New Insights Into Immunomodulatory Strategies for Drug Hypersensitivity Reactions: An EAACI Task Force Report.

Respiratory diseases are characterized by substantial heterogeneity in both clinical presentation and inflammatory mechanisms, and overlapping symptoms are frequently observed across upper and lower airway conditions. Within the unified airway framework, the nasal and bronchial compartments are recognized as anatomically and immunologically connected, with shared inflammatory pathways contributing to disease activity across the respiratory tract (, ). However, clinical assessment and disease monitoring are still most often performed using disease-specific tools and care pathways, which may not fully capture overlapping or coexisting inflammatory processes across airway compartments. Patient-reported outcome measures play an important role in assessing symptom burden and disease impact in respiratory medicine. However, many commonly reported symptoms, such as nasal obstruction, discharge, cough, sleep disturbance, and fatigue, are not specific to a single diagnosis and may reflect different underlying biological mechanisms depending on the disease context and patient phenotype (–). In addition, disease activity is often evaluated using a combination of questionnaires, physiological tests, imaging, and biomarkers, which vary across conditions and clinical settings (–). As a result, assessment approaches can be difficult to compare across respiratory diseases and may not consistently clarify relationships between patient-reported symptoms and underlying inflammatory processes. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a validated patient-reported outcome measure used to assess sinonasal symptom burden and health-related quality of life across rhinologic, functional, sleep, and emotional domains. Originally developed and validated for chronic rhinosinusitis, it has also been applied in CRS populations that include patients with comorbid asthma (, ). As a composite instrument, SNOT-22 captures overall symptom burden rather than specific underlying biological pathways. Accordingly, reported associations between SNOT-22 scores and individual inflammatory markers have been variable and appear to depend on factors such as disease phenotype, sample matrix and collection site, and analytical approach (–).