morbidity, and a significant financial burden on health care systems. Nevertheless, it is often considered as no more than a mere annoyance. This point of view has progressively led to underestimate and trivialize the disease. Therefore, there are numerous, mostly overlapping classifications of rhinopaties, but clear and standardized guidelines for diagnosis and treatment are still lacking. In the context of Precision Medicine, the development of a classification system focused on the endotypes of rhinitis to be widely adopted appears of utmost importance, also by virtue of study of the nasal immunophlogosis that, thanks to nasal cytology (NC), has recently allowed to better define the different forms of rhinitis, giving a new nosological dignity to several rhinopaties. AIM We aimed to summarize the current knowledge regarding rhinitis and to propose a systematic classification of rhinitis, based on both etiology and cytological findings.
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Affiliation(s)
- M Gelardi
- Unit of Otolaryngology, Department of Clinical and Experimental Medicine, University of Foggia, Via Luigi Pinto 1, 71122, Foggia, Italy
| | - V Fiore
- Unit of Otolaryngology, Department of Clinical and Experimental Medicine, University of Foggia, Via Luigi Pinto 1, 71122, Foggia, Italy
| | - R Giancaspro
- Unit of Otolaryngology, Department of Clinical and Experimental Medicine, University of Foggia, Via Luigi Pinto 1, 71122, Foggia, Italy.
| | - F M Di Canio
- Unit of Otolaryngology, Department of Clinical and Experimental Medicine, University of Foggia, Via Luigi Pinto 1, 71122, Foggia, Italy
| | - C Fiorentino
- Unit of Otolaryngology, Department of Clinical and Experimental Medicine, University of Foggia, Via Luigi Pinto 1, 71122, Foggia, Italy
| | - S Patruno
- Unit of Otolaryngology, Department of Clinical and Experimental Medicine, University of Foggia, Via Luigi Pinto 1, 71122, Foggia, Italy
| | - A Ruzza
- Unit of Otolaryngology, Department of Clinical and Experimental Medicine, University of Foggia, Via Luigi Pinto 1, 71122, Foggia, Italy
| | - M Cassano
- Unit of Otolaryngology, Department of Clinical and Experimental Medicine, University of Foggia, Via Luigi Pinto 1, 71122, Foggia, Italy
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Finocchio E, Locatelli F, Sanna F, Vesentini R, Marchetti P, Spiteri G, Antonicelli L, Battaglia S, Bono R, Corsico AG, Ferrari M, Murgia N, Pirina P, Olivieri M, Verlato G. Gastritis and gastroesophageal reflux disease are strongly associated with non-allergic nasal disorders. BMC Pulm Med 2021; 21:53. [PMID: 33557802 PMCID: PMC7869508 DOI: 10.1186/s12890-020-01364-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/30/2020] [Indexed: 01/10/2023] Open
Abstract
Background Gastroesophageal reflux disease (GERD) has been reported to be significantly associated with chronic rhinosinusitis, but the strength of the association is still debated. Aims To evaluate the strength of the association between gastritis/GERD and non-allergic rhinitis (NAR)/allergic rhinitis (AR)/sinusitis. Methods We investigated 2887 subjects aged 20–84 years, who underwent a clinical visit in seven Italian centres (Ancona, Palermo, Pavia, Terni, Sassari, Torino, Verona) within the study on Gene Environment Interactions in Respiratory Diseases, a population-based multicase-control study between 2008 and 2014. Subjects were asked if they had doctor-diagnosed “gastritis or stomach ulcer (confirmed by gastroscopy)” or “gastroesophageal reflux disease, hiatal hernia or esophagitis”. The association between NAR/AR/sinusitis and either gastritis or GERD was evaluated through relative risk ratios (RRR) by multinomial logistic regression. Results The prevalence of gastritis/GERD increased from subjects without nasal disturbances (22.8% = 323/1414) to subjects with AR (25.8% = 152/590) and further to subjects with NAR (36.7% = 69/188) or sinusitis (39.9% = 276/691). When adjusting for centre, sex, age, education level, BMI, smoking habits and alcohol intake, the combination of gastritis and GERD was associated with a four-fold increase in the risk of NAR (RRR = 3.80, 95% CI 2.56–5.62) and sinusitis (RRR = 3.70, 2.62–5.23) with respect to controls, and with a much smaller increase in the risk of AR (RRR = 1.79, 1.37–2.35).. Conclusion The study confirmed the association between gastritis/GERD and nasal disturbances, which is stronger for NAR and sinusitis than for AR.
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Affiliation(s)
- Eliana Finocchio
- Section of Epidemiology and Medical Statistics, Department of Diagnostic and Public Health, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Francesca Locatelli
- Section of Epidemiology and Medical Statistics, Department of Diagnostic and Public Health, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Francesca Sanna
- Section of Epidemiology and Medical Statistics, Department of Diagnostic and Public Health, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Roberta Vesentini
- Section of Epidemiology and Medical Statistics, Department of Diagnostic and Public Health, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Pierpaolo Marchetti
- Section of Epidemiology and Medical Statistics, Department of Diagnostic and Public Health, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Gianluca Spiteri
- Unit of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Leonardo Antonicelli
- Department of Internal Medicine Ospedali Riuniti Ancona, Via Conca, 71, 60126, Ancona, Italy
| | | | - Roberto Bono
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126, Torino, Italy
| | - Angelo Guido Corsico
- Department of Internal Medicine and Medical Therapy, University of Pavia, Palazzo Botta, 10, 27100, Pavia, Italy
| | - Marcello Ferrari
- Unit of Respiratory Diseases, Department of Medicine, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Piazza dell'Università, 1, 06123, Perugia, Italy
| | - Pietro Pirina
- Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Piazza Università, 21, 07100, Sassari, Italy
| | - Mario Olivieri
- Unit of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Giuseppe Verlato
- Section of Epidemiology and Medical Statistics, Department of Diagnostic and Public Health, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy.
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