xRead - Nonallergic Rhinitis (September 2025)

Clinical Management Review

Nonallergic Rhinopathy: A Comprehensive Review of Classification, Diagnosis, and Treatment

Fuad M. Baroody, MD a , Philippe Gevaert, MD, PhD b , Peter K. Smith, MD c , Navid Ziaie, MD d , and Jonathan A. Bernstein, MD d Chicago, Ill; Ghent, Belgium; Southport, Australia; and Cincinnati, Ohio

AMA PRA Category 1 Credit . Physicians should claim only the credit commensurate with the extent of their participation in the activity. List of Design Committee Members: Fuad M. Baroody, MD, Philippe Gevaert, MD, PhD, Peter K. Smith, MD, Navid Ziaie, MD, and Jona than A. Bernstein, MD (authors); David A. Khan, MD (editor) Learning objectives : 1. Describe the pathogenesis of non-allergic rhinopathy. 2. De fi ne clinical and diagnostic criteria for non-allergic rhinopathy. 3. Discuss the most effective treatment options for non-allergic rhinopathy. Recognition of Commercial Support: This CME has not received external commercial support. Disclosure of Relevant Financial Relationships with Commercial Interests: F. M. Baroody is a consultant for Bayer. P. Gevaert has served as an advisor or speaker and received grant/research support from ALK, Argenx, AstraZeneca, Genentech, GSK, Hall Allergy, Novartis, Regen eron, Roche, Sano fi -Genzyme, and Stallergenes-Greer. P. K. Smith is a principal investigator/consultant for GSK, Sano fi Regeneron, and Viatris. J. A. Bernstein is a principal investigator/consultant for Astra Zeneca, GlaxoSmithKline (GSK), Novartis, Genentech, Sano fi Regeneron, Optinose, ALK, and Allergy Therapeutics. N. Ziaie and the editor declares that they have no relevant con fl icts of interest. symptoms triggered by chemical irritants and weather changes through chemosensors, mechanosensors, thermosensors, and/or osmosensors activated through different transient receptor potential calcium ion channels. Elucidating the speci fi c role of transient receptor potential vanilloid 1, triggered by capsaicin, has been an important advancement in better understanding the pathophysiology of NAR because it has now been shown that investigator/consultant for Astra Zeneca, GlaxoSmithKline (GSK), Novartis, Genentech, Sano fi Regeneron, Optinose, ALK, and Allergy Therapeutics. N. Ziaie declares that he has no relevant con fl icts of interest. Received for publication January 25, 2024; revised February 29, 2024; accepted for publication March 4, 2024. Available online March 11, 2024. Corresponding author: Jonathan A. Bernstein, MD, Department of Internal Medi cine, Division of Immunology/Allergy Section, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML#563, Cincinnati, OH 45267-0563. E-mail: Bernstja@ucmailuc.edu. 2213-2198 2024 American Academy of Allergy, Asthma & Immunology https://doi.org/10.1016/j.jaip.2024.03.009

INFORMATION FOR CATEGORY 1 CME CREDIT Credit can now be obtained, free for a limited time, by reading the review articles in this issue. Please note the following instructions. Method of Physician Participation in Learning Process: The core material for these activities can be read in this issue of the Journal or online at the JACI: In Practice Web site: www.jaci-inpractice.org/. The accompanying tests may only be submitted online at www.jaci inpractice.org/. Fax or other copies will not be accepted. Date of Original Release: June 1, 2024. Credit may be obtained for these courses until May 31, 2025. Copyright Statement: Copyright 2024-2026. All rights are reserved, including those for text and data mining, AI training, and similar technologies. Overall Purpose/Goal: To provide excellent reviews on key aspects of allergic disease to those who research, treat, or manage allergic disease. Target Audience: Physicians and researchers within the fi eld of allergic disease. Accreditation/Provider Statements and Credit Designation: The American Academy of Allergy, Asthma & Immunology (AAAAI) is accredited by the Accreditation Council for Continuing Medical Edu cation (ACCME) to provide continuing medical education for physi cians. The AAAAI designates this journal-based CME activity for 1.00 Chronic nonallergic rhinitis syndromes encompass various conditions, of which vasomotor rhinitis is the most common form, representing approximately 80% of patients, also referred to as nonallergic rhinopathy (NAR), nasal hyperreactivity, neurogenic rhinitis, or idiopathic rhinitis. Expert panels have recommended replacing vasomotor rhinitis terminology because it is more descriptive of this condition that is characterized by a Section of Otolaryngology e Head and Neck Surgery, University of Chicago Med icine, Chicago, Ill b Upper Airways Research Laboratory, Department of Head and Skin, Ghent Uni versity, Ghent, Belgium c Department of Surgery-Otolaryngology-Head and Neck, School of Medicine, Grif fi th University, Southport, Queensland, Australia d Department of Internal Medicine, Division of Rheumatology, Allergy and Immu nology, University of Cincinnati College of Medicine, Cincinnati, Ohio No funding has been received for this study. Con fl icts of interest: F. M. Baroody is a consultant for Bayer. P. Gevaert has served as an advisor or speaker and received grant/research support from ALK, Argenx, AstraZeneca, Genentech, GSK, Hall Allergy, Novartis, Regeneron, Roche, Sano fi Genzyme, and Stallergenes-Greer. P. K. Smith is a principal investigator/ consultant for GSK, Sano fi Regeneron, and Viatris. J. A. Bernstein is a principal

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