Abstract
BackgroundThe symptoms of patients with respiratory disease are influenced by local environmental factors. The incidence of allergic rhinitis in grassland areas was significantly higher than that in non-grassland areas. We aimed to compare the profiles of chronic rhinitis patients obtained during the autumn pollen season in Baotou (grassland city) and Beijing (non-grassland city), China.MethodsQuestionnaire surveys and allergen testing were conducted on 1170 and 1232 patients with chronic rhinitis visiting the Second Affiliated Hospital of Baotou Medical College and Beijing Tongren Hospital, respectively, during the autumn pollen period. Information regarding medical history, severity of symptoms, and diagnosis and treatment was collected.ResultsMore patients with moderate to severe chronic rhinitis and asthma (both, P < 0.001) were present in Baotou than in Beijing. Mugwort was the most abundant allergen in both regions, but the number of patients sensitized to outdoor allergens in Baotou was higher than that in Beijing (P < 0.001). Indoor allergens in Beijing represented a considerable proportion of allergens, especially dust mites (33.4%). For patients with allergic rhinitis, nasal congestion, nasal itching, and runny nose were more severe in Baotou than in Beijing (P < 0.001). In both Baotou and Beijing, allergy (P < 0.001 vs. P = 0.004) and combined asthma (P = 0.049 vs. P = 0.005) were common factors affecting the severity of the clinical symptoms chronic rhinitis. In Baotou, age (rs = 0.195, P < 0.001) and family allergy history (P = 0.010) were also associated with symptom severity. Although significantly more patients in Baotou received oral antihistamines, nasal corticosteroids, and surgical treatment than in Beijing (P < 0.001), the number of people receiving allergy immunotherapy in Baotou was lower (P = 0.004) and post-treatment symptom control was worse (P < 0.001) that that in Beijing.ConclusionsDuring the pollen period, there were significant differences in the allergen spectrum between Baotou and Beijing. Allergy and combined asthma were common factors affecting the severity of clinical symptoms. Patients in Baotou presented with more severe clinical symptoms that were not satisfactorily managed due to the impact of pollen exposure, inconsistent access to care, and differing treatment modalities.
Highlights
Chronic rhinitis (CR) is a common inflammatory disease of the nasal mucosa
No studies have examined the influence of pollen exposure on the clinical characteristics of local patients with CR, the symptom severity and quality of life associated with varying intensities of pollen exposure
Demographic and clinical characteristics This study recruited patients with CR who were eligible for enrollment during the pollen period in two regions in 2019, including 1170 individuals in Baotou and 1232 in Beijing
Summary
Chronic rhinitis (CR) is a common inflammatory disease of the nasal mucosa. Its clinical manifestations include nasal congestion, nasal itching, runny nose, and sneezing. Patients with AR and NAR often show similar nasal symptoms, and the difference is based on the result of allergen sensitization. A longitudinal study from 18 major cities in China showed that the self-reported prevalence of AR in adults increased by 6.5% in 6 years [4]. As a representative of the Eurasian grassland, the Inner Mongolia grassland is characterized by an abundance of pollen and diverse species; the high local prevalence of AR is attributed to climatic and environmental factors, the large amount of pollen exposure [8,9,10]. The incidence of allergic rhinitis in grassland areas was significantly higher than that in non-grassland areas. We aimed to compare the profiles of chronic rhinitis patients obtained during the autumn pollen season in Baotou (grassland city) and Beijing (non-grassland city), China
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