Children with allergic and nonallergic rhinitis have a similar risk of asthma.
BACKGROUND
Both allergic and nonallergic rhinitis have been associated with increased prevalence of asthma.


OBJECTIVE
To characterize asthma and intermediary asthma endpoints in young children with allergic and nonallergic rhinitis.


METHODS
Thirty-eight 7-year-old children with allergic rhinitis, 67 with nonallergic rhinitis, and 185 without rhinitis from the Copenhagen Prospective Study on Asthma in Childhood birth cohort were compared for prevalence of asthma, eczema, food sensitization, filaggrin null-mutations, total IgE, blood eosinophil count, fractional exhaled nitric oxide (FeNO), lung function, and bronchial responsiveness.


RESULTS
Children with allergic rhinitis compared with asymptomatic controls had increased prevalence of asthma (21% vs 5%; P = .002), food sensitization (47% vs 13%; P < .001), and eczema (66% vs 43%; P = .01) and increased total IgE (155 kU/L vs 41 kU/L; P < .001), blood eosinophil count (0.46 x 10(9)/L vs 0.30 x 10(9)/L; P = .01), FeNO (15.9 ppb vs 6.6 ppb; P < .001), and bronchial hyperresponsiveness (23% vs 9%; P = .008). Filaggrin null-mutations were associated with allergic rhinitis (odds ratio, 3.3; 95% CI, 1.3-8.3) but did not modify these associations. Children with nonallergic rhinitis also had increased asthma prevalence (20% vs 5%; P = .001) but showed no association with filaggrin null-mutations, eczema, food sensitization, total IgE, blood eosinophil count, FeNO, or bronchial responsiveness.


CONCLUSIONS
Asthma is similarly associated with allergic and nonallergic rhinitis, suggesting a link between upper and lower airways beyond allergy associated inflammation. Only children with allergic rhinitis had increased bronchial responsiveness and elevated FeNO, suggesting different endotypes of asthma symptoms in young children with allergic and nonallergic rhinitis.
Chawes
Bo Lund Krogsgaard
BL
Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, and the Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark.
Bønnelykke
Klaus
K
Kreiner-Møller
Eskil
E
Bisgaard
Hans
H
D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000150:complications* / Q000453:epidemiology*; D002648:Child; D005260:Female; D000091344:Filaggrin Proteins; D006801:Humans; D007381:Intermediate Filament Proteins / Q000235:genetics; D008297:Male; D012220:Rhinitis / Q000150:complications*; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications* / Q000235:genetics; D012307:Risk Factors; D011795:Surveys and Questionnaires
D000485:Allergens; C000717249:FLG protein, human; D000091344:Filaggrin Proteins; D007381:Intermediate Filament Proteins