Comorbidities of asthma and the unified airway

Stachler, Robert J.

doi:10.1002/alr.21615

Cited by 36 publications

(31 citation statements)

References 65 publications

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“…There is a consecutive process in the progression of AR into asthma, as previously demonstrated by a long-term follow-up study (22). This has also been confirmed through a retrospectively study (23,24). The present results showed that the mean duration of AR was longer than asthma in the AR with asthma group, although certain patients reported that asthma was diagnosed earlier than AR.…”

Section: Discussionsupporting

confidence: 88%

FeNO for detecting lower airway involvement in patients with allergic rhinitis

Zhu

Xie

Guan

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. Allergic rhinitis (AR) is a risk factor for asthma development. The value of fractional exhaled nitric oxide (FeNO) in detecting lower airway involvement in the progress of AR-asthma march has not been evaluated. The aim of the present study was to investigate the value of FeNO in assessing lower airway inflammation and predicting bronchial hyperresponsiveness (BHR) in AR with or without asthma. FeNO and eosinophil count in induced sputum, and a methacholine bronchial provocation test were performed in 93 subjects, including: 45 AR patients (AR group); 20 patients with AR and asthma (AR with asthma group); and 28 normal controls (control group). The AR group was divided into two sub-groups: AR with asymptomatic BHR group and AR without BHR group. Correlation between FeNO and eosinophil count was assessed. Receiver operating characteristic (ROC) curve was applied to evaluate the predictive and diagnostic value of FeNO in detecting BHR. The values of FeNO in the AR and AR with asthma groups were higher [29.5 (22.0) ppb and 61.5 (33.0) ppb] compared with the normal control group (16.0 (10.0) ppb), where the values in brackets indicate the interquartile range of the values. The percentages of eosinophils in induced sputum were 2.43±3.56, 7.36±4.98 and 18.58±11.26% in the control, AR and AR with asthma groups, respectively. For the diagnosis of BHR, the area under the curve (AUC) was 0.910 (95%CI 0.836, 0.984), with the sensitivity and specificity 0.846 and 0.817 when the cut-off value takes 31.5 ppb. For diagnosis of asthma, the AUC was 0.873 (95%CI 0.753, 0.992) with sensitivity 0.857 and specificity 0.847 when taking the cut-off value to be 38.0 ppb. The value of FeNO was well correlated with eosinophil count in the sputum. The measurement of FeNO is an effective method in detecting lower airway involvement in AR developing to asthma.

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Section: Discussionsupporting

confidence: 88%

FeNO for detecting lower airway involvement in patients with allergic rhinitis

Zhu

Xie

Guan

et al. 2016

Experimental and Therapeutic Medicine

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“…In the unified airway model, patients with lower‐tract disease have an increased incidence of upper airway involvement. Similar histopathologic findings, including mucosa remodeling, have been noted in both asthma and CRS . Rhinosinusitis is more prevalent in patients with asthma than in those without asthma .…”

supporting

confidence: 68%

Asthma associated with chronic rhinosinusitis: a population‐based study

Chen

Chien

Tai

et al. 2016

Int Forum Allergy Rhinol

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“…As highlighted by the united airways concept, there are important pathological links between rhinitis and asthma, and this fact is largely independent of the inflammatory endotype . Therefore, the bronchospasm‐inducing potential of NACs both in asthmatic and nonasthmatic rhinitis patients warrants an investigation.…”

Section: Discussionmentioning

confidence: 99%

Safety and reproducibility of nasal allergen challenge

Eguiluz‐Gracia

Testera‐Montes

González

et al. 2019

Allergy

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Background:The nasal allergen challenge (NAC) is a useful tool for the diagnosis of allergic rhinitis (AR) and local allergic rhinitis (LAR) and might serve to design and monitor allergen immunotherapy. Nevertheless, data about its safety and reproducibility are scarce.Objective: To investigate the safety and reproducibility of NAC in pediatric and adult rhinitis patients with/without asthmatic symptoms, and in healthy controls. Methods:A retrospective evaluation of the NACs conducted in our Unit for 2005-2017 and monitored by acoustic rhinometry and nasal-ocular symptoms was performed to analyze the safety of two methods for allergen application (metered spray & micropipette) and NAC protocols (NAC with single or multiple allergens/session [NAC-S & NAC-M]). The adverse events (AEs), spirometry values, and rescue medication required for AE were recorded. The reproducibility was examined by a prospective analysis of three repeated NAC-S performed at 1-2-month interval in AR, LAR and nonallergic rhinitis patients, and in healthy controls. Results: A total of 11 499 NACs were performed in 518 children and 5830 adults.Only four local AE occurred, and 99.97% of NACs were well tolerated. The reproducibility and positive and negative predictive values of three consecutive NAC-S performed in 710 subjects were 97.32%, 100%, and 92.91%, respectively. There were no false-positive results in the 710 analyzed subjects. Safety and reproducibility were comparable between the methods of allergen application and the rhinitis phenotypes. Conclusion:The NAC is a safe and highly reproducible diagnostic test ready to be used in the clinical practice in both children and adults with or without asthma. K E Y W O R D Slocal allergic rhinitis, nasal allergen challenge, reproducibility, safety Abbreviations: AE, adverse event; AIT, allergen immunotherapy; AR, allergic rhinitis; DP, Dermatophagoides pteronyssinus; EAACI, European Academy of Allergy and Clinical Immunology; FEV1, forced respiratory volume in the first second; HC, healthy control individual; IQR, interquartile range; LAR, local allergic rhinitis; NAC-M, NAC with multiple allergens per session; NAC, nasal allergen challenge; NAC-S, NAC with a single allergen per session; NAR, nonallergic rhinitis; NHR, nasal hyperreactivity; NPV, negative predictive value; PPV, positive predictive value; sIgE, allergen-specific IgE; SPT, skin prick test; Vol 2-6 cm, volume 2-6 cm of each nostril.Eguiluz-Gracia and Testera-Montes contributed equally to this paper.

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Comorbidities of asthma and the unified airway

Cited by 36 publications

References 65 publications

FeNO for detecting lower airway involvement in patients with allergic rhinitis

FeNO for detecting lower airway involvement in patients with allergic rhinitis

Asthma associated with chronic rhinosinusitis: a population‐based study

Safety and reproducibility of nasal allergen challenge

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