Key message
In this review, we describe novel aspects of pediatric rhinitis, from mechanisms to phenotypes, diagnostic and monitoring tools, and the use of treatments, focusing on the traits of pediatric age groups.
Type 2 innate lymphoid cells and defective Treg cells may play a critical role in the pathogenesis of AR. Recent studies have identified the neural pathways and mediators implicated in nasal hyperreactivity in children, after exposure to environmental factors (pollutants, viruses, allergens). Local allergic rhinitis is present and probably underdiagnosed in pediatric populations. Polysensitization to inhalant allergens is associated with multimorbidity of allergy-associated diseases.
Personalized management of allergic rhinitis relies on the proper assessment of disease control, a combination of multiple measurable parameters with patient-reported outcomes, especially when validated for children, being quite valuable. E-Health applications are revolutionizing healthcare services, but data on their impact on pediatric allergic diseases are scarce.
Second-generation antihistamines for mild and intranasal corticosteroids for moderate-to-severe cases are the mainstay of allergic rhinitis treatment in children. Data from real-world studies have confirmed that allergen immunotherapy can prevent the occurrence of asthma in both adults and children with ΑR. The need for global policies to mitigate pollution and climate change is more relevant than ever.