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Bronchial hyperresponsiveness in young children with allergic rhinitis and its risk factors
Insights
Young children with allergic rhinitis have higher rates of bronchial hyperresponsiveness (BHR). Persistent allergic rhinitis and a family history of asthma are key risk factors for BHR in this age group.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Clinical Research
Background:
- Allergic rhinitis is linked to bronchial hyperresponsiveness (BHR) in adults, but data in young children are limited.
- Understanding BHR determinants in children with allergic rhinitis is crucial for early intervention.
Purpose of the Study:
- To determine the prevalence of BHR in young children (4-6 years) diagnosed with allergic rhinitis without asthma.
- To identify risk factors associated with BHR in this pediatric population.
Main Methods:
- Methacholine challenges were conducted on 83 children with allergic rhinitis and 32 healthy controls.
- BHR was defined by methacholine concentration
- Clinical data, laboratory markers, and parental allergy history were collected.
Main Results:
- BHR was found in 32.5% of children with allergic rhinitis versus 9.4% of controls.
- Persistent allergic rhinitis and parental history of asthma were significantly more common in children with BHR.
- Serum IgE, skin prick test results, and eosinophil markers did not differ between BHR groups.
Conclusions:
- Young children with allergic rhinitis exhibit an elevated prevalence of BHR.
- Persistent rhinitis and parental asthma history are independent risk factors for BHR in children with allergic rhinitis.
Background:
Subjects with allergic rhinitis but no clinical evidence of asthma have greater bronchial hyperresponsiveness (BHR), and several factors have been implicated as its determinants. However, studies in young children are lacking. The aims of this study were to evaluate the prevalence of BHR in young children with allergic rhinitis and to investigate its risk factors.
Methods:
Methacholine bronchial challenges were performed in 4- to 6-year-old nonasthmatic children with allergic rhinitis (n = 83) and in healthy nonatopic controls (n = 32), using a modified auscultation method. The end-point was defined as the appearance of wheezing and/or oxygen desaturation. Subjects were considered to have BHR when they had end-point concentrations of methacholine
Results:
BHR was observed in 27 subjects with allergic rhinitis (32.5%) and three controls (9.4%). Among subjects with allergic rhinitis, serum total IgE, the number and pattern of skin-prick test responses, blood eosinophil markers, and parental history of allergic rhinitis and atopic dermatitis were not different between the BHR(+) and BHR(-) groups, whereas the persistent type of rhinitis and parental history of asthma were more frequent in the BHR(+) group than in the BHR(-) group. These associations remained significant in a multivariable logistic regression.
Conclusions:
Young children with allergic rhinitis alone showed an increased prevalence of BHR. Both persistent type of rhinitis and parental history of asthma were significant and independent risk factors for BHR in these children.
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