Association between nasal and bronchial symptoms in subjects with persistent allergic rhinitis.
BACKGROUND
The association between nasal and bronchial symptoms, and the course of bronchial responsiveness and airway inflammation in house dust mite sensitive persistent rhinitis over a prolonged time period has not been thoroughly explored.


OBJECTIVE
To determine if nasal symptoms were associated with bronchial symptoms in persistent rhinitic subjects, and to assess their bronchial responsiveness and airway inflammation in comparison to nonrhinitic, nonatopic controls. The additional impact of pollen sensitivity on the lower airways in rhinitic subjects was also addressed.


METHODS
Rhinitics and controls answered telephone symptom questionnaires once every 2 weeks for 1 year. Every 3 months, exhaled nitric oxide (eNO) and bronchial responsiveness to histamine were measured.


RESULTS
Thirty-seven rhinitics and 19 controls completed the study. High nasal symptom scores in rhinitic subjects were associated with bronchial symptoms (OR = 1.7, 95% CI 1.2-2.5). Bronchial hyper-responsiveness was present in 32.4% of rhinitic subjects on at least one clinical visit during the year. Pollen allergy caused seasonal variation in eNO (P = 0.03).


CONCLUSIONS
In persistent rhinitic subjects, high nasal symptom scores were associated with bronchial symptoms, and many subjects experienced bronchial hyper-responsiveness during the year. Persistent rhinitic subjects were more at risk than healthy adults of bronchial symptoms and airway inflammation, which are likely risk factors for asthma.
Woolcock Institute of Medical Research, Camperdown, Sydney, Australia.
S R
SR
Downie
M
M
Andersson
J
J
Rimmer
J D
JD
Leuppi
W
W
Xuan
A
A
Akerlund
J K
JK
Peat
C M
CM
Salome
D000293:Adolescent; D000328:Adult; D001944:Breath Tests; D001985:Bronchial Provocation Tests; D006801:Humans; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D011058:Pollen / Q000276:immunology; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000503:physiopathology*; D006255:Rhinitis, Allergic, Seasonal / Q000503:physiopathology*
D009569:Nitric Oxide