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Purpose of Review <p>This review aims to provide a comprehensive summary of the pathophysiology, clinical presentation, diagnosis, and treatment of non-allergic rhinitis with eosinophilia syndrome (NARES), incorporating the most recent data with a particular emphasis on the underlying immunological mechanisms for disease pathogenesis.</p> Recent Findings <p>The pathophysiology of NARES is marked by eosinophil-driven chronic inflammation and tissue damage, potentially secondary to the effects of eosinophilic cationic protein (ECP) and Charcot-Leyden crystal (CLC) protein. Elevated levels of mast cells, and type 2 cytokines have been found in a subset of these patients without evidence of systemic atopy. Elevated IL-17 indicates a possible role for neutrophils in the disease process, although its precise role is yet to be fully elucidated. Diagnosis relies on detecting nasal eosinophilia, typically through nasal scraping of the inferior turbinate, with emerging biomarkers like Cystatin SN possibly improving accuracy. Treatment primarily involves intranasal corticosteroids, with combination therapy with antihistamines or montelukast monotherapy providing additional options.</p> Summary <p>NARES represents a subset of non-allergic rhinitis characterized by severe, chronic naso-ocular symptoms. Despite recent advances in the understanding NARES, further research is needed to elucidate its immunological mechanisms, standardize diagnostic criteria, and optimize treatment strategies.</p>

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An Updated Review of Non-Allergic Rhinitis with Eosinophilia Syndrome

  • 期刊论文

  • 发表日期：

    2025年3月13日

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  • Sophie E. Yu,
  • Margaret B. Mitchell,
  • Mitali Banerjee,
  • Chloe B. Warinner,
  • Simon Chiang,
  • Stella E. Lee

摘要

Purpose of Review

This review aims to provide a comprehensive summary of the pathophysiology, clinical presentation, diagnosis, and treatment of non-allergic rhinitis with eosinophilia syndrome (NARES), incorporating the most recent data with a particular emphasis on the underlying immunological mechanisms for disease pathogenesis.

Recent Findings

The pathophysiology of NARES is marked by eosinophil-driven chronic inflammation and tissue damage, potentially secondary to the effects of eosinophilic cationic protein (ECP) and Charcot-Leyden crystal (CLC) protein. Elevated levels of mast cells, and type 2 cytokines have been found in a subset of these patients without evidence of systemic atopy. Elevated IL-17 indicates a possible role for neutrophils in the disease process, although its precise role is yet to be fully elucidated. Diagnosis relies on detecting nasal eosinophilia, typically through nasal scraping of the inferior turbinate, with emerging biomarkers like Cystatin SN possibly improving accuracy. Treatment primarily involves intranasal corticosteroids, with combination therapy with antihistamines or montelukast monotherapy providing additional options.

Summary

NARES represents a subset of non-allergic rhinitis characterized by severe, chronic naso-ocular symptoms. Despite recent advances in the understanding NARES, further research is needed to elucidate its immunological mechanisms, standardize diagnostic criteria, and optimize treatment strategies.