TY - JOUR
T1 - Non-atopic rhinitis at age 6 is associated with subsequent development of asthma
AU - Carr, Tara F.
AU - Stern, Debra A.
AU - Halonen, Marilyn
AU - Wright, Anne L.
AU - Martinez, Fernando D.
N1 - Funding Information:
Funding information This work was funded by NIH grant HL 56177. The authors gratefully acknowledge the contributions of Lynn Taussig who started the TCRS in 1980. They thank Bruce Saul for data management and the study nurses, Marilyn Lindell, Lydia de la Ossa, and Nicole Pargas, for data collection and participant follow-up. They thank Lily Kim for assistance with manuscript data. Partial data were presented in part at the American Thoracic Society 2015 International Conference, Denver CO.
Funding Information:
This work was funded by NIH grant HL 56177.
Publisher Copyright:
© 2018 John Wiley & Sons Ltd
PY - 2019/1
Y1 - 2019/1
N2 - Background: It has been postulated that the association between allergic rhinitis and asthma is attributable to the progressive clinical expression of respiratory inflammation during childhood. The role of non-allergic rhinitis in early life in relation to subsequent asthma has not been extensively explored. Objective: We sought to determine whether rhinitis in early life was associated with risk of asthma development into adulthood, and whether this relationship is independent of allergic sensitization. Methods: Participants were identified from the Tucson Children's Respiratory Study, a non-selected birth cohort. Allergy skin prick testing was performed at age 6 years using house dust mix, Bermuda, mesquite, olive, mulberry, careless weed, and Alternaria aeroallergens. Atopy was defined as ≥1 positive tests. Physician-diagnosed active asthma from age 6 to 32 and physician-diagnosed rhinitis at age 6 were determined by questionnaire. Participants with asthma or active wheezing at age 6 were excluded from analyses. Risk estimates were obtained with Cox regression. Results: There were 521 participants who met inclusion criteria. The hazard ratio for subsequently acquiring a diagnosis of asthma between the ages of 8 and 32 for those with non-atopic rhinitis was 2.1 (95% CI: 1.2, 3.4, P = 0.005), compared with the non-atopic no rhinitis group, after adjusting for sex, ethnicity, maternal asthma, maternal education and smoking, and history of 4+ colds per year at age 6. Among the atopic participants, both the active and no rhinitis groups were more likely to develop and have asthma through age 32. The relation between non-atopic rhinitis and asthma was independent of total serum IgE levels at age 6. Conclusion and Clinical Relevance: Childhood rhinitis, even in the absence of atopy, confers significant risk for asthma development through adulthood. These findings underscore the importance of non-allergic mechanisms in the development of asthma.
AB - Background: It has been postulated that the association between allergic rhinitis and asthma is attributable to the progressive clinical expression of respiratory inflammation during childhood. The role of non-allergic rhinitis in early life in relation to subsequent asthma has not been extensively explored. Objective: We sought to determine whether rhinitis in early life was associated with risk of asthma development into adulthood, and whether this relationship is independent of allergic sensitization. Methods: Participants were identified from the Tucson Children's Respiratory Study, a non-selected birth cohort. Allergy skin prick testing was performed at age 6 years using house dust mix, Bermuda, mesquite, olive, mulberry, careless weed, and Alternaria aeroallergens. Atopy was defined as ≥1 positive tests. Physician-diagnosed active asthma from age 6 to 32 and physician-diagnosed rhinitis at age 6 were determined by questionnaire. Participants with asthma or active wheezing at age 6 were excluded from analyses. Risk estimates were obtained with Cox regression. Results: There were 521 participants who met inclusion criteria. The hazard ratio for subsequently acquiring a diagnosis of asthma between the ages of 8 and 32 for those with non-atopic rhinitis was 2.1 (95% CI: 1.2, 3.4, P = 0.005), compared with the non-atopic no rhinitis group, after adjusting for sex, ethnicity, maternal asthma, maternal education and smoking, and history of 4+ colds per year at age 6. Among the atopic participants, both the active and no rhinitis groups were more likely to develop and have asthma through age 32. The relation between non-atopic rhinitis and asthma was independent of total serum IgE levels at age 6. Conclusion and Clinical Relevance: Childhood rhinitis, even in the absence of atopy, confers significant risk for asthma development through adulthood. These findings underscore the importance of non-allergic mechanisms in the development of asthma.
KW - asthma
KW - inflammation
KW - non-allergic
KW - non-atopic
KW - rhinitis
UR - http://www.scopus.com/inward/record.url?scp=85054703722&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054703722&partnerID=8YFLogxK
U2 - 10.1111/cea.13276
DO - 10.1111/cea.13276
M3 - Article
C2 - 30220097
AN - SCOPUS:85054703722
SN - 0954-7894
VL - 49
SP - 35
EP - 43
JO - Clinical and Experimental Allergy
JF - Clinical and Experimental Allergy
IS - 1
ER -