Allergic rhinitis as a predictor for wheezing onset in school-aged children

• Published in: Journal of allergy and clinical immunology 2010-12, Vol.126 (6), p.1170-1175.e2
• Main Authors: Rochat, Mascha K., MD, Illi, Sabina, PhD, Ege, Markus J., MD, Lau, Susanne, MD, Keil, Thomas, MD, MSc, Wahn, Ulrich, MD, von Mutius, Erika, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Age; Age of Onset; Allergic rhinitis; allergic sensitization; Allergies; Allergy and Immunology; Asthma; Biological and medical sciences; birth cohort study; Child; Child, Preschool; Children & youth; Early Diagnosis; Families & family life; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Germany; Humans; Immunoglobulin E - blood; Immunopathology; Infant; Infant, Newborn; Male; Medical sciences; Milk; Multivariate analysis; Non tumoral diseases; Otorhinolaryngology. Stomatology; Population; Prognosis; Respiratory Sounds; Rhinitis, Allergic, Seasonal - diagnosis; Rhinitis, Allergic, Seasonal - epidemiology; Rhinitis, Allergic, Seasonal - immunology; Rhinitis, Allergic, Seasonal - physiopathology; Risk Factors; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; wheezing
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2010.09.008

Background Rhinitis in older children and adults has been shown to be a predictor for adolescent- and adult-onset asthma. These findings suggest an interaction between the upper and lower airways. Whether rhinitis is a predictor for childhood-onset asthma is unknown. Objective We sought to investigate whether rhinitis in early childhood is an independent predictor for wheezing between the ages of 5 and 13 years in the German Multicentre Allergy Study birth cohort. Methods The German Multicentre Allergy Study cohort initially included 1314 healthy children. They were followed from birth to the age of 13 years with regular questionnaires and interviews. Specific IgE levels were measured at yearly intervals. Airway hyperresponsiveness was assessed at 7 years. Results Allergic rhinitis until the age of 5 years was found to be a predictor for developing wheezing between the ages of 5 and 13 years, with an adjusted relative risk of 3.82 ( P  < .001). This association was not attributable to the type of sensitization, the severity of sensitization, or atopic dermatitis during the first 2 years of life. In this group of children, 41.5% of all new cases of wheezing occurred among children with preceding allergic rhinitis. Conclusions The first manifestation of allergic rhinitis occurs in preschool children in whom it is a predictor for subsequent wheezing onset. Preschool children with rhinitis might thus benefit from early assessment of allergic sensitization to identify the children at high risk of wheezing.