Effect of Nasal Allergy Over Spirometric Parameters: A Prospective Study

Abstract

Nasal allergy is characterized by an IgE mediated inflammatory response of nasal mucosa to allergens and it has a close association with Asthma. Nasal allergy has been demonstrated to be a strong risk factor for the onset of asthma in adults. Spirometric parameters like Forced expiratory volume at timed interval of 1 s (FEV1) and forced expiratory flow (FEF 25-75 % ) are impaired in patients with nasal allergy or allergic rhinitis. The FEF 25-75 % has been evidenced to be a reliable marker of early bronchial impairment in nasal allergy. Nasal allergy may be considered as the first step of the progression of respiratory allergy towards asthma. It has been demonstrated that FEF 25-75 % is useful in predicting the presence of airway hyper responsiveness.It may be a more sensitive indicator of chronic airway obstruction than FEV1 and is considered as a risk factor for the persistence of respiratory symptoms in asthmatic patients. The impact of allergic rhinitis or nasal allergy on asthma (ARIA) guidelines, clearly underlined the role of allergic rhinitis as risk factor for asthma development. The possible presence of spirometric abnormalities in patient with allergic rhinitis has been well documented. So keeping this in mind, present study is undertaken to evaluate the impairment of spirometric parameters, like FEV1, FEF 25-75 % , and forced vital capacity, in patients with nasal allergy and to predict the presence of airway hyper responsiveness.

A study of Spirometric parameters in non asthmatic allergic rhinitis

“…Poorey et al. reported in their study that 45% had AEC between 501-800/mm 3 [ 14 ]. Eosinophils play an important role in allergic airway diseases.…”

“…in their study observed that all three parameters (FVC, FEV 1, and FEF 25–75% ) were impaired in 6% of subjects and two parameters (FEV 1 and FEF 25–75% ) were impaired in 9% of subjects and only parameter FEF 25–75% was found impaired in 64% of subjects. They concluded that FEF 25–75% is a marker of small airway impairment in asthmatics with normal FVC values [ 14 ]. Ciprandi et al.…”

“…Poorey et al in their study observed that all three parameters (FVC, FEV1, and FEF 25-75%) were impaired in 6% of subjects and two parameters (FEV1 and FEF 25-75%) were impaired in 9% of subjects and only parameter FEF25-75% was found impaired in 64% of subjects. They concluded that FEF 25-75% is a marker of small airway impairment in asthmatics with normal FVC values [14]. Ciprandi et al in their study of bronchial hyperactivity and spirometric impairment in subjects with perennial allergic rhinitis observed 5 subjects with reduced FEV1 and 48 with reduced FEF 25-75% [17].…”

Rationale and Design of a Panel Study Investigating Six Health Effects of Airborne Pollen: The EPOCHAL Study

“…Individuals with allergic rhinitis (AR) frequently have co-existing asthma (estimated at 10-40%) (17), while another 45% of AR individuals without asthma have bronchial hyperresponsiveness (18), an intermediate step toward asthma development. Selected studies have observed that individuals with AR can have an abnormal pulmonary function test (PFT) (19)(20)(21)(22)(23)(24) and fractional excretion of nitric oxide (FeNO) (25)(26)(27)(28)(29) even in the absence of asthma, suggesting that pollen is an important trigger for lower airway inflammation. In addition, FeNO has been shown to increase in sensitized individuals at times of higher pollen counts (27) and has been associated with the number of positive reactions on the SPT (25).…”