Laboratoire Santé Publique et Environnement, Faculté des Sciences Pharmaceutiques et Biologiques,Université Paris Descartes, 4 avenue de l’Observatoire, Paris, France.
Allergy. 2011 Feb;66(2):214-21. doi: 10.1111/j.1398-9995.2010.02467.x. Epub 2010 Aug 30.
Early onset of allergic rhinitis (AR) is poorly described, and rhinitis symptoms are often attributed to infections. This study analyses the relations between AR-like symptoms and atopy in infancy in the PARIS (Pollution and Asthma Risk: an Infant Study) birth cohort.
Data on AR-like symptoms (runny nose, blocked nose, sneezing apart from a cold) were collected using a standardized questionnaire administered during the health examination at age 18 months included in the follow-up of the PARIS birth cohort. Parental history of allergy and children's atopy blood markers (blood eosinophilia ≥470 eosinophils/mm(3) , total immunoglobulin E ≥45 U/ml and presence of allergen-specific IgE) were assessed. Associations were studied using multivariate logistic regression models adjusted for potential confounders.
Prevalence of AR-like symptoms in the past year was 9.1% of the 1850 toddlers of the study cohort. AR-like symptoms and dry cough apart from a cold were frequent comorbid conditions. Parental history of AR in both parents increased the risk of suffering from AR-like symptoms with an OR 2.09 (P=0.036). Significant associations were found with the presence of concurrent biological markers of atopy, especially blood eosinophilia and sensitization to house dust mite (OR 1.54, P=0.046 and OR 2.91, P=0.042) whereas there was no relation with sensitization to food.
These results support the hypothesis that AR could begin as early as 18 months of life. Suspicion of AR should be reinforced in infants with parental history of AR or biological evidence of atopy, particularly blood eosinophilia and sensitization to inhalant allergens.
变应性鼻炎（AR）的早期发病情况描述较差，且鼻炎症状常归因于感染。本研究分析了巴黎（污染与哮喘风险：婴儿研究）出生队列中婴儿期类似 AR 症状与特应性之间的关系。
使用标准化问卷在随访的 PARIS 出生队列中收集了 18 个月时健康检查时出现的类似 AR 症状（流鼻涕、鼻塞、打喷嚏除外感冒）的数据。评估了父母过敏史和儿童特应性血液标志物（血嗜酸性粒细胞≥470 个/毫米 3 、总免疫球蛋白 E≥45 U/ml 和过敏原特异性 IgE 存在）。使用多变量逻辑回归模型调整潜在混杂因素后研究了相关性。
研究队列中 1850 名幼儿过去一年 AR 样症状的患病率为 9.1%。AR 样症状和除感冒外的干咳是常见的合并症。父母双方均有 AR 病史会增加患 AR 样症状的风险，OR 为 2.09（P=0.036）。与同时存在特应性的生物学标志物（尤其是血嗜酸性粒细胞和对屋尘螨过敏）存在显著相关性，OR 分别为 1.54（P=0.046）和 2.91（P=0.042），但与食物过敏无相关性。
这些结果支持了 AR 可能早在 18 个月大时就开始的假说。在有父母 AR 病史或特应性生物学证据（尤其是血嗜酸性粒细胞增多和对吸入性过敏原过敏）的婴儿中，应加强对 AR 的怀疑。
