Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2LEN paper

Authors

  • J. Bousquet,

    1. University Hospital and INSERM, Montpellier, France
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • W. Fokkens,

    1. Department of Otorhinolaryngology, University of Amsterdam, the Netherlands
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • P. Burney,

    1. National Heart and Lung Institute, Imperial College, Respiratory Epidemiology and Public Health, London, UK
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • S. R. Durham,

    1. National Heart and Lung Institute, Imperial College, London, UK
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • C. Bachert,

    1. URL, University Hospital Ghent, Belgium
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • C. A. Akdis,

    1. Swiss Institute of Allergy and Asthma Research (SIAF), Davos, Switzerland
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • G. W. Canonica,

    1. Allergy & Respiratory Diseases, Deprtment of Internal Medicine, University of Genoa, Genoa, Italy
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • S.-E. Dahlen,

    1. Karolinska Institutet, Stockholm, Sweden
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • T. Zuberbier,

    1. Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • T. Bieber,

    1. Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • S. Bonini,

    1. Second University of Naples, INMM-CNR, Rome, Italy
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • P. J. Bousquet,

    1. University Hospital and INSERM, Montpellier, France
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • J. L. Brozek,

    1. Department of Epidemiology, CLARITY Research Group, Italian National Cancer Institute “Regina Elena”, Rome, Italy
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • L.-O. Cardell,

    1. Division of ENT Diseases, Institution for Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • R. Crameri,

    1. Swiss Institute of Allergy and Asthma Research (SIAF), Davos, Switzerland
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • A. Custovic,

    1. University of Manchester, Manchester, UK
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • P. Demoly,

    1. University Hospital and INSERM, Montpellier, France
    2. INSERM U657, Montpellier, France
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • R. G. Van Wijk,

    1. Erasmus MC, Rotterdam, the Netherlands
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  • M. Gjomarkaj,

    1. Consiglio Nazionale delle Ricerche CNR, Istituto di Biomedicina e Immunologia Molecolare, Palermo, Italy
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • C. Holland,

    1. Department of Otorhinolaryngology, University of Amsterdam, the Netherlands
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • P. Howarth,

    1. Division of Infection, Inflammation Repair School of Medicine, Southampton University, Southampton, UK
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • M. Humbert,

    1. Université Paris-Sud, Service de Pneumologie, Hôpital Antoine-Béclère, Clamart, France
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  • S. L. Johnston,

    1. National Heart and Lung Institute, Imperial College, London, UK
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • F. Kauffmann,

    1. INSERM U780, Villejuif, France
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • M. L. Kowalski,

    1. Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Lodz, Poland
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • B. Lambrecht,

    1. URL, University Hospital Ghent, Belgium
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • S. Lehmann,

    1. University Hospital and CNRS, Montpellier, France
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  • B. Leynaert,

    1. INSERM U700, Paris, France
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • K. Lodrup-Carlsen,

    1. Department of Paediatrics, Ullevål University Hospital and The Faculty of Medicine, University of Oslo, Oslo, Norway
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • J. Mullol,

    1. ENT Department, Hospital Clínic, IDIBAPS, Barcelona, Catalunya, Spain
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • B. Niggemann,

    1. German Red Cross Hospital, Berlin, Germany
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  • E. Nizankowska-Mogilnicka,

    1. Department of Pulmonary Diseases, Jagiellonian University School of Medicine, Krakow, Poland
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • N. Papadopoulos,

    1. Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • G. Passalacqua,

    1. Allergy & Respiratory Diseases, Deprtment of Internal Medicine, University of Genoa, Genoa, Italy
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • H. J. Schünemann,

    1. Department of Epidemiology, CLARITY Research Group, Italian National Cancer Institute “Regina Elena”, Rome, Italy
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • H.-U. Simon,

    1. Institute of Pharmacology, University of Bern, Bern, Switzerland
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  • A. Todo-Bom,

    1. Immunoallergology Department, Coimbra University Hospital, Coimbra, Portugal
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • E. Toskala,

    1. Department of Otorhinolaryngology, Finnish Institute of Occupational Health, Helsinki, Finland
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • R. Valenta,

    1. Division of Immunopathology, Medical University of Vienna, Vienna, Austria
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • M. Wickman,

    1. Sach’s Children’s Hospital, Stockholm, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.

  • J. P. Zock

    1. Unitat de Recerca Respiratòria i Ambiental, Institut Municipal d’Investigacions Mèdiques (I.M.I.M), Barcelona, Spain
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      Members of GA2LEN (Global Allergy and Asthma European Network), supported by the Sixth EU Framework program for research, contract no. FOOD-CT-2004-506378.


Prof. Jean Bousquet
University Hospital and INSERM
Hopital Arnaud de Villeneuve 34295 Montpellier Cedex 5
France

Abstract

 Nonallergic rhinitis (NAR) can be defined as a chronic nasal inflammation which is not caused by systemic IgE-dependent mechanisms. It is common and probably affects far more than 200 million people worldwide. Both children and adults are affected. However, its exact prevalence is unknown and its phenotypes need to be evaluated using appropriate methods to better understand its pathophysiology, diagnosis and management. It is important to differentiate between infectious rhinitis, allergic/NAR and chronic rhinosinusitis, as management differs for each of these cases. Characterization of the phenotype, mechanisms and management of NAR represents one of the major unmet needs in allergic and nonallergic diseases. Studies on children and adults are required in order to appreciate the prevalence, phenotype, severity and co-morbidities of NAR. These studies should compare allergic and NAR and consider different age group populations including elderly subjects. Mechanistic studies should be carried out to better understand the disease(s) and risk factors and to guide towards an improved diagnosis and therapy. These studies need to take the heterogeneity of NAR into account. It is likely that neuronal mechanisms, T cells, innate immunity and possibly auto-immune responses all play a role in NAR and may also contribute to the symptoms of allergic rhinitis.

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