Predicting the course of chronic rhinosinusitis in young children-5-year prospective study.

Authors

Ł Dobrakowski, M Kalisiak, J Majak, A Otocka-Kmiecik, P Majak

Published in

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. Volume 37. Issue 7. Pages e70416.

Abstract

Predicting the course of chronic rhinosinusitis (CRS) and assessing the clinical relevance of IgE-mediated sensitization to house dust mite (HDM) in preschool children remain challenging. We aimed to identify early clinical characteristics of HDM-induced allergic rhinitis (AR-HDM) in preschoolers and to determine predictors of CRS persistence.
We conducted a 5-year prospective follow-up of a well-defined multi-omics cohort of 133 children aged 4-8 years with CRS symptoms, with or without IgE-mediated sensitization to HDM. We developed a multivariate logistic regression model with clinical and multi-omics variables assessed at preschool age to predict CRS persistence and AR-HDM diagnosis at school age.
Among 117 children who completed the 5-year follow-up, CRS persisted in 35%. Higher baseline SN-5 (Sinus and Nasal Quality of Life Survey) scores (>3.6 points) significantly increased the risk of persistent CRS (OR = 3.41; 95% CI: 1.50-7.76; p = .003). ILC-2 cells were detected more frequently in nasal samples from preschool children with persistent CRS. Independent predictors of AR-HDM included a history of food allergy in infancy (OR = 3.87; 1.10-13.60; 0.034) and prominent allergic symptoms at baseline (allergy-related SN-5 domain ratio ≥21%), (OR = 3.96; 1.20-13.10; 0.025). The combined presence of these factors additionally improves the prediction of AR-HDM.
Higher SN-5 score and presence of ILC-2 in the nasal mucosa increase the risk of persistence of CRS. The co-occurrence of a relatively higher allergy domain of SN-5 score and a history of food allergy facilitates prediction of HDM allergy in preschoolers, enabling the timely initiation of allergen immunotherapy in allergic children.
ClinicalTrials.gov Identifier: NCT03011632.

PMID:
42418237
Bibliographic data and abstract were imported from PubMed on 08 Jul 2026.

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