Skip to main content
Log in

Time Interval and the Factors Associated with the Development of Asthma in Patients with Allergic Rhinitis

  • Published:
Lung Aims and scope Submit manuscript

Abstract

Rhinitis and asthma commonly coexist and studies have shown a positive association between rhinitis and asthma in both atopic and nonatopic adults. Longitudinal studies have shown that in many cases rhinitis precedes the onset of asthma. The aims of this study were to study the time interval for the development of asthma after the onset of rhinitis, to determine the proportion of patients in whom rhinitis precedes asthma, and to study the factors associated with the development of asthma in patients with allergic rhinitis compared to patients who continue to have allergic rhinitis alone. This was a cross-sectional study done at a tertiary care allergy center in Mysore, South India. It included consecutive patients between 2004 and 2006 with allergic rhinitis and/or asthma. We used a structured questionnaire, clinical evaluation, spirometry, and skin-prick testing. A total of 1,141 subjects were included in the study. Among them, 700 had allergic rhinitis for varying intervals before developing asthma and 355 had rhinitis without asthma. In subjects aged 20 years or younger, logistic regression analysis confirmed an independent association with a family history of allergic rhinitis and sensitization to house dust mites as risk factors and ever-used nasal steroids as protective against developing asthma in subjects with allergic rhinitis. In subjects older than 20 years, a family history of allergic rhinitis, atopy, and sensitization to house dust mites and trees were risk factors and ever-user of nasal steroids was protective. Rhinitis often preceded asthma and a high proportion of patients, both children and adults, developed asthma within 2 years after the onset of rhinitis. A family history of allergic rhinitis, atopy, and sensitization to house dust mites and trees are associated with the development of asthma in patients with allergic rhinitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Corren J (1997) Allergic rhinitis and asthma: how important is the link? J Allergy Clin Immunol 99(2):S781–S786

    Article  CAS  PubMed  Google Scholar 

  2. Corren J (2007) The connection between allergic rhinitis and bronchial asthma. Curr Opin Pulm Med 13(1):13–18

    Article  PubMed  Google Scholar 

  3. Grossman J (1997) One airway, one disease. Chest 111(2 Suppl):11S–16S

    Article  CAS  PubMed  Google Scholar 

  4. Moller C, Dreborg S, Ferdousi HA, Halken S, Høst A, Jacobsen L, Koivikko A, Koller DY, Niggemann B, Norberg LA, Urbanek R, Valovirta E, Wahn U (2002) Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT-study). J Allergy Clin Immunol 109(2):251–256

    Article  PubMed  Google Scholar 

  5. Pedersen PA, Weeke ER (1983) Asthma and allergic rhinitis in the same patients. Allergy 38(1):25–29

    Article  CAS  PubMed  Google Scholar 

  6. Settipane RJ, Hagy GW, Settipane GA (1994) Long-term risk factors for developing asthma and allergic rhinitis: a 23-year follow-up study of college students. Allergy Proc 15(1):21–25

    Article  CAS  PubMed  Google Scholar 

  7. Huovinen E, Kaprio J, Laitinen LA, Koskenvuo M (1999) Incidence and prevalence of asthma among adult Finnish men and women of the Finnish Twin Cohort from 1975 to 1990, and their relation to hay fever and chronic bronchitis. Chest 115(4):928–936

    Article  CAS  PubMed  Google Scholar 

  8. Greisner WA III, Settipane RJ, Settipane GA (1998) Co-existence of asthma and allergic rhinitis: a 23-year follow-up study of college students. Allergy Asthma Proc 19(4):185–188

    Article  PubMed  Google Scholar 

  9. Bugiani M, Carosso A, Migliore E, Piccioni P, Corsico A, Olivieri M, Ferrari M, Pirina P, de Marco R, ISAYA (ECRHS Italy) Study Group (2005) Allergic rhinitis and asthma comorbidity in a survey of young adults in Italy. Allergy 60(2):165–170

    Article  CAS  PubMed  Google Scholar 

  10. Janson C, Anto J, Burney P, Chinn S, de Marco R, Heinrich J, Jarvis D, Kuenzli N, Leynaert B, Luczynska C, Neukirch F, Svanes C, Sunyer J, Wjst M, European Community Respiratory Health Survey II (2001) The European Community Respiratory Health Survey: what are the main results so far? Eur Respir J 18(3):598–611

