Related Experiment Video
Updated: Oct 2, 2025
Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Development of allergic rhinitis in early life: A prospective cohort study in high-risk infants
Sawako Masuda1, Mizuho Nagao2, Satoko Usui1
1Department of Otorhinolaryngology and Allergy Center, National Hospital Organization Mie National Hospital, Tsu, Japan.
Insights
Allergic rhinitis (AR) in infants with eczema or food allergies often develops into a wheezing condition. Early detection of AR-like symptoms in infancy is crucial for identifying children at high risk for recurrent wheeze.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Clinical Pediatrics
Background:
- Allergic rhinitis (AR) is a prevalent childhood allergic disease, yet its early developmental process remains unclear.
- Understanding AR development in early childhood is crucial for timely intervention.
- This study investigates AR development, nasal cytology, and sensitization in relation to recurrent wheeze in high-risk infants.
Purpose of the Study:
- To prospectively investigate the development of allergic rhinitis (AR) in infants.
- To examine the relationship between nasal symptoms, cytology, sensitization, and recurrent wheeze.
- To identify AR-like phenotypes in early childhood and their association with high-risk recurrent wheeze.
Main Methods:
- Recruited infants under 2 years with atopic dermatitis (AD) and/or food allergy (FA) symptoms for a 2-year prospective follow-up.
- Classified perennial AR phenotype based on persistent nasal symptoms, nasal eosinophils, and house dust mite (HDM) sensitization.
- Utilized Cox proportional hazards regression to analyze associations with high-risk recurrent wheeze, adjusting for covariates.
Main Results:
- Prevalence of nasal eosinophilia increased from 18.5% to 69.9% and HDM sensitization from 30.6% to 74.8% over 2 years.
- AR-like phenotypes rose from 18.4% to 65.0% in the study cohort.
- The AR-like phenotype at 2 years was significantly associated with the development of high-risk recurrent wheeze (HR 2.062).
Conclusions:
- An HDM-related AR-like phenotype significantly increased during infancy in infants with AD/FA.
- The development of an AR-like phenotype in infancy is a predictor of high-risk recurrent wheeze.
- Early identification of AR-like phenotypes in at-risk infants is vital for managing and preventing recurrent wheeze.
Background:
Allergic rhinitis (AR) is the most common allergic disease in children. The development process of AR in early childhood, however, is not well understood. We prospectively investigated the process in regard to not only the nasal symptoms and sensitization but also the nasal cytology, in relation to recurrent wheeze in a high-risk cohort.
Methods:
Infants under 2 years of age with atopic dermatitis (AD) and/or food allergy (FA) symptoms were recruited and followed prospectively for 2 years. The phenotype of perennial AR was classified based on the presence/absence of (1) persistent nasal symptoms, (2) nasal eosinophils, and (3) HDM sensitization, the most common allergen for perennial AR in Japan. AR-like phenotypes were defined as positive for at least two of those three categories. High-risk recurrent wheezer was diagnosed based on the Japanese guidelines and Global Initiative for Asthma. Cox proportional hazards regression analyses for high-risk recurrent wheeze and the AR-like phenotype, adjusting for known covariate risk factors for asthma.
Results:
A total of 299 children were enrolled, and 237 subjects (78%) completed the 2-year observation. The prevalence of eosinophilia in nasal secretions increased from 18.5% to 69.9%, while HDM-specific IgE ≥ 0.35 kUA /L increased from 30.6% to 74.8%. AR-like phenotypes increased from 18.4% to 65.0%. The AR-like phenotype at 2 years was associated with development of high-risk recurrent wheezer (HR 2.062; 95% CI 1.005-4.796).
Conclusions:
The prevalence of an HDM-related AR-like phenotype was markedly increased during infancy in infants with AD/FA and was associated with high-risk recurrent wheezer.
Related Concept Videos
02:06Allergic Reactions
01:29Asthma-I: Introduction
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include: