title: Prevalence and clinical relevance of allergic rhinitis in patients with classic asthma and cough variant asthma.
abstract: BACKGROUND
  A clinically relevant relationship between classic asthma and allergic rhinitis has been reported. However, the possible link between cough variant asthma (CVA) and allergic rhinitis remains unknown.
  
  
  OBJECTIVE
  To clarify the prevalence and clinical relevance of perennial allergic rhinitis or seasonal allergic rhinitis in CVA patients compared to classic asthma patients.
  
  
  METHODS
  We retrospectively studied adult patients with classic asthma (n = 190) and those with CVA (n = 83). The prevalence of perennial allergic rhinitis or seasonal allergic rhinitis and associations of concomitant perennial or seasonal allergic rhinitis with asthma severity, forced expiratory volume in 1 s (% predicted), fractional exhaled nitric oxide (FeNO) levels, and eosinophil proportions in sputum and blood were analyzed in the two groups.
  
  
  RESULTS
  The prevalence of perennial allergic rhinitis and/or seasonal allergic rhinitis was significantly higher in classic asthma patients than in CVA patients (all p < 0.05). Concomitant perennial allergic rhinitis was associated with higher FeNO levels and eosinophil proportions in sputum and blood in classic asthma patients (p = 0.035, p = 0.036, and p = 0.008, respectively) and with higher asthma severity, FeNO levels, and sputum eosinophil proportions in CVA patients (p = 0.031, p = 0.007, and p = 0.010, respectively). Concomitant seasonal allergic rhinitis was only associated with higher sputum eosinophil proportions in CVA patients with active rhinitis symptoms during the sensitized pollen season (p = 0.025).
  
  
  CONCLUSIONS
  Perennial allergic rhinitis may be relevant for CVA patients as well as classic asthma patients by consistently augmenting eosinophilic lower airway inflammation.
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tajiri
authors.forename: Akio
authors.initials: A
authors.lastname: Niimi
authors.forename: Hisako
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Isao
authors.initials: I
authors.lastname: Ito
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Oguma
authors.forename: Kojiro
authors.initials: K
authors.lastname: Otsuka
authors.forename: Tomoshi
authors.initials: T
authors.lastname: Takeda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nakaji
authors.forename: Hideki
authors.initials: H
authors.lastname: Inoue
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Iwata
authors.forename: Tadao
authors.initials: T
authors.lastname: Nagasaki
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D001944:Breath Tests; D015331:Cohort Studies; D003371:Cough / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D004802:Eosinophilia / Q000150:complications / Q000276:immunology; D004804:Eosinophils / Q000166:cytology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000276:immunology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis; D012189:Retrospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D012720:Severity of Illness Index; D013183:Sputum / Q000166:cytology
chemical_list: D009569:Nitric Oxide