Сlinical and allergological characteristics of chronic inflammatory diseases of the nose in patients with severe bronchial asthma receiving immunobiological therapy in the Sverdlovsk region

Introduction. Allergic rhinitis, chronic rhinosinusitis (with/without polyps) are chronic inflammatory diseases of the nose and often accompany asthma, aggravating its severity.Aim of the study. Тo determine the phenotypes, spectrum of sensitization and severity of chronic inflammatory diseases of the nose in patients with severe bronchial asthma receiving immunobiological therapy in the Sverdlovsk region.Materials and methods. The territorial register of adult patients with severe bronchial asthma (n = 85) who received immunobiological therapy in the Sverdlovsk region in October 2021 was analyzed. When diagnosing chronic inflammatory diseases of the nose, an examination by an otorhinolaryngologist and computed tomography of the paranasal sinuses were performed; were determined: the absolute number of blood eosinophils, specific IgE to inhaled allergens, including the FadiatopTM method; skin tests were performed; assessment of the severity of nasal symptoms was determined using the SNOT-22, VAS.Results. Chronic inflammatory diseases of the nose were reported in 89.4% of patients. Allergic rhinitis occurred in 54.1% of cases (n = 46). 54.3% (n = 25) were dominated by patients with a moderate course; severe course was observed in 28.3% of cases (n = 13). Allergic rhinitis in 92.3% of cases (n = 36) was accompanied by allergic asthma and in 71.4% (n = 10) – mixed. Sensitization to household allergens was more common, from seasonal allergens to tree pollen. Phadiatop was positive in all patients with allergic rhinitis and negative in patients with chronic rhinosinusitis with/without nasal polyps. Patients with chronic rhinosinusitis occurred in 35.3% of cases (n=30); nasal polyps were in 23.5% (n = 20). The highest rates of blood eosinophilia were in patients with concomitant chronic rhinosinusitis with nasal polyps – 920 cells/µl. This phenotype in 95% of cases was accompanied by non-allergic (eosinophilic) asthma.Conclusion. Severe bronchial asthma is almost always accompanied by chronic inflammatory diseases of the nose. Phadiatop shows its high informativeness in determining the phenotype of allergic rhinitis.