Impacts of the Severity of Allergic Rhinitis on Inflammatory Characteristics, Nasal Function, Anxiety and Depression

Aims/Background: Allergic rhinitis (AR) is an upper respiratory disease that affects inflammation levels, nasal function, and mental health in patients. However, the effect of AR severity on these indicators remains obscure. This study aimed to explore the impacts of AR severity on levels of inflammatory factors, nasal function, anxiety and depression. Methods: The clinical data of 188 patients with AR from January 2022 to January 2025 were collected and retrospectively analyzed. The patients were divided into mild group (n = 90) and moderate/severe group (n = 98) based on the severity of AR. Meanwhile, 79 healthy individuals matched in age, gender, and body mass index (BMI) with the AR patients were included in the control group. Nasal airway resistance (NAR) and nasal mucociliary clearance time (NMCT) were detected. Hospital Anxiety and Depression (HAD) scale was applied for the assessment of anxiety and depression. Serum level of C-reactive protein (CRP) was measured using an automatic biochemical analyzer. Serum procalcitonin (PCT) and nasal lavage fluid levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were measured using commercial assay kits. Results: Compared with the control group, the CRP, PCT, IL-1β, TNF-α, NAR, NMCT, and HAD anxiety and depression scores in AR patients were significantly increased (both p < 0.05). Compared with the mild group, the moderate/severe group exhibited increased levels of inflammatory biomarkers, NAR, NMCT, and HAD anxiety and depression scores (p < 0.05). In the mild group, anxiety and depression were correlated with the NAR, CRP, PCT, IL-1β, and TNF-α (p < 0.05); NMCT was correlated with the depression (p < 0.05). In moderate/severe group, anxiety and depression were correlated with the NAR, NMCT, CRP, PCT, IL-1β, and TNF-α (p < 0.05). The correlation between anxiety and depression and nasal function and inflammatory factors in moderate/severe group were stronger than those in mild group. Conclusion: The anxiety/depression and inflammation levels in AR patients increase, while the nasal function decreases, with the deteriorating severity of the disease. Anxiety and depression are correlated with nasal function and inflammation levels, with a more prominent correlation detected in patients with moderate/severe AR than those with mild disease.