Impact of IgE sensitization and rhinitis on inflammatory biomarkers and lung function in adolescents with and without asthma

Abstract

Background Both allergic and non‐allergic rhinitis are associated with worse asthma control. However, it is unclear how IgE sensitization and/or rhinitis are associated with lung function. We therefore evaluated the effect of rhinitis and sensitization on lung function, including the periphery of the airway system, and inflammatory biomarkers in individuals with and without asthma. Methods Participants in the BAMSE longitudinal birth cohort study underwent measures of spirometry, impulse oscillometry, and FeNO at age 16 years. Questionnaires were used to obtain data on asthma and rhinitis. Blood samples were analyzed for eosinophils and allergen‐specific IgE. Results Groups based on the combination of asthma, rhinitis, and sensitization were compared to a healthy reference group. Lower FEV1/FVC levels were seen for groups with asthma only (adjusted mean difference −2.8% units (95% CI −4.7; −1.0), P < 0.01), asthma with sensitization (−2.0 (−3.9; −0.2), P < 0.05), and asthma with sensitization and rhinitis (−2.5 (−3.6; −1.4), P < 0.001). The index of peripheral airway resistance R5–20 was higher in groups with asthma and sensitization (adjusted median difference 94.9 Pa L−1 s−1 (95% CI 60.4; 129.3), P < 0.001), as well as asthma with sensitization and rhinitis (36.9(15.0; 58.8), P < 0.01). These groups also had increased FeNO and blood eosinophil levels. Conclusions We found signs of peripheral airway obstruction and increased levels of inflammatory biomarkers in the presence of allergic asthma, irrespective of rhinitis status. Despite having a reduced FEV1/FVC, peripheral airway engagement was not seen in non‐sensitized adolescents with asthma. We suggest that small airway disease is a feature related to the eosinophilic inflammation in allergic asthma in adolescence.

The allergic phenotype during the first 10 years of life in a prospective cohort

“…This is not too surprising as our cohort includes very few individuals with severe asthma and the fact that allergy as such does not influence lung function. 40 Our cohort, where the children were born into the cohort by parents carefully characterized concerning allergic status is not a general population-based cohort. Yet, the well-known parental allergic status and subsequently children with different allergy risks, limits the likelihood of introducing bias and enabled us to study allergy also in low-risk children.…”

Changes of DNA methylation are associated with changes in lung function during adolescence

“…The Regional Ethical Review Board, Karolinska Institute in Stockholm, Sweden, approved the baseline study with its follow-up. A thorough description of the cohort, inclusion and enrollment criteria, and procedure of data collection have been described elsewhere [41]. Follow-up questionnaires focusing on the children's respiratory health, allergic diseases and on various exposure factors were collected at 1, 2, 4, 8, and 16 years old after obtaining informed consent from the parents of all participating children.…”

Highlights and recent developments in airway diseases in EAACI journals (2018)

“…The BAMSE birth cohort study showed peripheral airway obstruction in individuals with allergic asthma with or without rhinitis, as measured by impulse oscillometry. 85 These subjects also had significantly elevated levels of FeNO and blood eosinophils compared with nonallergic asthmatic individuals. These findings suggest that small airway disease can be attributed to the eosinophilic inflammation in allergic asthma.…”