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Determinants of allergic rhinitis in young children with asthma
Lise Moussu1, Philippe Saint-Pierre2, Virginie Panayotopoulos1
1Allergology department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (Assistance Publique Hôpitaux de Paris) - Université Pierre et Marie Curie, Paris, France.
Insights
Allergic rhinitis (AR) in young children with asthma is linked to peanut sensitization, food allergy, and mold exposure. Identifying these factors is crucial for diagnosing severe allergic asthma phenotypes in toddlers.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Asthma Research
Background:
- Allergic rhinitis (AR) is often underdiagnosed in preschoolers.
- Emerging evidence suggests AR occurs in toddlers, but its causes are unclear.
- This study aimed to identify determinants of AR in young children with asthma.
Purpose of the Study:
- To investigate the factors associated with allergic rhinitis in toddlers with asthma.
- To understand the relationship between AR, atopy, and environmental exposures in this population.
- To identify potential triggers for AR in young asthmatic children.
Main Methods:
- A case-control study involving 227 children with active asthma.
- Diagnosis of AR and other allergic diseases by medical professionals using standardized questionnaires.
- Collection of data on parental history, biological markers of atopy, and environmental parameters.
Main Results:
- 18.1% of children had allergic rhinitis (AR).
- AR was significantly associated with peanut sensitization, food allergy, mold exposure, and parental history of AR.
- Multivariate analysis and random forest analysis confirmed peanut sensitization and mold exposure as principal determinants of AR.
Conclusions:
- Investigating AR in young children with asthma is important for identifying severe allergic phenotypes.
- The findings suggest a potential link between peanut allergy and AR, possibly indicating peanut as an aeroallergen.
- Early identification of AR determinants can aid in managing allergic diseases in asthmatic toddlers.
Background:
In the preschool period, allergic rhinitis (AR) is infrequent and thus under-diagnosed. However, recent works have highlighted the occurrence of AR in toddlers although the causes of AR in this young population remain unknown. The objective of this study was to identify determinants of AR in young children with asthma.
Methods:
We carried out a case-control study of 227 children with active asthma and enrolled in the Trousseau Asthma Program. AR and other allergic diseases (asthma, food allergy and eczema) were diagnosed by medical doctors using standardized questionnaires. Parental history of AR and asthma, biological markers of atopy (total IgE, blood eosinophilia, allergic sensitization towards food and aeroallergens) and environmental parameters were also collected.
Results:
Forty one of the children (18.1%) had AR. By univariate logistic regression analysis, AR was mainly associated with peanut sensitization (OR = 6.75; p = 0.002); food allergy (OR = 4.31; p = 0.026); mold exposure (OR = 3.81 p<0.01) and parental history of AR (OR = 1.42; p = 0.046). Due to the strong link between food allergy and peanut sensitization three models of multivariate logistic regression were performed and confirmed that AR is associated with peanut sensitization but also food allergy and mold exposure. A random forest analysis was also performed to explain AR. The results reinforced the logistic analysis that peanut sensitization and mold exposure were the principal determinants of AR.
Conclusions & Clinical Relevance:
These results stress the importance of investigating AR in young children with asthma to potentially diagnose a particularly severe allergic asthmatic phenotype. Moreover, these data evoke the hypothesis that peanut could be an aeroallergen.
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