Non-Atopic Rhinitis at Age 6 Is Associated With Subsequent Development of Asthma

Abstract

The role of nonatopic rhinitis, aka nonallergic rhinitis (NAR), in relation to the development of asthma has not been extensively studied. The purpose of this study was to assess the role of NAR in the long-term development of asthma among participants in the Tucson Children’s Respiratory Study (TCRS).The TCRS is a nonselected birth cohort enrolled from 1980 to 1984. Participants were evaluated regularly through the age of 32 years.At the visit at age 6 years, rhinitis was determined by an affirmative response to a question about runny, stuffy, and itchy nose, apart from colds. “Active” rhinitis, asthma, or wheeze was defined as symptoms reported within the previous year at the 6-year visit. Skin prick testing to a range of local aeroallergens was performed at the 6-year visit. Atopy was defined as having a positive skin test result. Researchers in this study assessed the frequency of affirmative answers to questions about asthma at age 32 years among TCRS subjects, who did not have active wheeze or asthma at age 6 years.Overall, 521 subjects were analyzed. At age 6 years, 38% had active rhinitis, and 33% were atopic. Among nonatopic children, those with active rhinitis were significantly more likely to develop asthma through age 32 years than those without rhinitis (P = .005). Among those with atopy at age 6 years, those with and without active rhinitis also had increased risk of asthma development, compared with the nonatopic population (active rhinitis, P < .001 and nonactive rhinitis, P = .035). Sex, ethnicity, and maternal asthma did not influence these findings.This is the first study to show that NAR can increase the risk of developing asthma. Rhinitis (atopic or nonatopic) and atopy (with or without rhinitis) are both associated with the development of subsequent asthma.Strengths of this study include the use of a large cohort population with longitudinal data. Weaknesses involve the challenges in capturing and analyzing environmental factors (eg, smoke and particulate exposures) that may also contribute to the risk of asthma. Future studies should assess whether treating NAR helps with asthma control or prevents the development of asthma altogether.