Jung Sungsu, Lee So Yeon, Yoon Jisun, Cho Hyun Ju, Kim Young Ho, Suh Dong In, Yang Song I, Kwon Ji Won, Jang Gwang Cheon, Sun Yong Han, Woo Sung Il, Youn You Sook, Park Kang Seo, Lee Eun, Cho Hwa Jin, Kook Myung Hee, Yi Hye Ryoung, Chung Hai Lee, Kim Ja Hyeong, Kim Hyung Young, Jung Jin A, Woo Hyang Ok, Lee Jeom Kyu, Chang Woo Sung, Do Nam Hee, Cho Hyejoo, Hong Soo Jong
Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea.
Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Allergy Asthma Immunol Res. 2020 Jan;12(1):72-85. doi: 10.4168/aair.2020.12.1.72.
Data are lacking on the association between the allergic rhinitis (AR) phenotype and sensitization to specific allergens or bronchial hyperresponsiveness (BHR) in children. We here investigated risk factors and comorbidities, including sensitization to specific allergens and BHR, for the AR phenotype by AR and its Impact on Asthma (ARIA) classification in a general population-based birth cohort study.
We enrolled 606 children aged 7 years from the Panel Study of Korean Children. The AR phenotype was assigned in accordance with the ARIA classification in children. Skin prick tests and Provocholine provocation test were performed. Risk factors and comorbidities for AR phenotypes were then analyzed.
The prevalence of mild and moderate to severe AR in our study cohort was 37.2% and 8.8%, respectively. Recent use of analgesics or antipyretics and current cat ownership were associated with the risk of mild persistent AR. Sensitizations to (), Japanese hop and cat were associated with moderate to severe persistent AR. Children with moderate to severe AR had a higher risk of current asthma and BHR compared to mild AR cases (adjusted odds ratio [aOR], 5.26; 95% confidence interval [CI], 1.77-15.62). Moderate to severe AR with allergic sensitization was associated with the highest risk of BHR (aOR, 11.77; 95% CI, 3.40-40.74).
Moderate to severe-persistent AR is more closely related to respiratory comorbidities and sensitizations than mild AR. Stratifying the AR phenotype by ARIA classification may assist in disease management.
关于儿童过敏性鼻炎（AR）表型与对特定过敏原致敏或支气管高反应性（BHR）之间的关联，目前缺乏相关数据。在一项基于人群的出生队列研究中，我们通过AR及其对哮喘的影响（ARIA）分类，研究了AR表型的危险因素和合并症，包括对特定过敏原的致敏和BHR。
我们从韩国儿童面板研究中招募了606名7岁儿童。根据儿童的ARIA分类确定AR表型。进行了皮肤点刺试验和乙酰甲胆碱激发试验。然后分析AR表型的危险因素和合并症。
在我们的研究队列中，轻度AR和中重度AR的患病率分别为37.2%和8.8%。近期使用镇痛药或退热药以及目前养猫与轻度持续性AR的风险相关。对（）、日本蛇麻草和猫的致敏与中重度持续性AR相关。与轻度AR患儿相比，中重度AR患儿当前患哮喘和BHR的风险更高（调整优势比[aOR]，5.26；95%置信区间[CI]，1.77 - 15.62）。伴有过敏致敏的中重度AR与BHR的最高风险相关（aOR，11.77；95%CI，3.40 - 40.74）。
与轻度AR相比，中重度持续性AR与呼吸道合并症和致敏的关系更为密切。通过ARIA分类对AR表型进行分层可能有助于疾病管理。
