Chest
Airway Hyperresponsiveness in Allergic Rhinitis: A Risk Factor for Asthma
Section snippets
METHODS
Fifty-two Allergy Clinic patients with ragweed-sensitive allergic rhinitis without symptoms of asthma were studied initially during the winter seasons of 1979 and 1980. A follow-up study was done in the winter of 1984. Entrance criteria included the following: (1) rhinitis symptoms for at least two consecutive ragweed seasons; (2) a positive immediate (scratch) skin test to ragweed antigen; (3) no previous symptoms of chronic cough, sputum production, shortness of breath, or wheezing; and (4)
RESULTS
Forty patients (25 females, 15 males) with ragweed-sensitive allergic rhinitis were followed for a mean of 54 months (48 to 65 months). Their mean age was 27.4 years (12 to 54 years). Five were smokers; three were hyperresponders, and two nonresponders.
On the initial study, 20 (38 percent) of our original 52 patients were methacholine hyperresponders. The prevalence of methacholine hyperresponsiveness in our study group (those with initial and follow-up studies) was 40 percent (16 of the 40
DISCUSSION
Allergic rhinitis and asthma are closely related disorders that commonly occur together. It has even been suggested, but not proven, that they are two different manifestations of the same disease. They are strongly related by family history, are both associated with blood eosinophilia, and elevated IgE levels, and can both be precipitated by exposure to aeroallergens mediated by immediate hypersensitivity mechanisms. Most patients with allergic asthma have symptoms of rhinitis and some rhinitis
ACKNOWLEDGMENT
Mrs. Nina Dunn provided secretarial assistance and Mr. John Pezzullo was the statistician.
References (24)
- et al.
Risk factors for developing asthma and allergic rhinitis
J Allerg Clin Immunol
(1976) - et al.
Comparative action of acetyl-beta-methylcholine, histamine, and pollen antigens in subjects, with hay fever and patients with bronchial asthma
J Allergy
(1965) - et al.
Bronchial sensitivity to methacholine in current and former asthmatic and allergic rhinitis patients and control subjects
J Allerg Clin Immunol
(1975) - et al.
Small airway obstruction in allergic rhinitis
J Allerg Clin Immunol
(1975) - et al.
Standardization of bronchial inhalation challenge procedures
J Allerg Clin Immunol
(1975) - et al.
Allergen-induced increase in bronchial responsiveness to histamine: relationship to the late asthmatic response and change in airway caliber
J Allerg Clin Immunol
(1982) Mechanism of perennial allergic asthma
Lancet
(1983)Epidemiology and natural history of asthma, allergic rhinitis, and atopic dermatitis (eczema)
- et al.
Asthma in children
N Engl J Med
(1952) Comparative action of acetyl-beta-methyl choline and histamine on the respiratory tract in normals, patients with hay fever, and subjects with bronchial asthma
J Clin Invest
(1947)
Methacholine aerosol as test for bronchial asthma
Arch Intern Med
Studies with the quantitative-inhalation challenge technique: I. Curve of dose response to acetyl-beta-methylcholine in patients with asthma of known and unknown origin, hay fever subjects, and nonatopic volunteers
J Allergy
Cited by (254)
Unified Airway Disease: Examining Prevalence and Treatment of Upper Airway Eosinophilic Disease with Comorbid Asthma
2023, Otolaryngologic Clinics of North AmericaUnified Airway Disease: Environmental Factors
2023, Otolaryngologic Clinics of North AmericaCitation Excerpt :Within the weed pollen category, ragweed (Ambrosia spp.) is the most significant contributor to allergic airway disease; with studies finding rates of skin test responsiveness ranging from 10 to greater than 33% of individuals.37,38 Ragweed-responsive patients have increased rates of rhinitis symptoms and bronchial hyperresponsiveness, which may be a predisposing feature for the development of asthma.39,40 Data on the role of pollen allergy in CRS are conflicting, but there are certain subtypes that have been strongly associated with perennial allergy.
Does allergen immunotherapy for allergic rhinitis prevent asthma?
2022, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :In the Isle of Wight cohort, 22.4% of 10-year-old children with rhinitis had bronchial hyperreactivity even when they had no asthma symptoms.3 The progression from rhinitis and bronchial hyperresponsiveness (BHR) to asthma has been found in several studies.4 This is not surprising as the common underlying mechanisms, being the T helper 2 (TH2) immune responses in these individuals, based on their atopic predisposition and airway epithelium, act in a similar way from the nose to the lung.5
Diagnosis and management of nonallergic rhinitis with eosinophilia syndrome using cystatin SN together with symptoms
2020, World Allergy Organization JournalExercise-Induced Bronchoconstriction: Background, Prevalence, and Sport Considerations
2018, Immunology and Allergy Clinics of North AmericaCitation Excerpt :It has been also extensively reported that asthma and allergic rhinitis frequently coexist, with symptoms of rhinitis being reported in 80% to 90% of asthma patients, and asthma symptoms reported in 20% to 40% of patients with allergic rhinitis.34 Prospective studies also suggest that rhinitis frequently precedes the development of asthma42 and that many patients with rhinitis alone show nonspecific bronchial hyperresponsiveness after exercise or methacholine, this being a risk factor for developing asthma.43 Furthermore, it has been proven that the severity of allergic rhinitis and asthma is related and that proper management of allergic rhinitis improves asthma control.34
Revisiting the Dutch hypothesis
2015, Journal of Allergy and Clinical Immunology
Manuscript received August 11; revision accepted October 14