Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report

Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report

Abstract

Rhinitis is an umbrella term that encompasses many different subtypes, several ofwhich still elude complete characterization. The concept of phenotyping, beingthe definition of disease subtypes on the basis of clinical presentation, has beenwell established in the last decade. Classification of rhinitis entities on the basis ofphenotypes has facilitated their characterization and has helped practicing clini-cians to efficiently approach rhinitis patients. Recently, the concept of endotypes,that is, the definition of disease subtypes on the basis of underlying pathophysiol-ogy, has emerged. Phenotypes/endotypes are dynamic, overlapping, and mayevolve into one another, thus rendering clear-cut definitions difficult. Neverthe-less, a phenotype-/endotype-based classification approach could lead toward theapplication of stratified and personalized medicine in the rhinitis field. In thisPRACTALL document, rhinitis phenotypes and endotypes are described, and rhi-nitis diagnosis and management approaches focusing on those phenotypes/endo-types are presented and discussed. We emphasize the concept of control-basedmanagement, which transcends all rhinitis subtypes.