Inflammatory characterization of different non-allergic rhinitis in patients attending tertiary care hospital


  • Ashish Sharma Department of ENT, MNR Medical College and Hospital, Sangareddy, Telangana, India
  • Nagababu Pyadala Department of Biochemistry, MNR Medical College and Hospital, Sangareddy, Telangana, India



Allergic rhinitis, Eosinophil level, Non-allergic rhinitis


Background: Non-allergic rhinitis is a chronic inflammation of nasal cavity, which can be classified based on the level of eosinophil. Thus, the present study aimed to characterize the various types of non-allergic rhinitis.

Methods: This study conducted during the period of 1 year from April 2019 to February 2020 in the ENT department of MNR Medical College and Hospital, Sangareddy. A total of 60 participants were enrolled in this study.  

Results: In case of non-allergic rhinitis, the nasal IL-17 level was 27.31±5.1, IL-4 level was 44.24±21.31, as well as serum IL-4 and IL-17 level was 50.1 and 31.06 respectively. The control group IL-4 and IL-17 level were respectively less (p<0.05). But the IL-10 level (3.7) and proportion of tregs in peripheral blood (5.2) were lower than the control group (p<0.05). There was no significant difference found between the non-allergic rhinitis group and allergic rhinitis group or the non-allergic rhinitis without eosinophilia group and the control group (p>0.05).

Conclusions: Hence, the non-allergic rhinitis was classified on the basis of eosinophil level, allergic rhinitis and NARES had similar kind of inflammatory response, but two different types of non-allergic rhinitis had different inflammatory characteristics. Therefore, it is recommended to classify the rhinitis on the basis of eosinophil level.

Author Biographies

Ashish Sharma, Department of ENT, MNR Medical College and Hospital, Sangareddy, Telangana, India



Nagababu Pyadala, Department of Biochemistry, MNR Medical College and Hospital, Sangareddy, Telangana, India




Pilette C, Jacobson MR, Ratajczak C, Detry B, Banfield G, VanSnick J, et al. Aberrant dendritic cell function conditions Th2-cell polarization in allergic rhinitis. Allergy. 2013;68:312-21.

Cheng X, Lou W, Wang C, Zhang W, Han D, Zhang L. FOXP3-marked IL-17a-producing regulatory T cells are increased in patients with allergic rhinitis. Acta Otolaryngol. 2012;132:1311-7.

Crobach M, Hermans J, Kaptein A, Ridderikhoff J, Mulder J. Nasal smear eosinophilia for the diagnosis of allergic rhinitis and eosinophilic non-allergic rhinitis. Scand J Prim Health Care. 1996;14:116-21.

Powe DG, Bonnin AJ, Jones NS. ‘Entopy’: local allergy paradigm. Clin Exp Allergy. 2010;40:987-97.

Rondon C, Dona I, Torres MJ, Campo P, Blanca M. Evolution of patients with nonallergic rhinitis supports conversion to allergic rhinitis. J Allergy Clin Immunol. 2009;123:1098-102.

Vignali DA. Multiplexed particle-based flow cytometric assays. J Immunol Methods. 2000;243:243-55.

Riechelmann H, Deutschle T, Friemel E, Gross HJ, Bachem M. Biological markers in nasal secretions. Eur Respir J. 2003;21:600-5.

Canakcioglu S, Tahamiler R, Saritzali G, Alimoglu Y, Isildak H, Guvenc MG, et al. Evaluation of nasal cytology in subjects with chronic rhinitis: a 7-year study. Am J Otolaryngol. 2009;30:312-7.

Wang ZY, Jiang MJ, Zhang Y, Cheng Y, Pang XJ, Xie YQ, et al. Classification of non-allergic rhinitis based on inflammatory characteristics. Int J Clin Exp Med. 2015;8:17523-9.

Wakashin H, Hirose K, Maezawa Y, Kagami S, Suto A, Watanabe N, et al. IL-23 and Th17 cells enhance Th2-cellmediated eosinophilic airway inflammation in mice. Am J Respir Crit Care Med. 2008;178:1023-32.

Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, et al. Joint task force on practice; American academy of allergy; asthma and immunology; American college of allergy; asthma and immunology; joint council of allergy, asthma and immunology. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008;122:S1-S84.

Zhang Y, Wang Q, Xie Y, Wang Z, Li D, Ma L, et al. The normative value of inflammatory cells in the nasal perfusate of Chinese adults: a pilot study. J Thorac Dis. 2014;6:905-12.

Carney AS, Powe DG, Huskisson RS, Jones NS. Atypical nasal challenges in patients with idiopathic rhinitis: more evidence for the existence of allergy in the absence of atopy? Clin Exp Allergy. 2002;32:1436-40.

Rondón C, Doña I, López S, Campo P, Romero JJ, Torres MJ, et al. Seasonal idiopathic rhinitis with local inflammatory response and specific IgE in absence of systemic response. Allergy. 2008;63:1352-8.

Shaaban R, Zureik M, Soussan D, Neukirch C, Heinrich J, Sunyer J, et al. Rhinitis and onset of asthma: a longitudinal population-based study. Lancet. 2008;372:1049-57.

Greiner AN, Hellings PW, Rotiroti G, Scadding GK. Allergic rhinitis. Lancet. 2011;378:2112-22.

Amin K, Lúdvíksdóttir D, Janson C, Nettelbladt O, Björnsson E, Roomans GM, et al. Inflammation and structural changes in the airways of patients with atopic and nonatopic asthma. BHR Group. Am J Respir Crit Care Med. 2000;162:2295-301.

Wang ZY, Jiang MJ, Wu MH, Zhang Y, Chen W, Zhu MH, et al. Inflammatory characteristics in different types of nonallergic rhinitis. Int J Clin Exp Pathol. 2017;10(3):2887-94.






Original Research Articles