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Understanding menstrual cycle changes in sinonasal symptoms, function, and biomarkers in allergic rhinitis

Award Number: K23AI193081
ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2031

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Understanding menstrual cycle changes in sinonasal symptoms, function, and biomarkers in allergic rhinitis - The goal of this K23 is to demonstrate a direct association between higher ovarian steroid levels and worse allergic rhinitis (AR) outcomes. AR is a common and costly chronic sinonasal inflammatory disease. Ovarian steroids are known to influence immune cell function and inflammation in other conditions. Yet our two scoping reviews of clinical and basic studies found that despite some early suggestive findings, surprisingly little is known about the role of biological sex and ovarian steroids in AR. Addressing that gap, in the National Health and Nutrition Examination Survey, All of Us, and the Hispanic Community Health Study/Study of Latinos, we found that AR is more common in women than men; this female predominance is most pronounced in the reproductive ages, with a narrowing/reversal before puberty and after menopause. Further, oral contraceptive use was associated with higher rates of AR, and menopause was associated with lower rates of AR. Collectively, these epidemiological findings convincingly support the need for further investigation into ovarian steroids in AR and the hypothesis that higher estrogen/progesterone states contribute to AR. In this K23, we will use a prospective clinical approach to directly study associations between endogenous ovarian steroids and AR outcomes. The menstrual cycle offers the ideal opportunity to study AR in a setting of predictable and well-described ovarian steroid (i.e., estrogen and progesterone) variations. We will recruit 56 naturally cycling women aged 18-35 with AR for a two-visit study: one during a low estrogen and progesterone menstrual phase (mid-follicular) and the other during a high estrogen and progesterone menstrual phase (mid-luteal). AR symptoms will be assessed daily using innovative ecological momentary assessment methods. At each visit, we will assess validated patient-reported AR outcome measures, sinonasal function (smell testing, nasal peak inspiratory flow), and AR type 2 biomarkers (in nasal secretions). Our Research Aims are to evaluate within- subject change in AR symptoms (Aim 1), sinonasal function (Aim 2), and AR biomarkers (Aim 3), across the menstrual cycle in natural cycling women with AR. The related Training Objectives to accomplish the proposed research and to support future research are to 1) gain experience with menstrual cycle clinical study design/implementation; 2) learn key considerations in data collection/coding and statistical modeling to study menstrual cycle effects; 3) develop expertise in the basic biology of and role of ovarian steroids in type 2 inflammation; 4) learn skills in geospatial analysis (to utilize location-specific environmental data); and 5) develop expertise in menopause research. The proposed research and training are critical to my goal of becoming an independent surgeon-scientist and pioneering researcher in the role of biological sex and ovarian steroids in AR and other sinonasal inflammatory diseases. Long-term, this work has the potential to identify women at higher risk based on their hormonal profile and develop targeted hormonal therapy recommendations to improve outcomes in AR and other sinonasal inflammatory diseases.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $203,483 )
2026	2026	UNIVERSITY OF ILLINOIS	809 S MARSHFIELD AVE M/C 551	CHICAGO	IL	60612	COOK	USA	Allergy and Infectious Diseases Research	000	1	8/19/2026	NEW	$203,483
														Subtotal = $203,483

Grand Total All Awards = $203,483

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Understanding menstrual cycle changes in sinonasal symptoms, function, and biomarkers in allergic rhinitis

Award Number: K23AI193081

ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2031

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