Relationship between Asthma and Allergic Rhinitis in Terms of Prevalence and Severity in East-Azerbaijan, Iran
Abstract
Background: Asthma and Allergic rhinitis (AR) are frequently concurrent diseases. Epidemiological,
immunological, and clinical studies reported increasing evidence of the links between AR and asthma.
Epidemiologically, up to 40% of patients with AR also have asthma, and up to 80% of patients with asthma
experience nasal symptoms. Furthermore, patients with AR are at three times the risk of developing asthma
compared with those without AR.
Method: This cross-sectional study was carried out during one year from all patients between 0-16 years
who were referred to allergy and ENT clinics with symptoms of chronic cough (more than four weeks) or
upper respiratory tract symptoms such as sneezing, runny nose, and nasal congestion. Data and diagnosis
were classified according to the Global Initiative for Asthma (GINA) and the AR criteria and its Impact on
Asthma guidelines (ARIA), respectively.
Results: 190 (120 individuals with asthma and 70 individuals with AR) were enrolled in the study. The mean
age of patients with asthma was 9.14±3.13, and 43.3% were female. The severity of asthma was classified as
mild (20%), moderate (70.8%), and severe (9.2%). The mean age of patients with rhinitis was 10.13±3.45 years,
and 35.7% were female. Rhinitis was classified as intermittent (40%) and persistent (60%). The prevalence of
AR in the asthma group was 42 individuals (35%). Twenty-nine cases of them (24.2%) had intermittent AR,
and 13 (10.8%) cases had persistent AR. The prevalence of asthma in AR was 18 cases (25.7%) 3 cases (4.3%)
had mild asthma, 12 cases (17/1%) had moderate asthma, and 3 cases (4.3%) had severe asthma. A significant
correlation was found ( P<0.0001) between the severity of AR and asthma.
Conclusion: Based on the findings of our study, there is a significant relationship between the severity of
asthma and AR in patients with asthma and AR. The results show that asthma prevalence is high in patients
with AR. Also, the frequency of AR in patients with asthma is significantly higher.
2. Bush A, Fleming L. Diagnosis and management of asthma in children. Bmj. 2015 Mar;350:h996.
3. Caminati M, Morais-Almeida M, Bleecker E, Ansotegui I, Canonica GW, Bovo C, et al. Biologics and global burden of asthma: a worldwide portrait and a call for action. Waojou. 2021 Jan;14(2):100502.
4. Ferrante G, La Grutta S. The burden of pediatric asthma. F ped. 2018 Jun;22 (6):186.
5. Heidarnia MA, Entezari A, Moein M, Mehrabi Y, Pourpak Z. Prevalence of asthma symptom in Iran: a meta-analysis. Research in Medicine. 2007;31(3):217-25.
6. Pawankar R, Canonica GW, Holgate ST, Lockey RF, Blaiss M. WAO white book on allergy: update 2013. WAO. 2013;248.
7. Leynaert B, Bousquet J, Neukirch C, Liard R, Neukirch F, European Community respiratory Health S. Perennial rhinitis: an independent risk factor for asthma in nonatopic subjects: results from the European Community Respiratory Health Survey. J Allergy and clin immunol. 1999Aug;104(2):301-4.
8. Jacob L, Keil T, Kostev K. Comorbid disorders associated with asthma in children in Germany–National analysis of Pediatric primary care data. Pediatr Allergy Immunol. 2016 Dec;27(8):861-6.
9. Shaaban R, Zureik M, Soussan D, Neukirch C, Heinrich J, Sunyer J, et al. Rhinitis and onset of asthma: a longitudinal population-based study.Lancet. 2008 Sep;372(9643):1049-57.
10. Demoly P, Bousquet J. The relation between asthma and allergic rhinitis.Lancet. 2006 Aug;368(9537):711-3.
11. Bousquet J, Schünemann HJ, Togias A, Bachert C, Erhola M, Hellings PW, et al. Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020Jan;145(1):70-80.
12. Chipps BE, Murphy KR, Oppenheimer J. 2020 NAEPP Guidelines Update and GINA 2021—asthma care differences, overlap, and challenges. J Allergy Clin Immunol Pract. 2022 Jan;10(1):S19-S30.
