title: Relationship between bronchial hyperreactivity and bronchodilation in patients with allergic rhinitis.
abstract: BACKGROUND
  Allergic rhinitis (AR) may be considered a risk factor for the onset of asthma. Recently, it has been reported that forced expiratory flow between 25% and 75% of vital capacity (FEF(25%-75%)) may predict a positive response to bronchodilation test in asthmatic children. Moreover, bronchial hyperreactivity (BHR) is frequently detected in AR patients.
  
  
  OBJECTIVE
  To evaluate the possible relationship between the response to bronchodilation test and methacholine challenge, also considering the FEF(25%-75%) values in a large group of patients with persistent allergic rhinitis.
  
  
  METHODS
  Three hundred sixty-five consecutive AR patients were evaluated. Clinical examination, spirometry, methacholine bronchial challenge, and bronchodilation test were performed in all patients.
  
  
  RESULTS
  Two hundred forty-one patients (66%) had "positive" results for bronchodilation test; FEF(25%-75%) was abnormal in 78 patients (21.4%), and 76 patients (20.8%) had severe BHR. An FEF(25%-75%) cutoff value of less than 58.5% of predicted may optimally (AUC 0.97) discriminate patients with both severe BHR and reversibility.
  
  
  CONCLUSIONS
  This study confirms previous studies and increases the strength of the role of FEF(25%-75%) as a marker of early bronchial involvement in patients suffering from persistent allergic rhinitis. Moreover, an FEF(25%-75%) value less than 58.5% of predicted may suggest the co-existence of severe BHR and reversibility.
authors.affiliation: Department of Internal Medicine, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy. gio.cip@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
authors.forename: Alessio
authors.initials: A
authors.lastname: Signori
authors.forename: Ignazio
authors.initials: I
authors.lastname: Cirillo
mesh_terms: D000328:Adult; D000420:Albuterol; D001249:Asthma; D001980:Bronchi / Q000502:physiology*; D016535:Bronchial Hyperreactivity / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D001993:Bronchodilator Agents; D003430:Cross-Sectional Studies; D005260:Female; D005540:Forced Expiratory Flow Rates; D005541:Forced Expiratory Volume; D006801:Humans; D007249:Inflammation; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D012221:Rhinitis, Allergic, Perennial / Q000503:physiopathology*; D012307:Risk Factors; D013147:Spirometry; D014797:Vital Capacity; D055815:Young Adult
chemical_list: D001993:Bronchodilator Agents; D016210:Methacholine Chloride; D000420:Albuterol