title: The impact of intranasal corticosteroids on lung function in children with allergic rhinitis.
abstract: BACKGROUND
  Subjects with allergic rhinitis (AR) suffer from impaired lung function, especially decreased FEF(25-75%). The purpose of this study was to examine lung function and the long-term response to INCS in AR patients with impaired lung function, and to characterize the phenotype of these children.
  
  
  METHODS
  Two hundred two children with AR underwent an allergy evaluation including a skin prick test and spirometry. Children with impaired lung function were treated with daily nasal corticosteroids spray (INCS) and antihistamine as needed.
  
  
  RESULTS
  Fifty-three children out of 202 (26.3%) had impaired lung function: 34 of them (64.2%) had FEF(25-75%) values under 80% of predicted and normal FEV(1) values, and 19 individuals (35.8%), had both FEF(25-75%) and FEV(1) values below 80% of predicted. A positive correlation between FEV(1) and FEF(25-75%) values (r = 0.369, P = 0.007) and a reverse correlation between duration of nasal symptoms and FEF(25-75%) values (r = -0.364, P = 0.012) were found. Post-ronchodilation FEV(1) levels increased from 81.9 ± 8.0 to 87.7 ± 10.4 (P < 0.0001). Thirty-five of the 53 children complied with a continuous INCS treatment regimen over a period of 3-12 months, demonstrated increased FEF(25-75%) (84.4 ± 13.6 vs. 70.1 ± 7.1, P < 0.001) and FEV(1) (92.3 ± 10.9 vs. 84.4 ± 7.8, P < 0.0001) after INCS treatment. However, FEF(25-75%) values were still significantly lower compared to the group of AR children with normal lung function (84.4 ± 13.6 vs. 95.7 ± 8.8, P < 0.0001).
  
  
  CONCLUSIONS
  INCS improve FEF(25-75%) above 80% of predicted values in 2/3 of children with abnormal lung function. However, this improvement does not reach levels of AR children with normal lung function. Pediatr
authors.affiliation: Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Technion Faculty of Medicine, Haifa, Israel.
authors.forename: Aharon
authors.initials: A
authors.lastname: Kessel
mesh_terms: D000281:Administration, Intranasal; D001249:Asthma / Q000503:physiopathology; D002648:Child; D005260:Female; D005540:Forced Expiratory Flow Rates / Q000502:physiology*; D005541:Forced Expiratory Volume / Q000502:physiology*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D065631:Rhinitis, Allergic / Q000188:drug therapy* / Q000503:physiopathology*; D013147:Spirometry
chemical_list: D005938:Glucocorticoids
keywords: allergic rhinitis; asthma; lung function; nasal corticosteroids