Abstract
Allergic rhinitis (AR) and asthma are common respiratory allergic disorders which are increasing globally more in developed countries. Although much has been written about childhood asthma and guidelines published by various international and national fora, not much information is available on AR. This is most common in children, is a significant risk factor for developing asthma, is a common comorbidity with asthma and affects quality of life. This paper highlights the risk factors for developing respiratory allergy asthma and AR, linkages between them and the management issues, particularly in relation to the allergic or allergological aspects as they have important bearing on management of children suffering from respiratory allergy. Specific immunotherapy (SIT) is re-emerging as useful therapy which alone has the potential to modify the natural history of disease and prevent the ‘allergic march’. Timely diagnosis, correct management including timely referrals can ensure good quality life for those suffering from respiratory allergies.
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Seaton A, Godden DJ, Brown K. Increase in asthma: a more toxic environment or a more susceptible population?Thorax 1994; 49; 171–174.
Lewis S. ISAAC.Lancet 1998; 351: pl220.
Russel G, Helms PJ. Reporting of common respiratory and atopic symptoms has increased.BMJ 1997: 315: 1014–1015.
Beasley R, Mutius EV. Worldwide variation is symptoms of asthma, allergic rhinoconjunctivitis and atopic eczema. ISAAC.Lancet 1998; 351: 1225–1232.
Holgate ST. The epidemic of allergy and asthma.Nature 1999; 402: (Suppl): 182–184.
Weiss ST. Epidemiology and heterogeneity of asthma.Ann Allergy Asthma Immunol 2001; 87: (Suppl) 5–8.
Yunginger JW, Reed CE, O’Connelet al. A community based study of the epidemiology of asthma: incidence rates, 1964-1983.Am Rev Respir Dis 1992; 146: 888–894.
Anderson HR, Bland JM, Patel S, Peakham C. The natural history of asthma in childhood.J Epidemiol Comn Health 1986; 40:121–129.
Tariq SM, Mathews SM, Hakim EA, Stevens M, Arshad DM, Hide DW. The prevalence of and risk factors for atopy in early childhood: A whole population birth cohort study.Allerg Clin Immunol 1998; 101: 587–593.
Duffy DL. Genetic epidemiology of asthma. Epidemiol Rev 1997; 19: 129–143.
Burrows B, Martinez FD, Halonen M, Barbee RA, Cline MG. Association of asthma with serum IgE levels and skin test reactions to allergens.N Eng J Med 1989; 320: 271–276.
Zimmerman B, Chambers C, Forsyth S. Allergy in asthma, ii, the highly atopic infant and asthma.J Allerg Clin Immunol 1988; 81: 71–77.
Von Mutius E, Martinez FD, Fritzshe C, Nicoli T, Roell Gthieman MH. Prevalence of asthma and alopy in two areas of West and East Germany.Am J Respir Crit Care Med 1994; 49: 358–364.
Braback I, Breborowicz A, Dreborg S, Knutsson A, Picklick H, Bjorkstein, B. Atopic sensitization and respiratory symptoms among Polish and Swedish school children.Clin Exp Allerg 1994; 24: 826–835.
Exl BM, Fritche R. Cow’s milk protein allergy and possible means for its prevention.Nutrition 2001; 17: 642–651.
Shirakawa T, Enomoto T, Shimazu S, Hopkin JM. The inverse association between tubercular response and atopic disorders.Science 1997; 275: 77–79.
Herz U, Gerfold K, Gruber C, Braun A, Wahn U, Renz Het al. BCG infection suppresses allergic sensitization and development of increased airway reactivity in an animal model.J Allerg Clin Immunol 1998; 102: 867–874.
Creticos PS. The consideration of immunotherapy in treatment of allergic asthma.Annals of Allergy, Asthma, Immunol 2001; 87(s) 1: 13–27.
American Thoracic Society. Achieving healthy indoor air; Report of ATS workshop; Santa Fe, New Mexico, November 16-19,1995.Am J Respir Crit Care Med. 1997; 156: S33-S64.
Corren J. Alergic rhinitis and asthma: how important is the link?J Allerg Clin Immonol 1997: 99. S780-S786.
Simons FE. Allergic rhinobronchitis: the asthma-allergic rhinitis link.J Allerg Clin Immunol 1999; 104: 534–540.
Togias A. Mechanisms of nose-lung interaction.Allergy 1999; 54 (Suppl): 94–105.
Madonini E, Briatico-Vangosa G, Papacoda Aet al. Seasonal increase of bronchial reactivity in allergic rhinitis.J Allerg Clin Immunol 1987; 79: 358–363.
Ramsdale EH, Morris MM, Roberts RS, Hargreave FE. Asymptomatic bronchial hyper responsiveness in rhinitis.J Allerg Clin Immunol 1985; 75: 573–577.
