מתוך medicontext.co.il
By Paula Moyer
WESTPORT, CT (Reuters Health) – Results from several international studies suggest that allergic rhinitis is an important risk factor for bronchial asthma.
The findings were presented at the 59th annual meeting of the American College of Allergy, Asthma, and Immunology (ACAAI) in Orlando, Florida. In a statement, the ACAAI calls attention to newly released World Health Organization guidelines titled "Allergic Rhinitis and its Impact on Asthma" (ARIA), which "aim to broaden the perspectives for primary prevention of bronchial asthma through the management of allergic rhinitis."
The guidelines provide updated information on allergic rhinitis, emphasize its impact on asthma, and provide a stepwise therapeutic protocol.
Bolstering this approach, one of the studies presented at the meeting showed that 90% of patients with asthma reported at least one symptom of rhinitis, and that approximately 85% reported at least four of six rhinitis symptoms, according to the ACAAI statement.
Separately, of 345 people with asthma surveyed, 81% described the onset of upper airway disease as being before or concurrent with their asthma. A third study showed that asthma was present in 16.2% of 1412 European subjects with perennial rhinitis versus 1% of 5198 controls.
"In one study reviewed, investigators showed that injecting pollen into the nose of a patient with asthma and allergies can cause bronchospasm in the lower airways, and that pollen injected into the lower airways of such a patient can cause rhinitis," Dr. William Storms told Reuters Health. "We should say the patient has respiratory allergies, rather than distinguishing between their rhinitis and their asthma."
Physicians often need to go under the surface to determine whether the asthma patient is suffering from rhinitis as well, he said. "Because patients often will present with only the asthma complaint, the physician must question the patient regarding rhinitis. Also, because patients often have a low awareness of non-sedating antihistamines, the physician may have to counsel the patient that the rhinitis can be treated without incurring drowsiness."
Dr. Storms is a practicing allergist in Colorado Springs and a clinical professor at the University of Colorado in Denver.
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