Abnormal spirometry in children with persistent allergic rhinitis due to mite sensitization: the benefit of nasal corticosteroids

Area of Science:

• Pediatric Allergy and Immunology
• Pulmonary Medicine
• Respiratory Physiology

Background:

• Inflammatory processes in the nasal and bronchial mucosa share similarities.
• Perennial allergic rhinitis (PAR) in children may impact lower airway function.
• Asthma is often considered in differential diagnoses for pediatric respiratory symptoms.

Purpose of the Study:

• To investigate pulmonary function in children with PAR but without asthma.
• To determine if nasal corticosteroids and loratidine improve lung function in these children.
• To assess the prevalence of impaired pulmonary function in children with PAR.

Main Methods:

• Fifty children with moderate/severe persistent PAR (dust mite-sensitized) and 26 healthy controls were assessed.
• Pulmonary function tests, including forced expiratory volume/1s (FEV1) and forced expiratory flow from 25-75% (FEF(25-75)), were performed.
• Subjects with airway obstruction (<80% predicted FEF(25-75)) received loratidine and nasal budesonide treatment.

Main Results:

• 22% of children with PAR exhibited impaired pulmonary function (FEF(25-75) <80%) compared to 3.8% in controls (p <= 0.05).
• Airway obstruction was reversible in 81.8% of affected children.
• Three months of treatment led to improved FEF(25-75) and significant increases in FEV1 (p=0.04) and FEV1/FVC (p=0.04).

Conclusions:

• A significant portion of children with PAR experience diminished FEF(25-75) values and reversible airway obstruction.
• Nasal corticosteroids effectively improve pulmonary function tests in children with PAR and impaired lung function.
• These findings highlight the importance of assessing lower airway function in pediatric allergic rhinitis.