Issue 12/2025
Novakova1, S., Novakova2, P.
1 University Hospital “St. George” – Plovdiv
2 Clinic of Clinical Allergology, University Hospital Alexandrovska; Clinic of Allergology, Medical University of Sofia
Nonallergic rhinitis represents a heterogeneous group of chronic inflammatory conditions of the nasal mucosa, characterized by rhinorrhea, nasal congestion, and sneezing in the absence of IgE-mediated allergy. In recent years, interest in phenotyping nonallergic rhinitis has increased, aiming for more precise diagnosis and personalized treatment. Among the most established phenotypes are: vasomotor rhinitis, characterized by dysregulation of the autonomic nervous system; nonallergic rhinitis with eosinophilia, marked by eosinophilic inflammation without allergic sensitization; hormonal rhinitis, associated with endocrine fluctuations; medication-induced rhinitis (including rhinitis medicamentosa caused by decongestants); as well as food- or chemically induced rhinitis, triggered by nonspecific irritants. Identifying these phenotypes enables more accurate targeting of therapeutic approaches and avoidance of triggers, leading to better symptom control and improved quality of life for patients. The aim of this review is to present both the different phenotypes and the current understanding of the underlying mechanisms.
Key words: rhinitis, phenotypes, mechanism, nonallergic rhinitis
Address for correspondence:
Dr. S. Novakova, MD
Internal advisory department,
University Hospital “St. George” Plovdiv
66, „Peshtersko Shose“, Blvd.
4001, Plovdiv