Therapy of allergic rhinitis using ribavirin spray to clear nasal commensal viruses

For analyzing the exploratory nasal commensal viruses, we performed the metatranscriptomic analysis of the nose swabs from the enrolled AR patients both before and after treatments, as well as sequenced the nose swabs from a set of healthy volunteers without AR history.Simultaneously, to assess the expression of interferon-stimulated genes in patients with allergic rhinitis, we analyzed the gene expression of host reads. We had designed and conducted a randomized, double-blind, parallel-controlled phase 2 clinical trial. Eligible patients diagnosed with AR based on the typical symptoms and either a positive skin prick test (SPT) or allergen-specific IgE level ≥ 0.35 kU/L following the Chinese Guidelines for the Diagnosis and Treatment of Allergic Rhinitis criteria were enrolled. Each patient received detailed information on the study procedures, the treatments, the potential risks and benefits, and the fundamental rights in the clinical trial. To evaluate the efficacy and safety of ribavirin spray for AR treatment, ribavirin (12 mg daily) or placebo was given twice a day, one spray per nostril for 4 weeks. We obtained nasal swab samples from enrolled patients with allergic rhinitis for metatranscriptomic sequencing, with sampling time points before medication and four weeks after commencing treatment. Simultaneously, to assess whether there is a significant difference in the abundance of nasal commensal viruses between healthy individuals and patients with allergic rhinitis, we collected nasal swabs from healthy individuals without allergic rhinitis as controls for metatranscriptomic sequencing. All patients provided written informed consent.The clinical trial was registered at Chinese Clinical Trial Registry (ChiCTR2400082642).