13. Klain A, Indolfi C, Dinardo G, Decimo F, Tosca MA, Miraglia Del Giudice M, et al. Comparing available treatments for pollen-induced allergic rhinitis in children. Expert Rev Clin Immunol. 2022Aug;18(8):835-843.
14. Rahimian N, Aghajanpour M, Jouybari L, Ataee P, Fathollahpour A, Lamuch-Deli N, et al. The prevalence of asthma among iranian children and adolescent: a systematic review and meta-analysis. Oxid Med Cell Longev. 2021Aug 21:6671870.
15. Kusunoki T, Morimoto T, Nishikomori R, Yasumi T, Heike T, Fujii T, et al. Changing prevalence and severity of childhood allergic diseases in Kyoto, Japan, from 1996 to 2006. Allergol Int. 2009Des;58(4):543-8.
16. Almqvist C, Worm M, Leynaert B, Working Group of GALENWPG. Impact of gender on asthma in childhood and adolescence: a GA2LEN review. Allergy. 2008Jan;63(1):47-57.
17. Ruokonen M, Kaila M, Haataja R, Korppi M, Paassilta M. Allergic rhinitis in school‐aged children with asthma–still under‐diagnosed and under‐treated? A retrospective study in a children‘s hospital. Pediatr Allergy Immunol. 2010;21(1‐Part‐II):e149-e54.
18. Koponen P, Helminen M, Paassilta M, Luukkaala T, Korppi M. Preschool asthma after bronchiolitis in infancy. Eur Respir J. 2012Jan;39(1):76-80.
19. Verlato G, Nguyen G, Marchetti P, Accordini S, Marcon A, Marconcini R, et al. Smoking and new-onset asthma in a prospective study on Italian adults. Int Arch Allergy Immunol. 2016 Aug;170(3):149-57.
20. Sly PD, Boner AL, Björksten B, Bush A, Custovic A, Eigenmann PA, et al. Early identification of atopy in the prediction of persistent asthma in children. Lancet. 2008 Sep;372(9643):1100-6.
21. Pinart M, Benet M, Annesi-Maesano I, von Berg A, Berdel D, Carlsen KCL, et al. Comorbidity of eczema, rhinitis, and asthma in IgE-sensitised and non-IgE-sensitised children in MeDALL: a population-based cohort study. Lancet Respir Med. 2014 Feb ;2(2):131-40.
22. Borish L. The immunology of asthma: asthma phenotypes and their implications for personalized treatment. Ann Allergy Asthma Immunol. 2016Aug;117(2):108-14.
23. Jones AC, Troy NM, White E, Hollams EM, Gout AM, Ling K-M, et al. Persistent activation of interlinked type 2 airway epithelial gene networks in sputum-derived cells from aeroallergen-sensitized symptomatic asthmatics. Sci Rep. 2018 Jan;8(1):1-13.
24. Voraphani N, Stern DA, Wright AL, Guerra S, Morgan WJ, Martinez FD. Risk of current asthma among adult smokers with respiratory syncytial virus illnesses in early life. Am J Respir Crit Care Med. 2014 Aug;190(4):392-8.
25. Carr TF, Stern DA, Halonen M, Wright AL, Martinez FD. Non‐atopic rhinitis at age 6 is associated with subsequent development of asthma. Clin Exp Allergy. 2019 Jan;49(1):35-43.
26. Törmänen S, Lauhkonen E, Riikonen R, Koponen P, Huhtala H, Helminen M, et al. Risk factors for asthma after infant bronchiolitis. Allergy. 2018;73(4):916-22.
27. Tohidinik HR, Mallah N, Takkouche B. History of allergic rhinitis and risk of asthma; a systematic review and meta-analysis. World Allergy Organ J. 2019 Oct;12(10):100069.
Files | ||
Issue | Vol 7, No 2 (2024) | |
Section | Original Article | |
DOI | https://doi.org/10.18502/igj.v7i2.17851 | |
Keywords | ||
Allergic Rhinitis Asthma Children Severity |
Rights and permissions | |
![]() |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |