Allergy Asthma Immunol Res.  2010 Apr;2(2):108-113. 10.4168/aair.2010.2.2.108.

Asthmatics Without Rhinitis Have More Fixed Airway Obstruction Than Those With Concurrent Rhinitis

• Jang AS
• Park JS
• Lee JH
• Park SW
• Kim DJ
• Uh ST
• Kim YH
• Park CS

• KMID: 2260596
• DOI: http://doi.org/10.4168/aair.2010.2.2.108

Abstract

PURPOSE
Rhinitis and asthma usually occur together. There are increasing evidences that allergic rhinitis (AR) may influence the clinical course of asthma. The aim of this study is to evaluate clinical parameters and therapeutic response in patients with between asthma and asthma with AR.
METHODS
Four-hundred eighty-five patients with asthma and 428 asthmatics with AR, who had lesser than 50 years old and smoked less than 10 pack-years were recruited. We compared FEV1 and FEV1/FVC following bronchodilator, atopy, IgE, emphysema on HRCT, and aspirin intolerance between two groups. Also we compared physiologic fixed airway obstruction defined using FEV1/FVC and FEV1 less than 75% following anti-asthmatic drug for 1 year.
RESULTS
46.8% (428/913) asthmatics suffered from AR. There were no differences of total IgE, body mass index, PC20, sputum eosinophils and emphysema on HRCT between two groups. The age in asthmatics was higher than that in those with AR. FEV1/FVC was lower in asthmatics than in those with AR. The prevalence of atopy was higher in asthmatics with AR than in asthmatics. Aspirin intolerance was higher in asthmatics with AR than in asthmatics (42/218 vs 13/109, P=0.001). Fixed airway obstruction were more observed in asthmatics than in those with AR (39/319 vs 28/355, P=0.001) after anti-asthmatic drug for 1 year.
CONCLUSIONS
Asthmatics with AR had more atopy and aspirin intolerance than asthmatics, and asthmatics had poor response to anti-inflammatory drugs than those with concurrent rhinitis, indicating that asthmatics have more fixed airway obstruction than those with concurrent rhinitis.

Keyword

Asthma; allergic rhinitis; airway obstruction

MeSH Terms

Airway Obstruction
Aspirin
Asthma
Body Mass Index
Emphysema
Eosinophils
Humans
Immunoglobulin E
Prevalence
Rhinitis
Rhinitis, Allergic, Perennial
Smoke
Sputum
Aspirin
Immunoglobulin E
Smoke

Figure

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  Fig. 1 Differences in age between asthmatics and those with allergic rhinitis.

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  Fig. 2 Lung function following bronchodilator between asthmatics and those with allergic rhinitis. A: asthmatics, B: asthmatics with allergic rhinitis. FEV1, forced expiratory volume in one second; FVC, forced vital capacity.

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  Fig. 3 Aspirin intolerance between asthmatics and those with AR. Aspirin intolerance defined as showing symptoms with a fall in FEV1 greater than 15% following aspirin provocation test in patients.

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  Fig. 4 Fixed airway obstruction between asthmatics and those with AR following anti-inflammatory drug for 1 year.

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