TY - JOUR
T1 - Ongoing allergic rhinitis impairs asthma control by enhancing the lower airway inflammation
AU - Oka, Asako
AU - Matsunaga, Kazuto
AU - Kamei, Tadashi
AU - Sakamoto, Yukihiro
AU - Hirano, Tsunahiko
AU - Hayata, Atsushi
AU - Akamatsu, Keiichiro
AU - Kikuchi, Takashi
AU - Hiramatsu, Masataka
AU - Ichikawa, Tomohiro
AU - Nakanishi, Masanori
AU - Minakata, Yoshiaki
AU - Yamamoto, Nobuyuki
PY - 2014/3
Y1 - 2014/3
N2 - Background: The relationship between allergic rhinitis and asthma is well accepted; however, little is known about the mechanism that underlies the interactions between the upper and lower airways. Objective: To investigate the symptomatic and inflammatory linkages between allergic rhinitis and asthma in patients with atopy. Methods: We enrolled 520 patients with asthma who were taking inhaled corticosteroids, and examined them by using the Asthma Control Questionnaire, spirometry, exhaled nitric oxide fraction (FENO), visual analog scale for nasal symptoms, allergic rhinitis questionnaire, and serum specific IgE (study 1). The symptomatic and inflammatory marker responses to nasal corticosteroids in patients with incompletely controlled asthma (Asthma Control Questionnaire > 0.75) and moderate-to-severe persistent allergic rhinitis were also observed (study 2). Results: A total of 348 patients (66.9%) had atopy and allergic rhinitis. There was a striking difference in the proportion of patients with incomplete asthma control, depending on the presence as well as the activity of rhinitis (no rhinitis, 11.0%; mild intermittent, 20.4%; moderate-to-severe intermittent, 44.6%; mild persistent, 53.1%; moderate-to-severe persistent, 65.7%). The FENO levels were increased with the activity of rhinitis, and the nasal visual analog scale was positively correlated with the FENO levels (r = 0.31; P < .0001). The additive treatment with nasal corticosteroids improved the nasal visual analog scale, Asthma Control Questionnaire, and FENO levels, and the changes in these variables were correlated with each other in all parameters (all P < .001). Conclusion: This observational study of patients with atopy indicates that the ongoing allergic rhinitis is related to worsening of asthma by enhancing the lower airway inflammation.
AB - Background: The relationship between allergic rhinitis and asthma is well accepted; however, little is known about the mechanism that underlies the interactions between the upper and lower airways. Objective: To investigate the symptomatic and inflammatory linkages between allergic rhinitis and asthma in patients with atopy. Methods: We enrolled 520 patients with asthma who were taking inhaled corticosteroids, and examined them by using the Asthma Control Questionnaire, spirometry, exhaled nitric oxide fraction (FENO), visual analog scale for nasal symptoms, allergic rhinitis questionnaire, and serum specific IgE (study 1). The symptomatic and inflammatory marker responses to nasal corticosteroids in patients with incompletely controlled asthma (Asthma Control Questionnaire > 0.75) and moderate-to-severe persistent allergic rhinitis were also observed (study 2). Results: A total of 348 patients (66.9%) had atopy and allergic rhinitis. There was a striking difference in the proportion of patients with incomplete asthma control, depending on the presence as well as the activity of rhinitis (no rhinitis, 11.0%; mild intermittent, 20.4%; moderate-to-severe intermittent, 44.6%; mild persistent, 53.1%; moderate-to-severe persistent, 65.7%). The FENO levels were increased with the activity of rhinitis, and the nasal visual analog scale was positively correlated with the FENO levels (r = 0.31; P < .0001). The additive treatment with nasal corticosteroids improved the nasal visual analog scale, Asthma Control Questionnaire, and FENO levels, and the changes in these variables were correlated with each other in all parameters (all P < .001). Conclusion: This observational study of patients with atopy indicates that the ongoing allergic rhinitis is related to worsening of asthma by enhancing the lower airway inflammation.
KW - Airflow limitation
KW - Airway inflammation
KW - Atopy
KW - Exhaled nitric oxide
KW - Inhaled corticosteroids
KW - Nasal corticosteroids
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U2 - 10.1016/j.jaip.2013.09.018
DO - 10.1016/j.jaip.2013.09.018
M3 - Article
C2 - 24607045
AN - SCOPUS:84895446763
VL - 2
SP - 172-178.e1
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
SN - 2213-2198
IS - 2
ER -