Abstract
BackgroundRhinitis is a common problem within the population. Many subjects with rhinitis also have atopic multimorbidity, such as asthma and eczema. The purpose of this investigation was to compare subjects with only rhinitis to those that have rhinitis, asthma and/or eczema in relation to immunoglobulin E (IgE) sensitization, inflammatory markers, family history, lung function and body mass index (BMI).MethodsA total of 216 adult subjects with rhinitis from the European Community Respiratory Health Survey II were investigated with multiplex component allergen analysis (103 allergen components), total IgE, C-reactive protein, eosinophilic cationic protein, fractional exhaled nitric oxide and spirometry. Rhinitis, eczema, asthma and parental allergy were questionnaire-assessed.ResultsOf the 216 participants with rhinitis, 89 also had asthma and/or eczema. Participants with rhinitis that also had asthma or eczema were more likely to be IgE-sensitized (3.44, odds ratio, OR: 95% CI 1.62–7.30, adjusted for sex, age, mother’s allergy, total IgE and forced expiratory volume (FEV1)). The number of IgE-positive components was independently associated with atopic multimorbidity (1.11, OR: 95% Cl 1.01–1.21) adjusted for sex, age, mother’s allergy, total IgE and FEV1. When analysing different types of sensitization, the strongest association with atopic multimorbidity was found in participants that were IgE-sensitized both to perennial and seasonal allergens (4.50, OR: 95% CI 1.61–12.5). Maternal allergy (2.75, OR: 95% CI 1.15–4.46), high total IgE (2.38, OR: 95% CI 1.21–4.67) and lower FEV1 (0.73, OR: 95% CI 0.58–0.93) were also independently associated with atopic multimorbidity, while no association was found with any of the other inflammatory markers.ConclusionIgE polysensitization, to perennial and seasonal allergens, and levels of total IgE seem to be the main determinants of atopic multimorbidity in subjects with rhinitis. This indicates that disease-modifying treatment that targets IgE sensitization may be of value when decreasing the risk of developing atopic multimorbidity.
Highlights
Rhinitis is a common problem within the population
Multimorbidity involving the triad of rhinitis, asthma and eczema exists among both atopic and non-atopic individuals, the prevalence is higher among atopic individuals [6,7,8,9]
Significant group differences were found for body mass index (BMI) and F EV1, with the lowest mean value for both variables in the group with both asthma and eczema
Summary
Many subjects with rhinitis have atopic multimorbidity, such as asthma and eczema. Rhinitis is a common problem [1,2,3] and is troublesome on its own, but it has been shown to be a risk factor for developing bronchial hyper-responsiveness and asthma [4, 5]. Multimorbidity involving the triad of rhinitis, asthma and eczema exists among both atopic and non-atopic individuals, the prevalence is higher among atopic individuals [6,7,8,9]. The worldwide prevalence of allergic rhinitis, asthma and eczema in children under 18 years of age is 13%, 12% and 8% respectively [1]. The likelihood of having all three conditions together was 10 times higher than could be expected by chance [1, 14]
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