Mailing HJ, Weeke B. Immunotherapy position paper of the European Academy of Allergology and Clinical Immunology.Allergy 1993; 9-35.
ETAC. Allergic factors associated with the development of asthma and the influence of cetrizine in a double blind randomized, placebo controlled trial: First results of ETAC (Early treatment of atopic child).Pediatr Allerg Immunol 1998; 9: 116–124.
Dykewicz MS, Fineman S, Skoner DP. Joint task force summary statement on diagnosis and management of rhinitis.Annals of Allergy, Asthma and Immunology 1998; 81: 474–477.
Sibbald B, Rink E. Epidemilogy of seasonal and perennial rhinitis: Clinical presentation and medical history.Thorax 1991; 46: 895–901.
Meltzer EO, Zeiger RS, Schatz M, Jalowayski AA. Chronic rhinitis in infants and children: etiological, diagnostic and therapeutic consideration.Pediatr Clin North Am 1983; 30: 847–871.
National Heart Lung and Blood Institute, Expert Panel Report 2. Guidelines for the diagnosis and management of asthma. National Institutes of Health, Bathesda HD, 1997 Publication No. 95-3659.
Blair H. Natural history of childhood asthma. 20 year followup.Arch Dis Child 1997; 52: 613–619.
Martinez FD, Wright AL, Taussig LMet al. Asthma and wheezing in first six years of life. The Group Health Med Associates.N Eng J Med 1995; 332: 133–138.
Sherman CB, Tosteson TD, Tager IB, Speizer FE and Weiss ST. Early childhood perdictors of asthma.Am J Epidemiol 1990; 132: 83–95.
Rupp GH, Fiedman RA. Eosinophilic non allergic rhinitis in children.Pediatrics 1982; 70: 437–439.
Kumar L, Mahajan J, Singh BP, Singh AB. Studies on some inhalant allergens of Shimla Shivalik hills and Chandigarh Region.Indian J Allerg Appl Immunol 1987; 1: 49–53.
The British guidelines on asthma management; review and position statement.Thorax 1997; 52 : S1-S21.
Singh M, Kumar L, Ramanathan RMPL (Writing group). Consensus guidelines on management of childhood asthma in India.Indian Pediatr 1999; 36: 157–165.
Ciprandi G, Ricca V, Tosca Met al. Continuous antihistamine treatment controls allergic inflammation and reduces respiratory morbidity in children with mite allergy.Allergy 1999; 54: 358–365.
Renwick AG. The metabolism of antihistamine and drug interactions: the role of cytochrome P 450 enzyme.Clin Exp Allerg 1999; 3: 116–124.
Simons H, Kessselman MS, Giddins NGet al. Astemizole induced to torsade de points.Lancet 1998; 11: 624.
Barbery J, Anderson M, Ciprandi Get al. Cardiovascular safety of second generation antihistamines.Am J Rhinol 1999; 13: 235–243.
Neilsen LP, Mygind N, Dahl R. Intranasal corticosteroids for allergic rhinitis. Superior relief?Drugs 2001; 61: 1563–1579.
BosquetJ, Lockey RF, Mailing HJ. Allergen immunotherapy therapeutic vaccines for allergic disease.Allergy 1998; 53 (Suppl.) 44: 4–42.
Bosquet Jet al. Wold Health Organization position paper-A allergen immunotherapy: therapeutic vaccines for allergic diseases.Annals Allerg Asthma Immunol 1998; 81: 401–405.
Abramson MJ, Puy RM, Weiner JM.Allergen Immunotherapy for Asthma (Coichrane Review). The Cochrane Library, Issue 1, 2001. Oxford: Update Software.
Practice parameter for allergic immunotherapy.J Allerg Clin Immunol 1996; 98 : 1001-1008.
Kumar L. Efficacy of immunotherapy in nasobronchial allergies in children as judged by mucosal sensitivity tests.Indian Pediatr 1977; 14: 461–465.
Bjorksten B, Moller C, Broberger Uet al. Clinical and immunological effects of oral immunotherapy with standardised birch pollen extract.Allergy 1986; 41: 290–295.
Clavel R, Bosquet J, Andre C. Clinical efficacy of sublingual swallow immunotherapy: a double blind placebo controlled trial of a standardized five-grass pollen extract in rhinitis.Allergy 1998; 53: 493–498.
Theodoropoulos DS, Lockey RF. Allergen immunotherapy: Guidelines update and recommendations of the World Health Organization.Allerg Asthma Proc 2000; 21: 159–166.
Pawankar R. Anti IgE treatment in allergic disease.ACI International 2002; 13: 4–10.
Practice parameters for the diagnosis and treatment of asthma.J Allerg Clin Immunol 1995; 96 : 5 : S707-870.
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Kumar, L., Singh, M. Respiratory allergy. Indian J Pediatr 69, 237–244 (2002). https://doi.org/10.1007/BF02734233
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DOI: https://doi.org/10.1007/BF02734233