    Article  CAS  PubMed  Google Scholar 

  11. Sears MR, Herbison GP, Holdaway MD, Hewitt CJ, Flannery EM, Silva PA (1989) The relative risks of sensitivity to grass pollen, house dust mite and cat dander in the development of childhood asthma. Clin Exp Allergy 19(4):419–424

    Article  CAS  PubMed  Google Scholar 

  12. Navarro A, Valero A, Juliá B, Quirce S (2008) Coexistence of asthma and allergic rhinitis in adult patients attending allergy clinics: ONEAIR study. J Investig Allergol Clin Immunol 18(4):233–238

    CAS  PubMed  Google Scholar 

  13. Boulet LP, Turcotte H, Laprise C, Lavertu C, Bédard PM, Lavoie A, Hébert J (1997) Comparative degree and type of sensitization to common indoor and outdoor allergens in subjects with allergic rhinitis and/or asthma. Clin Exp Allergy 27(1):52–59

    Article  CAS  PubMed  Google Scholar 

  14. Magnan A, Fourre-Jullian C, Jullian H, Badier M, Lanteaume A, Vervloet D, Charpin D (1998) Rhinitis alone or rhinitis plus asthma: what makes the difference? Eur Respir J 12(5):1073–1078

    Article  CAS  PubMed  Google Scholar 

  15. Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M, Gibson P, Ohta K, O’Byrne P, Pedersen SE, Pizzichini E, Sullivan SD, Wenzel SE, Zar HJ (2008) Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 31(1):143–178

    Article  CAS  PubMed  Google Scholar 

  16. Bousquet J et al (2008) Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 63(Suppl 86):8–160

    Article  PubMed  Google Scholar 

  17. Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R, Sicherer S, Golden DB, Khan DA, Nicklas RA, Portnoy JM, Blessing-Moore J, Cox L, Lang DM, Oppenheimer J, Randolph CC, Schuller DE, Tilles SA, Wallace DV, Levetin E, Weber R, American Academy of Allergy, Asthma, Immunology, American College of Allergy, Asthma, Immunology (2008) Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol 100(3 Suppl 3):S1–S148

    CAS  Google Scholar 

  18. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J, ATS/ERS Task Force (2005) Standardisation of spirometry. Eur Respir J 26(2):319–338

    Article  CAS  PubMed  Google Scholar 

  19. Burgess JA, Walters EH, Byrnes GB, Matheson MC, Jenkins MA, Wharton CL, Johns DP, Abramson MJ, Hopper JL, Dharmage SC (2007) Childhood allergic rhinitis predicts asthma incidence and persistence to middle age: a longitudinal study. J Allergy Clin Immunol 120(4):863–869

    Article  PubMed  Google Scholar 

  20. Wright AL, Holberg CJ, Martinez FD, Halonen M, Morgan W, Taussig LM (1994) Epidemiology of physician-diagnosed allergic rhinitis in childhood. Pediatrics 94(6 Pt 1):895–901

    CAS  PubMed  Google Scholar 

  21. Shibasaki M, Hori T, Shimizu T, Isoyama S, Takeda K, Takita H (1990) Relationship between asthma and seasonal allergic rhinitis in schoolchildren. Ann Allergy 65(6):489–495

    CAS  PubMed  Google Scholar 

  22. Linneberg A, Henrik Nielsen N, Frølund L, Madsen F, Dirksen A, Jørgensen T (2002) The link between allergic rhinitis and allergic asthma: a prospective population-based study. The Copenhagen Allergy Study. Allergy 57(11):1048–1052

    Article  CAS  PubMed  Google Scholar 

  23. Plaschke PP, Janson C, Norrman E, Björnsson E, Ellbjär S, Järvholm B (2000) Onset and remission of allergic rhinitis and asthma and the relationship with atopic sensitization and smoking. Am J Respir Crit Care Med 162(3 Pt 1):920–924

