Ongoing allergic rhinitis impairs asthma control by enhancing the lower airway inflammation

Asako Oka, Kazuto Matsunaga, Tadashi Kamei, Yukihiro Sakamoto, Tsunahiko Hirano, Atsushi Hayata, Keiichiro Akamatsu, Takashi Kikuchi, Masataka Hiramatsu, Tomohiro Ichikawa, Masanori Nakanishi, Yoshiaki Minakata, Nobuyuki Yamamoto

研究成果: Article査読

39 被引用数 (Scopus)


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.

ジャーナルJournal of Allergy and Clinical Immunology: In Practice
出版ステータスPublished - 2014 3月

ASJC Scopus subject areas

  • 免疫アレルギー学


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