慢性非过敏性鼻炎综合征包括各种疾病,其中血管运动性鼻炎是最常见的形式,代表大约80%的患者,也称为非过敏性鼻病(NAR),鼻腔高反应性,神经性鼻炎,或者特发性鼻炎.专家小组建议替换血管运动性鼻炎术语,因为它更多地描述了这种情况,其特征是由化学刺激物和天气变化通过化学传感器触发的症状,机械传感器,温度传感器,和/或通过不同的瞬时受体电位钙离子通道激活的渗透传感器。阐明辣椒素引发的瞬时受体电位香草酸1的特定作用,在更好地理解NAR的病理生理学方面取得了重要进展,因为现在已经表明,几种治疗性化合物对瞬时受体电位香草素1受体的下调可以缓解这种情况。NAR的分类因其与变应性鼻炎(称为混合鼻炎)的关联而进一步复杂化。涉及免疫球蛋白E介导的和神经源性的机制途径。与NAR相关的合并症,包括鼻窦炎,头痛,哮喘,慢性咳嗽,和睡眠障碍,强调全面管理的必要性。NAR的治疗方案包括环境干预,药物治疗,在难治性病例中,手术选择,强调需要为每个患者量身定制的方法。因此,准确诊断NAR极为重要,因为不适当的治疗会导致不良的临床结局,并给这些患者带来不必要的医疗保健和经济负担.这篇综述提供了NAR亚型的全面概述,注重分类,诊断,和NAR的治疗方法。
Chronic nonallergic rhinitis syndromes encompass various conditions, of which vasomotor rhinitis is the most common form, representing approximately 80% of patients, also referred to as nonallergic rhinopathy (NAR), nasal hyperreactivity, neurogenic rhinitis, or idiopathic rhinitis. Expert panels have recommended replacing vasomotor rhinitis terminology because it is more descriptive of this condition that is characterized by symptoms triggered by chemical irritants and weather changes through chemosensors, mechanosensors, thermosensors, and/or osmosensors activated through different transient receptor potential calcium ion channels. Elucidating the specific role of transient receptor potential vanilloid 1, triggered by capsaicin, has been an important advancement in better understanding the pathophysiology of NAR because it has now been shown that downregulation of transient receptor potential vanilloid 1 receptors by several therapeutic compounds provides symptomatic relief for this condition. The classification of NAR is further complicated by its association with allergic rhinitis referred to as mixed rhinitis, which involves both immunoglobulin E-mediated and neurogenic mechanistic pathways. Comorbidities associated with NAR, including rhinosinusitis, headaches, asthma, chronic cough, and sleep disturbances, underscore the need for comprehensive management. Treatment options for NAR include environmental interventions, pharmacotherapy, and in refractory cases, surgical options, emphasizing the need for a tailored approach for each patient. Thus, it is extremely important to accurately diagnose NAR because inappropriate therapies lead to poor clinical outcomes and unnecessary health care and economic burdens for these patients. This review provides a comprehensive overview of NAR subtypes, focusing on classification, diagnosis, and treatment approaches for NAR.