Risk Factors and Comorbidities Associated With the Allergic Rhinitis Phenotype in Children According to the ARIA...

Area of Science:

• Pediatric Allergy and Immunology
• Respiratory Medicine
• Epidemiology

Background:

• Allergic rhinitis (AR) is common in children, but its association with specific allergen sensitization and bronchial hyperresponsiveness (BHR) requires further investigation.
• The Allergic Rhinitis and its Impact on Asthma (ARIA) classification provides a framework for categorizing AR phenotypes.
• Understanding risk factors and comorbidities associated with different AR phenotypes is crucial for effective management.

Purpose of the Study:

• To investigate risk factors and comorbidities, including allergen sensitization and BHR, for different AR phenotypes in children using the ARIA classification.
• To analyze the relationship between AR phenotypes and respiratory outcomes in a general population-based birth cohort.

Main Methods:

• A cohort of 606 children aged 7 years was studied.
• AR phenotypes were assigned based on the ARIA classification.
• Skin prick tests, Provocholine provocation tests, and analyses of risk factors and comorbidities were performed.

Main Results:

• The prevalence of mild AR was 37.2% and moderate to severe AR was 8.8%.
• Mild AR risk factors included recent analgesic/antipyretic use and cat ownership.
• Moderate to severe AR was associated with sensitization to Dermatophagoides Pteronyssinus, Japanese hop, and cat.
• Children with moderate to severe AR showed increased risk of asthma and BHR (aOR 5.26).
• Moderate to severe AR with allergic sensitization had the highest risk of BHR (aOR 11.77).

Conclusions:

• Moderate to severe persistent AR is more strongly associated with respiratory comorbidities and allergen sensitization than mild AR.
• Stratifying AR by ARIA classification can aid in disease management and risk stratification for children.