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.