Abstract Rationale Rhinitis is a common condition comprising diverse underlying mechanisms. We examined nasal epithelial transcriptomic profiles to identify immune pathways or endotypes for rhinitis in Puerto Rican youths with and without co-existing asthma. Methods We used nasal epithelial transcriptomic profiles to characterize rhinitis in 482 Puerto Rican youths aged 9-20 years with (cases) and without (controls) asthma. Current rhinitis was defined as physician-diagnosed hay fever or naso-ocular symptoms without a cold or flu in the previous 12 months. Using a K-means clustering approach, cases and controls were separately classified into 3 transcriptomic profiles (T helper 2 (T2) -high, T17-high and T2-low/T17-low) according to expression levels for 8 “signature genes” for T2 and T17 immunity. Results Of the 237 cases, 62 of 69 classified as T2-high had rhinitis (90%), 65 of 83 classified as T17-high had rhinitis (78%), and 58 (68%) of 85 classified as T2-low/T17-low had rhinitis (68%) (Figure, panel A). Cases with co-existing rhinitis were more likely to have had ≥1 severe asthma exacerbation in the prior year and to have used inhaled corticosteroids in the past 6 months (regardless of transcriptomic profile) than those cases without rhinitis. Among T17-high cases, those who had rhinitis were more likely to be male and overweight or obese than those without rhinitis. Of the 245 controls, 37 (76%) of 49 classified as T2-high had rhinitis, 42 (38%) of 110 classified as T17-high had rhinitis, and 33 (38%) of 86 classified as T2-low/T17-low had rhinitis (Figure, panel B). In T2-high controls, those with rhinitis were more likely to be female and to have an annual household income ≥15, 000 and private or employer-based health insurance than those without rhinitis. In T17-high controls, those with rhinitis were more likely to have parental history of atopy, ≥1 positive allergen-specific IgE, and higher total serum IgE and blood eosinophils than controls without rhinitis. Among T2-low/T17-low controls, those with rhinitis were more likely to have ≥1 positive allergen-specific IgE and a higher total serum IgE than controls without rhinitis. Conclusions In a study of Puerto Rican youths 9-20 years old who were characterized with nasal epithelial transcriptomic profiles, the prevalence of rhinitis was highest in those with a T2-high profile (90% in asthma cases and 76% in controls) and lowest in those with a T2-low/T17-low profile (68% in asthma cases and 38% in controls). Further studies are needed to better understand non-T2-mediated rhinitis in youths with and without asthma. This abstract is funded by: NIH grants: HL079966, HL117191, HL159333
Han et al. (2026) studied this question.