Rhinitis Linked To
Adult-Onset Asthma
Reported
October 07, 2008
Adult-onset asthma can be predicted by the presence of
rhinitis, both allergic and non-allergic, according to an article released
on September 19, 2008 in The Lancet.
To investigate the potential implications of both allergic and non-allergic
rhinitis on adult-onset asthma, Rafea Shaaban, Mahmoud Zureik, and Benedicte
Leynaert, of the INSERM Epidemiology Team, Paris, France, and colleagues,
examined data from the European Community Health Survey. Adult patients
between the ages of 20 and 44 years with allergic and non-allergic rhinitis
were tracked over 8.8 years. In total, 6,461 patients were examined in 29
centers in 14 different countries, mostly in Western Europe. None of the
participants had asthma at the start of the study.
Each patient was examined for rhinitis. Then, any potential allergies were
tested by a skin-prick test for the following exposures: house dust mites,
cats, two types of fungus, grass, birch, the flowering plant Parietartia,
olive, or ragweed. Based on these results, the patients were classified into
one of four groups: the control group, with no allergies and no rhinitis;
atopy only, with no rhinitis; non-allergic rhinitis; and allergic rhinitis.
In the 8.8 years of follow up, asthma had developed in 1.1% of the control
group, 1.9% of the atopy only group, 3.1% of the non-allergic rhinitis, and
4.0% of the allergic rhinitis groups. After adjustment for country, sex,
baseline age, body-mass index, lung capacity, family history of asthma, and
smoking, those with allergies were 1.63 times as likely than controls to
have asthma. those with non-allergic rhinitis were more than 2.5 times as
likely to have asthma, those with allergic rhinitis had 3.5 times the risk
of asthma. Notably, sensitization to dust mites was the only allergy
associated independently with asthma. All of the associations were seen in
men and women.
The authors point
out that, especially given the magnitude of this study, this association
between asthma and rhinitis is a powerful direction for future asthma
research. "This large prospective study provides strong evidence for an
increased risk of asthma in adults with allergic rhinitis, and to a lesser
extent non-allergic rhinitis...Several clinical trials in asthmatic patients
with allergic rhinitis were associated with a reduction in asthma symptoms.
However, only interventional studies could be used to conclude that the
treatment of allergic rhinitis is effective in reducing the incidence of
asthma."
Dr Erika von Mutius, University Children's Hospital, Munich, Germany,
contributed an accompanying comment which points out the potential
implications of this work: "The idea that allergic rhinitis could cause
asthma raises the possibility of preventing asthma by preventing atopic
sensation, which could in turn prevent allergic rhinitis."
Source : Medical News Today