    CAS  PubMed  Google Scholar 

  24. Leynaert B, Bousquet J, Neukirch C, Liard R, Neukirch F (1999) Perennial rhinitis: an independent risk factor for asthma in nonatopic subjects: results from the European Community Respiratory Health Survey. J Allergy Clin Immunol 104(2 Pt 1):301–304

    Article  CAS  PubMed  Google Scholar 

  25. Verdiani P, Di Carlo S, Baronti A (1990) Different prevalence and degree of nonspecific bronchial hyperreactivity between seasonal and perennial rhinitis. J Allergy Clin Immunol 86(4 Pt 1):576–582

    Article  CAS  PubMed  Google Scholar 

  26. Shaaban R, Zureik M, Soussan D, Antó JM, Heinrich J, Janson C, Künzli N, Sunyer J, Wjst M, Burney PG, Neukirch F, Leynaert B (2007) Allergic rhinitis and onset of bronchial hyperresponsiveness: a population-based study. Am J Respir Crit Care Med 176(7):659–666

    Article  PubMed  Google Scholar 

  27. Shaaban R, Zureik M, Soussan D, Neukirch C, Heinrich J, Sunyer J, Wjst M, Cerveri I, Pin I, Bousquet J, Jarvis D, Burney PG, Neukirch F, Leynaert B (2008) Rhinitis and onset of asthma: a longitudinal population-based study. Lancet 372(9643):1049–1057

    Article  PubMed  Google Scholar 

  28. Watson WT, Becker AB, Simons FE (1993) Treatment of allergic rhinitis with intranasal corticosteroids in patients with mild asthma: effect on lower airway responsiveness. J Allergy Clin Immunol 91(1 Pt 1):97–101

    Article  CAS  PubMed  Google Scholar 

  29. Aubier M, Neukirch C, Peiffer C, Melac M (2001) Effect of cetirizine on bronchial hyperresponsiveness in patients with seasonal allergic rhinitis and asthma. Allergy 56(1):35–42

    Article  CAS  PubMed  Google Scholar 

  30. Grant JA, Nicodemus CF, Findlay SR, Glovsky MM, Grossman J, Kaiser H, Meltzer EO, Mitchell DQ, Pearlman D, Selner J et al (1995) Cetirizine in patients with seasonal rhinitis and concomitant asthma: prospective, randomized, placebo-controlled trial. J Allergy Clin Immunol 95(5 Pt 1):923–932

    Article  CAS  PubMed  Google Scholar 

  31. Crimi N, Li Gotti F, Mangano G, Paolino G, Mastruzzo C, Vancheri C, Lisitano N, Polosa R (2004) A randomized, controlled study of specific immunotherapy in monosensitized subjects with seasonal rhinitis: effect on bronchial hyperresponsiveness, sputum inflammatory markers and development of asthma symptoms. Ann Ital Med Int 19(2):98–108

    PubMed  Google Scholar 

  32. Polosa R, Li Gotti F, Mangano G, Paolino G, Mastruzzo C, Vancheri C, Lisitano N, Crimi N (2004) Effect of immunotherapy on asthma progression, BHR and sputum eosinophils in allergic rhinitis. Allergy 59(11):1224–1228

    Article  CAS  PubMed  Google Scholar 

  33. Polosa R, Al-Delaimy WK, Russo C, Piccillo G, Sarvà M (2005) Greater risk of incident asthma cases in adults with allergic rhinitis and effect of allergen immunotherapy: a retrospective cohort study. Respir Res 6:153

    Article  PubMed  Google Scholar 

  34. Corren J, Adinoff AD, Irvin CG (1992) Changes in bronchial responsiveness following nasal provocation with allergen. J Allergy Clin Immunol 89(2):611–618

    Article  CAS  PubMed  Google Scholar 

  35. Corren J (1998) The impact of allergic rhinitis on bronchial asthma. J Allergy Clin Immunol 101(2 Pt 2):S352–S356

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. A. Mahesh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mahesh, P.A., Vedanthan, P.K., Holla, A.D. et al. Time Interval and the Factors Associated with the Development of Asthma in Patients with Allergic Rhinitis. Lung 187, 393–400 (2009). https://doi.org/10.1007/s00408-009-9179-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-009-9179-x

Keywords

Navigation