Impact of Rhinitis on Asthma Control in Children: Association With FeNO

Chiron, R.; Vachier, Isabelle; Khanbabaee, Ghamartaj; Molinari, Nicolas; Varrin, Muriel; Godard, P.; Chanez, Pascal

doi:10.3109/02770901003759402

Cited by 17 publications

(17 citation statements)

References 26 publications

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“…However, studies have shown that asthma is still not fully controlled in many patients [33, 34]. Despite environmental and allergic factors and poor adherence to treatment, rhinitis has been recognized as a cause of poor asthma control, and the development of rhinitis may be an indicator of persistent asthma [4, 35]. To date, there are few objective tools for evaluating rhinitis.…”

Section: Discussionmentioning

confidence: 99%

“…One study found the comorbidity of rhinitis and asthma to be as high as 100% [2]. Local allergen exposure in the nose of patients with allergic rhinitis can quickly lead to asthma or significant allergic inflammation in the lung [3], with an elevation of fractional exhaled nitric oxide (FeNO) [4]. It is important for pediatricians to understand the relationship between these two disorders that all children with rhinitis are evaluated for lower airway disease, and all patients with asthma are screened for upper airway conditions.…”

Section: Introductionmentioning

confidence: 99%

“…FeNO may increase during asthma and airway hyperresponsiveness, and decrease with anti-inflammatory treatments, such as corticosteroids [20]. Furthermore, symptoms of rhinitis may be partly responsible for increased FeNO, independently of asthma control [4]. FeNO is now generally considered a valuable biomarker in allergic airway disease.…”

Section: Introductionmentioning

confidence: 99%

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Nasal Airflow Measured by Rhinomanometry Correlates with FeNO in Children with Asthma

et al. 2016

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BackgroundRhinitis and asthma share similar immunopathological features. Rhinomanometry is an important test used to assess nasal function and spirometry is an important tool used in asthmatic children. The degree to which the readouts of these tests are correlated has yet to be established. We sought to clarify the relationship between rhinomanometry measurements, fractional exhaled nitric oxide (FeNO), and spirometric measurements in asthmatic children.MethodsPatients’ inclusion criteria: age between 5 and 18 years, history of asthma with nasal symptoms, and no anatomical deformities. All participants underwent rhinomanometric evaluations and pulmonary function and FeNO tests.ResultsTotal 84 children were enrolled. By rhinomanometry, the degree of nasal obstruction was characterized as follows: (1) no obstruction in 33 children, (2) slight obstruction in 29 children, and (3) moderate obstruction in 22 children. FeNO was significantly lower in patients without obstruction than those with slight or moderate obstruction. Dividing patients according to ATS Clinical Practice Guidelines regarding FeNO, patients < 12 years with FeNO > 20 ppb had a lower total nasal airflow rate than those with FeNO < 20 ppb. Patients ≥ 12 years with FeNO > 25 ppb had a lower total nasal airflow rate than those with FeNO < 25 ppb.ConclusionsHigher FeNO was associated with a lower nasal airflow and higher nasal resistance. This supports a relationship between upper and lower airway inflammation, as assessed by rhinomanometry and FeNO. The results suggest that rhinomanometry may be integrated as part of the functional assessment of asthma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nasal Airflow Measured by Rhinomanometry Correlates with FeNO in Children with Asthma

et al. 2016

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“…36 Rhinitis was more frequent when control of asthma was worse. 37 Both retrospective and prospective claims data show that treating AR reduces asthma-related hospitalizations and emergency room visits by about half.…”

Section: Ar Control Impacts Asthma Controlmentioning

confidence: 99%

Underdiagnosed and Undertreated Allergic Rhinitis in Urban School-Aged Children with Asthma

Esteban

Klein

Kopel

et al. 2014

Pediatric Allergy, Immunology, and Pulmonology

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Allergic rhinitis (AR) is a risk factor for the development of asthma, and if poorly controlled, it may exacerbate asthma. We sought to describe AR symptoms and treatment in a larger study about asthma, sleep, and school performance. We examined the proportion (1) who met criteria for AR in an urban sample of school children with persistent asthma symptoms, (2) whose caregivers stated that they were not told of their child's allergies, (3) who had AR but were not treated or were undertreated for the disease, as well as (4) caregivers and healthcare providers' perceptions of the child's allergy status compared with study assessment, and (5) associations between self-report of asthma and AR control over a 4-week monitoring period. One hundred sixty-six children with persistent asthma participated in a clinical evaluation of asthma and rhinitis, including allergy testing. Self-report of asthma control and rhinitis control using the Childhood Asthma Control Test (C-ACT) and Rhinitis Control Assessment Test (RCAT) were measured 1 month after the study clinic session. Persistent rhinitis symptoms were reported by 72% of participants; 54% of rhinitis symptoms were moderate in severity, though only 33% of the sample received adequate treatment. AR was newly diagnosed for 53% during the clinic evaluation. Only 15% reported using intranasal steroids. Participants with poorly controlled AR had poorer asthma control compared with those with well-controlled AR. This sample of urban school-aged children with persistent asthma had underdiagnosed and undertreated AR. Healthcare providers and caregivers in urban settings need additional education about the role of allergies in asthma, recognition of AR symptoms, and AR's essential function in the comanagement of asthma. Barriers to linkages with allergy specialists need to be identified.

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“…Measuring fractional exhaled nitric oxide (FeNO) is a validated inflammatory marker in the diagnosis and management of patients with asthma, atopy, and allergic rhinitis (AR). [1][2][3] It is a useful, reproducible, noninvasive tool and easy to perform in a short time. However, interpretation is usually difficult because of interfering factors such as height, age, gender, lung function, smoking, and respiratory tract infections.…”

Section: T He Magnitude Of Nitric Oxide (No) Concentration In Exhaledmentioning

confidence: 99%

Comparison of Orally Exhaled Nitric Oxide in Allergic versus Nonallergic Rhinitis

2012

Am J Rhinol�Allergy

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Impact of Rhinitis on Asthma Control in Children: Association With FeNO

Cited by 17 publications

References 26 publications

Nasal Airflow Measured by Rhinomanometry Correlates with FeNO in Children with Asthma

Nasal Airflow Measured by Rhinomanometry Correlates with FeNO in Children with Asthma

Underdiagnosed and Undertreated Allergic Rhinitis in Urban School-Aged Children with Asthma

Comparison of Orally Exhaled Nitric Oxide in Allergic versus Nonallergic Rhinitis

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