B. Leynaert et al., Perennial rhinitis: An independent risk factor for asthma in nonatopic subjects. Results from the European Community Respiratory Health Survey, J ALLERG CL, 104(2), 1999, pp. 301-304
Background: Although clinical and experimental studies suggest that upper r
espiratory tract dysfunction may affect the lower airways, rhinitis is usua
lly not studied as a potential risk factor for asthma, This is because both
diseases share key elements of pathogenesis and are usually considered as
different manifestations of the same underlying "atopic" state.
Objective: We sought to assess whether asthma is associated with rhinitis i
n the absence of immunologic disorders in a population study.
Methods: Data from 34 centers participating in the European Community Respi
ratory Health Survey were analyzed. Random samples of 20- to 44-year-old su
bjects were invited to complete a detailed questionnaire and undergo total
and specific IgE measurements, skin prick tests to 9 allergens, and broncho
provocation challenges with methacholine,
Results: Subjects with perennial rhinitis (n = 1412) were more likely than:
control subjects (n = 5198) to have current asthma, After adjustment for se
x, age, smoking habit, family history of asthma, geographic area, and seaso
n at the time of examination, asthma was strongly associated with rhinitis
among atopic subjects (odds ratio [OR] = 8.1; 95% confidence interval [CI]
= 5.4-12.1) but also among nonatopic subjects (OR = 11.6; 95% CI = 6.2-21.9
), Moreover, the association remained very strong when the analysis was res
tricted to nonatopic subjects with IgE levels of 80 kIU/L or less (OR = 13.
3; 95% CI = 6.7-26.5), In nonasthmatic subjects bronchial hyperresponsivene
ss was also more frequent in subjects with rhinitis than in those without r
hinitis (OR = 1.7; 95% CI = 1.2-2.6 in nonatopic subjects with IgE levels o
f less than or equal to 80 kIU/L).
Conclusion: The strong association between perennial rhinitis and: asthma i
n nonatopic subjects with normal IgE levels is consistent with the hypothes
is that rhinitis is an independent risk factor for asthma.