title: Lower airways may also be affected in asymptomatic patients with recent onset of allergic rhinitis.
abstract: OBJECTIVE
  It is well known that there is a close association between allergic rhinitis (AR) and asthma, and AR is a strong risk factor for the onset of asthma. AR duration is significantly associated with a possible bronchial involvement. The aim of this study was to investigate the presence of possible spirometric abnormalities and bronchial hyperreactivity (BHR) in a large group of patients with recent onset of AR.
  
  
  METHODS
  Observational cross-sectional study.
  
  
  METHODS
  A total of 1,539 AR patients were consecutively evaluated. Clinical examination, skin prick test, spirometry, and methacholine challenge were performed on all patients.
  
  
  RESULTS
  : There were 362 (23%) patients with FEF(25-75) values <70% of predicted. The methacholine challenge was positive in 74.43% of patients, and 72.22% of the population presented a polysensitization. At multivariable analysis, an FEV(1) value lower than 92% of predicted, as well as increasing severity of BHR and polysensitization appeared to be independent predictors of a reduced FEF(25-75) value.
  
  
  CONCLUSIONS
  This study shows that reduced FEF(25-75) values may be present in some patients with recent onset of AR. FEV(1) <92%, severity of BHR, and polysensitization may be considered risk factor for this phenomenon.
authors.affiliation: Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino-University of Genoa, 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: Catherine
authors.initials: C
authors.lastname: Klersy
mesh_terms: D000293:Adolescent; D000328:Adult; D016535:Bronchial Hyperreactivity / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005541:Forced Expiratory Volume; D006801:Humans; D016210:Methacholine Chloride; D008875:Middle Aged; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology / Q000503:physiopathology*; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology / Q000503:physiopathology*; D012882:Skin Tests
chemical_list: D016210:Methacholine Chloride