Impact of allergic rhinitis on asthma: Effects on bronchial hyperreactivity

I. Cirillo, A. Pistorio, M. Tosca, G. Ciprandi

Research output: Contribution to journalArticlepeer-review


Background: Remarkable relationship exists between upper and lower airways. Bronchial hyperreactivity (BHR) is a paramount feature of asthma and may be considered a strong risk factor for the onset of asthma in patients with allergic rhinitis. Objective: This study is aimed at evaluating the presence of BHR in a large group of patients with moderate-severe persistent allergic rhinitis alone, and at investigating possible risk factors related to severe BHR. Methods: Three hundred and forty-two patients with moderate-severe persistent allergic rhinitis were prospectively and consecutively evaluated. Clinical examination, skin prick test, spirometry and bronchial methacholine (MCH) test were performed in all patients. Results: Twenty-two (6.4%) patients had severe BHR, 74 (21.6%) patients had mild BHR and 192 (56.2%) had borderline BHR; 54 (15.8%) patients had a negative MCH test. The logistic regression analysis evidenced that trees and house dust mites sensitization (OR Adj: 8.1), rhinitis duration > 5 years (ORAdj: 5.4) and FEV1 ≤ 86% of predicted (ORAdj: 4.0) were significantly associated with severe BHR. The discriminative ability of this model is appreciably satisfactory, being the AUC = 0.90. Conclusion: This study highlights the close link between upper and lower airways and the role of some risk factors, such as tree and mite sensitization, > 5-year duration, and ≤ 86% FEV1 values, as risk factors for severe BHR in patients with moderate-severe persistent allergic rhinitis alone. Therefore, BHR is frequently present in patients with chronic rhinitis and should be suspected in the presence of defined risk factors.

Original languageEnglish
Pages (from-to)439-444
Number of pages6
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number3
Publication statusPublished - Mar 2009


  • Allergic rhinitis
  • Bronchial hyperreactivity
  • Duration
  • Methacholine
  • Risk factors
  • Spirometry

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy


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