Daijiworld Media Network - New York
New York, Jul 25: A five-year prospective study has identified key clinical and immunological markers that could help predict which preschool children with chronic rhinosinusitis (CRS) are at risk of developing persistent disease and house dust mite (HDM)-induced allergic rhinitis.
The study tracked 133 children aged between four and eight years who had symptoms of CRS, with or without IgE-mediated sensitisation to HDM. A total of 117 children completed the five-year follow-up.
Researchers found that CRS persisted in 35% of the participants. Children with more severe symptoms at preschool age were significantly more likely to continue experiencing the condition during their school years. Those with a baseline Sinus and Nasal Quality of Life Survey (SN-5) score above 3.6 had more than three times the likelihood of persistent CRS compared to children with lower scores (OR 3.41; 95% CI 1.50–7.76).
The study also identified an immunological indicator linked to long-term disease. Group 2 innate lymphoid cells (ILC-2s), which are associated with type 2 inflammation, were found more frequently in nasal samples of children whose CRS persisted throughout the study period.
Researchers further examined factors associated with the later development of HDM-induced allergic rhinitis. A history of food allergy during infancy was independently linked to nearly a fourfold higher risk of developing HDM allergy (OR 3.87; 95% CI 1.10–13.60).
Similarly, children whose allergy-related symptoms accounted for at least 21% of their baseline SN-5 score were almost four times more likely to be diagnosed with HDM-induced allergic rhinitis during follow-up (OR 3.96; 95% CI 1.20–13.10).
The study found that combining these clinical indicators improved the ability to predict HDM allergy, suggesting that readily available clinical information may help identify children at greater risk before they reach school age.
The researchers concluded that assessing symptom severity alongside immune and allergy-related factors could enable earlier identification of children at risk of persistent CRS and HDM allergy. They noted that early recognition may support timely initiation of allergen immunotherapy in suitable patients, although further studies are needed to validate the predictive model.