The last year has seen great progress in the understanding of upper airway disease and in its management. For
allergic rhinitis, authors focused on the prediction of and effect on the natural course of disease. New evidence was published for the disease-modifying effect of allergen immunotherapy in terms of avoidance of new sensitizations and prevention of
asthma in either randomized or real-life studies. Specifically, for patients with house dust mite
allergies, which are often underestimated and difficult to diagnose, the efficacy of SQ house dust mite sublingual immunotherapy
tablets has been demonstrated in patients with
allergic rhinitis and
asthma. For the first time, allergen immunotherapy significantly reduced
asthma exacerbations. In patients with chronic
rhinosinusitis, a novel endotyping approach purely based on T helper cell
biomarkers has been developed and has shown clinical relevance through associations with
asthma comorbidity and recurrence after surgery. Severe nasal polyposis with high risk for
asthma comorbidity and disease recurrence is characterized by type 2 inflammatory patterns, including
IgE antibodies to staphylococcal
superantigens; several studies using biologic agents have targeted exactly this spectrum of mediators. This goes in parallel with new knowledge on even more type 2 mediators derived from epithelial cells, which will expand the number of possible candidates for innovative intervention.