Perennial rhinitis : An independent risk factor for asthma in nonatopic subjects: Results from the European Community Respiratory Health Survey

Although clinical and experimental studies suggest that upper respiratory tract dysfunction may affect the lower airways, rhinitis is usually not studied as a potential risk factor for asthma. This is because both diseases share key elements of pathogenesis and are usually considered as different ma...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 1999-08, Vol.104 (2), p.301-304
Main Authors: LEYNAERT, B, BOUSQUET, J, NEUKIRCH, C, LIARD, R, NEUKIRCH, F
Format: Article
Language:English
Subjects:
Adult
Asthma - epidemiology
Asthma - physiopathology
Biological and medical sciences
Bronchial Hyperreactivity - physiopathology
Chronic obstructive pulmonary disease, asthma
Health Surveys
Humans
Hypersensitivity, Immediate
Immunoglobulin E - blood
Medical sciences
Non tumoral diseases
Odds Ratio
Otorhinolaryngology. Stomatology
Pneumology
Rhinitis, Allergic, Perennial - epidemiology
Risk Factors
Skin Tests
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:Although clinical and experimental studies suggest that upper respiratory tract dysfunction may affect the lower airways, rhinitis is usually not studied as a potential risk factor for asthma. This is because both diseases share key elements of pathogenesis and are usually considered as different manifestations of the same underlying "atopic" state. We sought to assess whether asthma is associated with rhinitis in the absence of immunologic disorders in a population study. Data from 34 centers participating in the European Community Respiratory Health Survey were analyzed. Random samples of 20- to 44-year-old subjects were invited to complete a detailed questionnaire and undergo total and specific IgE measurements, skin prick tests to 9 allergens, and bronchoprovocation challenges with methacholine. Subjects with perennial rhinitis (n = 1412) were more likely than control subjects (n = 5198) to have current asthma. After adjustment for sex, age, smoking habit, family history of asthma, geographic area, and season at the time of examination, asthma was strongly associated with rhinitis among atopic subjects (odds ratio [OR] = 8.1; 95% confidence interval [CI] = 5.4-12.1) but also among nonatopic subjects (OR = 11.6; 95% CI = 6.2-21.9). Moreover, the association remained very strong when the analysis was restricted to nonatopic subjects with IgE levels of 80 kIU/L or less (OR = 13.3; 95% CI = 6. 7-26.5). In nonasthmatic subjects bronchial hyperresponsiveness was also more frequent in subjects with rhinitis than in those without rhinitis (OR = 1.7; 95%CI = 1.2-2.6 in nonatopic subjects with IgE levels of
ISSN:0091-6749
1097-6825
DOI:10.1016/s0091-6749(99)70370-2