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Publications

Journal Article Epublish

PubMed: 42328578 DOI: 10.3389/fmed.2026.1824028

Allergic rhinitis and nasal septum deviation in children: cause, consequence, or bidirectional relationship? Insights from the ARHINASD study.

Front Med (Lausanne) 13:1824028

Authors: Laura Carucci, Rita Nocerino, Elena Cantone, Francesco Berni Canani, Margherita Licito, Luciano La Marca, Margherita Farnetano, Antonio Masino, Franca Oglio, Dario Marziali, Serena Coppola, Roberto Berni Canani

Affiliations

  • Department of Translational Medical Science, University Federico II, Naples, Italy.
  • ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy.
  • Department of Neuroscience, Reproductive Science and Odontostomatology, University Federico II, Naples, Italy.
  • ENT Section, Department of Pharmacy and Health and Nutrition Sciences, University of Calabria, Calabria, Italy.
  • ENT Unit, Annunziata Hospital, Cosenza, Italy.
  • Otorhinolaryngology Unit, Penne and Popoli Hospitals, ASL of Pescara, Pescara, Italy.
  • Internal Medicine Kantonsspital Graubuenden, Chur, Switzerland.
  • European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy.
  • NutriTechLab, University Federico II, Naples, Italy.

Abstract

BACKGROUND

Allergic rhinitis (AR) is one of the most common allergic conditions in children. Nasal septum deviation (NSD) is observed in nearly 34% of the pediatric population and is characterized by reduced nasal airflow and mucosal inflammation. While NSD and AR can coexist, the potential relationship between the two conditions remains largely unexplored. Here, we present the baseline data from the Allergic Rhinitis in pediatric subjects with Nasal Septum Deviation (ARHINASD) study, which investigates the relationship between NSD and AR in children.

METHODS

A multicenter, prospective study was conducted involving 138 participants aged 6-14 years with (NSD+, n = 69) or without NSD (NSD-, n = 69). AR diagnosis and sensitization, nasal endoscopy and cytology, nasal fluid cytokines, nasal airflow (nasal peak inspiratory flow, NPIF), and nasal obstruction (visual analog scale, VAS) were evaluated in all participants.

RESULTS

The prevalence of AR was significantly higher in NSD+ children than in NSD- children (66.7% vs. 36.2%; p < 0.0001). A multivariable logistic regression analysis showed that NSD was independently associated with AR (aOR 3.51, 95% CI 1.65-7.47; p = 0.001), along with a family history of allergy (aOR 2.49, 95% CI 1.01-6.16; p = 0.048). NSD+ children experienced more severe AR, with higher VAS scores, median (interquartile range, IQR) [7(3.5) vs. 2(4), p < 0.05] and lower NPIF values [40(30) vs. 60(40) L/min, p < 0.05]. NSD+ children had higher eosinophil counts and increased levels of IL-4, IL-5, and eosinophil cationic protein (ECP) in the nasal fluid compared to NSD- children (p < 0.05).

CONCLUSION

The findings suggest a higher prevalence of AR among NSD children. NSD may negatively influence the disease course of AR. Early identification and management of NSD may improve AR outcomes and reduce the overall disease burden. Longitudinal studies are needed to confirm causality and to explore preventive strategies.

MeSH

Rhinitis, Allergic, Eosinophils, Nasal Septum, Prevalence, Rhinitis, Child