title: Early bronchial airflow impairment in patients with persistent allergic rhinitis and bronchial hyperreactivity.
abstract: BACKGROUND
  Allergic rhinitis and its impact on asthma (ARIA) document underlines the link between upper and lower airways. Patients suffering from allergic rhinitis frequently (up to 80%) show bronchial hyperreactivity (BHR).
  
  
  OBJECTIVE
  This study aimed at evaluating a group of subjects suffering from persistent allergic rhinitis, with BHR but with nasal symptoms only, to investigate the type and intensity of nasal symptoms, nasal and bronchial airflow, and BHR grade during the pollen season.
  
  
  METHODS
  One hundred and twenty one polysensitized rhinitics were investigated. Total symptom score (TSS) was assessed in all patients. Rhinomanometry, spirometry and methacholine bronchial challenge were performed in all patients.
  
  
  RESULTS
  65 (53.7%) patients had impaired FEF 25-75 values. TSS correlated with nasal airflow (P<0.001) and BHR grade (P<0.001). Nasal airflow correlated with FEF 25-75 values (P<0.05) and BHR (P<0.001). FEF 25-75 values correlated with FEV(1) levels (P<0.003), BHR grade (P<0.001), and nasal obstruction symptom (P<0.05). Severe BHR correlated with FEV(1) (P<0.05) and FEF 25-75 (P<0.03) values, nasal airflow (P<0.05) and nasal symptoms (P<0.001).
  
  
  CONCLUSIONS
  This study evidences that early bronchial impairment is frequently detectable in patients with persistent allergic rhinitis and BHR. Moreover, nasal function is strictly related with bronchial calibre and BHR grade. Therefore, careful evaluation of lower airways should be investigated in all rhinitics as suggested by the ARIA document.
authors.affiliation: Head-Neck Dpt., San Martino Hospital, Genoa, Italy. gio.cip@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
authors.forename: Ignazio
authors.initials: I
authors.lastname: Cirillo
authors.forename: Andrea
authors.initials: A
authors.lastname: Vizzaccaro
authors.forename: Margherita
authors.initials: M
authors.lastname: Monardo
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Tosca
mesh_terms: D000328:Adult; D000403:Airway Resistance; D001249:Asthma / Q000276:immunology / Q000503:physiopathology; D001980:Bronchi / Q000503:physiopathology*; D016535:Bronchial Hyperreactivity / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D009278:Naphazoline; D014663:Nasal Decongestants; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000503:physiopathology*; D025363:Rhinomanometry; D012882:Skin Tests; D013147:Spirometry
chemical_list: D014663:Nasal Decongestants; D009278:Naphazoline