Journal
ALLERGY
Volume 69, Issue 11, Pages 1515-1521Publisher
WILEY
DOI: 10.1111/all.12467
Keywords
asthma severity; childhood asthma; childhood rhinitis
Categories
Funding
- MRC [G0601361, MR/K002449/1]
- JP Moulton Charitable Foundation
- National Institute for Health Research Clinical Research Facility at University Hospital of South Manchester NHS Foundation Trust
- MRC [G0601361, MR/K002449/1] Funding Source: UKRI
- Medical Research Council [G0601361, MR/K002449/1] Funding Source: researchfish
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Background: In a population-based sample of school-age children, we investigated factors associated with rhinitis, and differences between allergic and nonallergic rhinitis. Alhongst children with asthma, we explored the association between rhinitis and asthma severity. Methods: Children participating in a birth cohort study (n = 906) were reviewed at age 8 years. Asthma was defined as at least two of the following three features: physician-diagnosed asthma, currently using asthma medication and current wheeze. We measured lung function (plethysmography and spirometry) and airway hyper-reactivity (AHR; methacholine challenge). Results: In the analysis adjusted for the presence of asthma, children with rhinitis had significantly higher AHR (P = 0.001). Maternal smoking and absence of breast-feeding were stronger predictors of nonallergic rhinitis, whereas current wheeze and eczema were stronger predictors of allergic rhinitis. Amongst asthmatics (n = 159), when compared to 76 children without rhinitis, those with rhinitis (n = 83) were 2.89-fold (95% CI 1.41-5.91) more likely to experience frequent attacks of wheezing, 3.44-fold (1.19-9.94) more likely to experience severe attacks of wheezing limiting speech, 10.14-fold (1.27-81.21) more likely to have frequent visits to their doctor because of asthma and nine-fold (1.11-72.83) more likely to miss school. Reported use of intranasal corticosteroids resulted in a numerically small, but consistent reduction in risk, rendering the associations between rhinitis and asthma severity nonsignificant. Conclusion: We observed differences in risk factors and severity between allergic and nonallergic rhinitis. In children with asthma, rhinitis had adverse impact on asthma severity. The use of intranasal corticosteroids resulted in a small, but consistent reduction in the risk.
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