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Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Children with allergic and nonallergic rhinitis have a similar risk of asthma
Bo Lund Krogsgaard Chawes1, Klaus Bønnelykke, Eskil Kreiner-Møller
1Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, and the Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark.
Insights
Asthma is linked to both allergic and nonallergic rhinitis in children. While allergic rhinitis shows specific markers like elevated FeNO, both rhinitis types indicate a connection between upper and lower airway inflammation.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Genetics
Background:
- Rhinitis, both allergic and nonallergic, is frequently observed alongside an increased incidence of asthma.
- Understanding the relationship between rhinitis and asthma in early childhood is crucial for effective management.
Purpose of the Study:
- To investigate and characterize asthma and its precursor indicators in young children diagnosed with allergic or nonallergic rhinitis.
- To differentiate the asthma-related profiles associated with allergic versus nonallergic rhinitis in a pediatric cohort.
Main Methods:
- A cohort of 7-year-old children, including those with allergic rhinitis (n=38), nonallergic rhinitis (n=67), and no rhinitis (n=185), were assessed.
- Evaluations included asthma prevalence, eczema, food sensitization, filaggrin mutations, total IgE, blood eosinophils, fractional exhaled nitric oxide (FeNO), lung function, and bronchial responsiveness.
Main Results:
- Children with allergic rhinitis exhibited higher rates of asthma, food sensitization, eczema, total IgE, blood eosinophils, FeNO, and bronchial hyperresponsiveness compared to controls.
- Nonallergic rhinitis was associated with increased asthma prevalence but not with filaggrin mutations, eczema, food sensitization, or other measured inflammatory markers.
- Filaggrin null-mutations were linked to allergic rhinitis but did not influence the observed associations.
Conclusions:
- Asthma prevalence is similarly elevated in children with both allergic and nonallergic rhinitis, suggesting a broader upper-lower airway connection.
- Distinct endotypes of asthma symptoms may exist, as only allergic rhinitis was associated with increased bronchial responsiveness and elevated FeNO.
Background:
Both allergic and nonallergic rhinitis have been associated with increased prevalence of asthma.
Objective:
To characterize asthma and intermediary asthma endpoints in young children with allergic and nonallergic rhinitis.
Methods:
Thirty-eight 7-year-old children with allergic rhinitis, 67 with nonallergic rhinitis, and 185 without rhinitis from the Copenhagen Prospective Study on Asthma in Childhood birth cohort were compared for prevalence of asthma, eczema, food sensitization, filaggrin null-mutations, total IgE, blood eosinophil count, fractional exhaled nitric oxide (FeNO), lung function, and bronchial responsiveness.
Results:
Children with allergic rhinitis compared with asymptomatic controls had increased prevalence of asthma (21% vs 5%; P = .002), food sensitization (47% vs 13%; P < .001), and eczema (66% vs 43%; P = .01) and increased total IgE (155 kU/L vs 41 kU/L; P < .001), blood eosinophil count (0.46 x 10(9)/L vs 0.30 x 10(9)/L; P = .01), FeNO (15.9 ppb vs 6.6 ppb; P < .001), and bronchial hyperresponsiveness (23% vs 9%; P = .008). Filaggrin null-mutations were associated with allergic rhinitis (odds ratio, 3.3; 95% CI, 1.3-8.3) but did not modify these associations. Children with nonallergic rhinitis also had increased asthma prevalence (20% vs 5%; P = .001) but showed no association with filaggrin null-mutations, eczema, food sensitization, total IgE, blood eosinophil count, FeNO, or bronchial responsiveness.
Conclusion:
Asthma is similarly associated with allergic and nonallergic rhinitis, suggesting a link between upper and lower airways beyond allergy associated inflammation. Only children with allergic rhinitis had increased bronchial responsiveness and elevated FeNO, suggesting different endotypes of asthma symptoms in young children with allergic and nonallergic rhinitis.
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