Heterogeneity and Future Perspectives on Personalized Treatment of Pediatric Allergic Rhinitis

Allergic rhinitis is one of the most common chronic diseases of childhood. Early manifestation of symptoms, late diagnosis, and irrational (or insufficiently effective) pharmacotherapy increase the risk of polysensitization and contribute to the development of other diseases of the respiratory system and ENT organs. The pathogenetic and clinical heterogeneity of allergic rhinitis, as well as difficulties in achieving compliance, are the main reasons for the high variability in treatment response. The results of recent studies focusing on phenotypic differences in patients with allergic rhinitis open up prospects for the development of new effective personalized algorithms for medical care. A review of current research on the problem of heterogeneity (genetic, microbiome-related, and multimorbid) of pediatric allergic rhinitis and its associated variable efficacy of pharmacotherapy was conducted using data from the scientific electronic libraries eLibrary and PubMed. Current research findings may serve as a basis for the development of phenotype-oriented approaches to the treatment of allergic rhinitis in children — both by improving the efficacy of traditional drugs and their combinations (antihistamines, intranasal corticosteroids, antileukotriene agents) and through potential targeting of novel pharmacotherapeutic targets.

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