Clinical and laboratory evidence linking allergy and acute or chronic rhinosinusitis in children.

Background: allergic rhinitis is a common childhood disease in industrialized countries that is responsible for a major impact on quality of life and health care resources.The objective of this review was to provide a systemic review of experimental and clinical evidence linking allergy to rhinosinusitis in children including common cold.Furthermore, we questioned if antiallergy treatment may prevent the occurrence of rhinosinusitis or improve outcomes of its specific management.Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process to identify experimental and clinical articles about allergy and acute or chronic rhinosinusitis in children published since January 2000.The research was performed in April 2020 including only English-language peer-reviewed papers.Our search yielded 7103 that were finally screened.This resulted in 30 publications of which the full texts were assessed and included in a qualitative analysis per different phenotypes of rhinosinusitis.Results: The evidence suggests that allergy may lead to overall impairment of mechanical and immunological defense function of the nasal mucosa against viruses and that antiallergy treatment may significantly decrease the number and severity of upper respiratory tract infections including common colds in children.It was not possible to perform the analysis for allergy and post viral acute rhinosinusitis, bacterial acute rhinosinusitis and recurrent acute rhinosinusitis because of paucity and heterogeneity of data.We found interesting data linking allergy to chronic rhinosinusitis: although there is no definitive proof of causation studies lead to suppose that anti-allergy treatment may improve outcomes of specific CRS treatments.Conclusion: We summarized conclusions in a practical algorithm taking into account different phenotypes of rhinosinusitis in order to elucidate when prompt and accurate diagnosis of allergy is recommended.We lastly focused attention on the needs for future research. INTRODUCTION.Allergic rhinitis (AR) in children has a significant impact on global quality of life, including school performance, sleep disorders, and emotional health (2) .Furthermore, over the years many authors tried to correlate allergy with comorbidities and in particular to the onset of rhinosinusitis including common cold, even though conflicting results are frequently reached.AR is a nasal mucosa inflammatory condition caused by environmental allergens interacting with immunoglobulin (Ig) E in sensitized subjects.Repeated exposure may lead to long-term changes in systemic