Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, and the Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark.
J Allergy Clin Immunol. 2010 Sep;126(3):567-73.e1-8. doi: 10.1016/j.jaci.2010.06.026.
Both allergic and nonallergic rhinitis have been associated with increased prevalence of asthma.
To characterize asthma and intermediary asthma endpoints in young children with allergic and nonallergic rhinitis.
Thirty-eight 7-year-old children with allergic rhinitis, 67 with nonallergic rhinitis, and 185 without rhinitis from the Copenhagen Prospective Study on Asthma in Childhood birth cohort were compared for prevalence of asthma, eczema, food sensitization, filaggrin null-mutations, total IgE, blood eosinophil count, fractional exhaled nitric oxide (FeNO), lung function, and bronchial responsiveness.
Children with allergic rhinitis compared with asymptomatic controls had increased prevalence of asthma (21% vs 5%; P = .002), food sensitization (47% vs 13%; P < .001), and eczema (66% vs 43%; P = .01) and increased total IgE (155 kU/L vs 41 kU/L; P < .001), blood eosinophil count (0.46 x 10(9)/L vs 0.30 x 10(9)/L; P = .01), FeNO (15.9 ppb vs 6.6 ppb; P < .001), and bronchial hyperresponsiveness (23% vs 9%; P = .008). Filaggrin null-mutations were associated with allergic rhinitis (odds ratio, 3.3; 95% CI, 1.3-8.3) but did not modify these associations. Children with nonallergic rhinitis also had increased asthma prevalence (20% vs 5%; P = .001) but showed no association with filaggrin null-mutations, eczema, food sensitization, total IgE, blood eosinophil count, FeNO, or bronchial responsiveness.
Asthma is similarly associated with allergic and nonallergic rhinitis, suggesting a link between upper and lower airways beyond allergy associated inflammation. Only children with allergic rhinitis had increased bronchial responsiveness and elevated FeNO, suggesting different endotypes of asthma symptoms in young children with allergic and nonallergic rhinitis.
过敏性和非过敏性鼻炎均与哮喘患病率增加有关。
描述患过敏性和非过敏性鼻炎的幼儿哮喘和哮喘相关中间终点的特征。
比较来自哥本哈根儿童哮喘前瞻性研究队列的 38 名 7 岁过敏性鼻炎患儿、67 名非过敏性鼻炎患儿和 185 名无鼻炎患儿的哮喘、特应性皮炎、食物过敏、丝聚合蛋白缺失突变、总 IgE、血嗜酸性粒细胞计数、呼出气一氧化氮分数（FeNO）、肺功能和支气管反应性的发生率。
与无症状对照者相比，过敏性鼻炎患儿哮喘（21%比 5%；P =.002）、食物过敏（47%比 13%；P <.001）和特应性皮炎（66%比 43%；P =.01）的发生率更高，总 IgE（155 kU/L 比 41 kU/L；P <.001）、血嗜酸性粒细胞计数（0.46×10(9)/L 比 0.30×10(9)/L；P =.01）、FeNO（15.9 ppb 比 6.6 ppb；P <.001）和支气管高反应性（23%比 9%；P =.008）更高。丝聚合蛋白缺失突变与过敏性鼻炎相关（比值比，3.3；95%置信区间，1.3-8.3），但并未改变这些关联。非过敏性鼻炎患儿哮喘的患病率也增加（20%比 5%；P =.001），但与丝聚合蛋白缺失突变、特应性皮炎、食物过敏、总 IgE、血嗜酸性粒细胞计数、FeNO 或支气管高反应性无关。
哮喘与过敏性和非过敏性鼻炎同样相关，提示上、下呼吸道之间存在除过敏相关炎症之外的关联。只有过敏性鼻炎患儿的支气管高反应性和 FeNO 升高，提示过敏性和非过敏性鼻炎患儿的哮喘症状存在不同的表型。
