Summary of reported effect of endogenous and exogenous factors on either rhinitis or rhinosinusitis
| Rhinitis | Rhinosinusitis | |
|---|---|---|
| Endogenous factors | ||
| Genetic factors | Allergic rhinitis: SNPs in genes coding for leucotrienes, chemokines, chemokine receptors, cytokines, TLRs4 5 Non-allergic rhinitis: SNPs in genes coding for Cfos and Cdc2426 | CRS with nasal polyps: SNPs in genes coding for TGF-β1, iNOS, PARS2, IL-1α, IL-33, genes related to eosinophilia2 |
| Immune deficiencies | Primary humoral immune deficiencies: increased prevalence of chronic upper airway disease (specific, common variable and SPAD)2 Secondary immune deficiencies: difficult-to-treat rhinosinusitis with resistant or uncommon microorganisms12 | |
| Hormones | Pregnancy rhinitis18 Anecdotal reports linking rhinitis to hypothyroidism and acromegaly20 | Anecdotal reports linking rhinosinusitis to hypothyroidism20 |
| Systemic diseases | Sarcoidosis25 | Difficult-to-treat CRS in Churg–Strauss syndrome24 Granulomatosis with polyangiitis22 Sarcoidosis25 |
| Psychological factors | Increased prevalence of allergic rhinitis in persons who experienced stressful life events26 27 Increased risk of developing upper airway infection in subjects with psychological stress31 | |
| Exogenous factors | ||
| Viruses | Common cold | ARS2 |
| Bacteria | Staphylococcus aureus colonisation is increased in allergic rhinitis47 | Superinfection of viral ARS70 CRS with nasal polyps: increased colonisation with S. aureus and increased IgE towards S. aureus enterotoxins47 |
| Fungi | Can cause allergic sensitisation | Mycetoma or fungal ball (one sinus) AFRS (multiple sinuses)50 Granulomatous and chronic invasive FRS in immunocompromised patients49 |
| Allergens | Cause of allergic rhinitis1 | Increased prevalence of CRS in atopic patients56 |
| Occupational agents | Allergic rhinitis to HMW allergens Allergic rhinitis to LMW sensitisers Irritant-induced rhinitis | Increased occupational exposure in FESS-requiring CRS patients56 |
| Cigarette smoke | Active and passive smoking increase the risk of developing rhinitis61 | Higher prevalence of CRS in smokers62 |
| Pollution and DEP | DEP aggravate pre-existing rhinitis68 | Weak association between pollution and prevalence of CRS69 |
ARS, acute rhinosinusitis; CRS, chronic rhinosinusitis; DEP, diesel exhaust particles; FESS, functional endoscopic sinus surgery; FRS, fungal rhinosinusitis; HMW, high molecular weight; IL, interleukin; iNOS, inducible nitric oxide synthase; LMW, low molecular weight; SNP, single nucleotide polymorphism; SPAD, specific polysaccharide antibody deficiency syndrome; TGF, transforming growth factor; TLR, Toll-like receptor.