When asthma and rhinitis coexist, could rhinitis reduce asthma control in children?
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Published on: June 4, 2017
Valentina De Vittori1, Anna Pacilio1, Luciana Indinnimeo1
1From the Department of Pediatrics, Faculty of Medicine and Odontology, Sapienza University, Rome, Italy.
Insights
Many children with asthma have uncontrolled symptoms, often linked to rhinitis. Lower nasal airflow and higher nasal inflammation were observed in uncontrolled asthma cases, suggesting a connection between upper and lower airway health.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
Background:
- Bronchial asthma and rhinitis are common childhood diseases, frequently co-occurring.
- Effective asthma management focuses on achieving disease control.
- The Children Asthma Control Test (C-ACT) is a widely used tool for assessing pediatric asthma control.
Background:
Bronchial asthma and rhinitis are among the most common diseases in children and frequently coexist in the patient. The primary aim of anti-asthmatic therapy is disease control. Several questionnaires can be used in pediatrics to assess asthma control and the Children Asthma Control Test (C-ACT) is one of the most used.
Objective:
To evaluate the percentage of asthma control in our cohort of patients with asthma and correlate C-ACT with bronchial and nasal function tests.
Methods:
We enrolled all children ages between 5 and 11 years with persistent bronchial asthma, sensitized to dust mite, and who presented to our center during an 8-month period. All the children had skin-prick tests, spirometry, measurement of fractional exhaled nitric oxide levels, active anterior rhinomanometry, measurement of nasal nitric oxide level, and C-ACT.
Results:
Sixty patients were enrolled; 80% of these children had rhinitis. According to C-ACT, 31% of our patients had uncontrolled asthma. Nasal flow values were significantly lower in patients with uncontrolled asthma, who also had higher nasal inflammation.
Conclusion:
The disease is not controlled in a significant percentage of children with asthma. In patients with uncontrolled asthma, worse nasal flow was detected. These results supported the relationship between upper and lower airways, and highlighted the importance of performing nasal function tests in all patients with asthma, which could be useful to determine whether better control of asthma symptoms can be reached through an appropriate treatment of rhinitis.
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