Admin_Adham
TOPLINE
Among children without clinician-diagnosed asthma, allergic rhinitis was associated with more than threefold higher odds of elevated fractional exhaled nitric oxide (FeNO), a biomarker of eosinophilic airway inflammation, compared with no rhinitis, despite largely similar lung function.
METHODOLOGY
- Researchers conducted a cross-sectional study to determine whether children with allergic rhinitis but without clinician-diagnosed asthma had higher levels of FeNO than children without rhinitis.
- They analyzed 559 children without clinician-diagnosed asthma, aged 7-12 years (mean age, 8.7 years; 52.2% boys), from 20 public schools in Portugal; of these, 84 (15.0%) had allergic rhinitis.
- Legal guardians completed a questionnaire that captured clinician-diagnosed allergic rhinitis and asthma, parental education, lifetime wheezing, physical activity, and tobacco smoke exposure.
- Levels of FeNO were measured as per standard procedures, with values ≥ 35 parts per billion (ppb) considered elevated. Lung function was assessed using spirometry, and atopy was defined as at least one positive skin prick test reaction to common aeroallergens.
TAKEAWAY
- Children with allergic rhinitis had significantly higher FeNO levels than those without rhinitis (median, 15 ppb vs 10 ppb; P = .0001).
- In adjusted analyses, allergic rhinitis was associated with more than threefold higher odds of having elevated FeNO levels than without rhinitis (odds ratio, 3.50; P = .002).
- Children with allergic rhinitis more often had evidence of atopy (53.6% vs 31.2%), more often reported lifetime wheezing (32.1% vs 16.8%), and were less likely to be physically active (40.5% vs 56.1%; P < .05 for all).
- Lung function measures were mostly similar between the two groups.
IN PRACTICE
"[The study] findings reinforce the concept of united airway disease and indicate that increased FeNO may be present in children with AR [allergic rhinitis] even in the absence of detectable functional impairment," the authors wrote.
SOURCE
Ana Vitória Soares, with São João University Hospital, Porto, Portugal, was the corresponding author of the study, which was published online on October 8 as a Clinical Letter in Pediatric Allergy and Immunology.
LIMITATIONS
Because the study was cross-sectional, it could not establish cause and effect or whether allergic rhinitis or eosinophilic airway inflammation came first. Diagnoses of allergic rhinitis and asthma relied on guardians' reports; therefore, undiagnosed or developing asthma could not be ruled out. Information on allergic rhinitis treatment, current rhinitis symptoms, sensitization burden, recent respiratory infections, and the season in which FeNO was measured was not available.
DISCLOSURES
The study was funded by multiple sources, including Fundação para a Ciência e Tecnologia through the Project NORTE-01-0145-FEDER-000010 — Health, Comfort and Energy in the Built Environment, which was cofinanced by Programa Operacional Regional do Norte through Fundo Europeu de Desenvolvimento Regional (FEDER), and the EXALAR 21 project, which was funded by FEDER/FNR and Fundação para a Ciência e Tecnologia. The authors declared having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
