Exercise-Induced Bronchoconstriction in Non-Asthmatic Children with Moderate-to-Severe Persistent Allergic Rhinitis...

Area of Science:

• Pediatric Allergy and Immunology
• Respiratory Medicine
• Clinical Research

Background:

• Allergic rhinitis is a common condition in children, often associated with lower airway hyperresponsiveness.
• Subcutaneous allergen immunotherapy (SCIT) is a treatment for allergic rhinitis, but its effect on exercise-induced bronchoconstriction (EIB) in its early phase is not well-defined.

Purpose of the Study:

• To determine the prevalence of EIB in children with moderate-to-severe persistent allergic rhinitis during the early stages of SCIT.
• To identify clinical risk factors associated with EIB in this pediatric population.

Main Methods:

• A cross-sectional observational study involving 62 children (aged 6-18 years) receiving early SCIT for allergic rhinitis.
• Exclusion of patients with asthma or asthma symptoms.
• Exercise provocation testing with spirometry to diagnose EIB (defined as ≥10% decrease in FEV1 post-exercise).

Main Results:

• EIB was detected in 33.9% of the children.
• Higher prevalence of EIB was observed in patients with a family history of asthma (23.8% vs 2.4%) and elevated baseline nasal symptom scores (Visual Analogue Scale and Total Nasal Symptom Score).
• No significant differences in IgE levels, eosinophil counts, or baseline spirometry were found between EIB-positive and negative groups.

Conclusions:

• Latent EIB affects one-third of children with allergic rhinitis initiating SCIT, even without asthma symptoms.
• Exercise provocation testing is valuable for early diagnosis of subclinical lower airway issues in children with a family history of asthma and high nasal symptom burden.