Allergy Asthma Immunol Res.  2020 Jan;12(1):72-85. 10.4168/aair.2020.12.1.72.

Risk Factors and Comorbidities Associated With the Allergic Rhinitis Phenotype in Children According to the ARIA Classification

• Jung S
• Lee SY
• Yoon J
• Cho HJ
• Kim YH
• Suh DI
• Yang SI
• Kwon JW
• Jang GC
• Sun YH
• Woo SI
• Youn YS
• Park KS
• Lee E
• Cho HJ
• Kook MH
• Yi HR
• Chung HL
• Kim JH
• Kim HY
• Jung JA
• Woo HO
• Lee JK
• Chang WS
• Do NH
• Cho H
• Hong SJ

• KMID: 2462573
• DOI: http://doi.org/10.4168/aair.2020.12.1.72

Abstract

PURPOSE
Data are lacking on the association between the allergic rhinitis (AR) phenotype and sensitization to specific allergens or bronchial hyperresponsiveness (BHR) in children. We here investigated risk factors and comorbidities, including sensitization to specific allergens and BHR, for the AR phenotype by AR and its Impact on Asthma (ARIA) classification in a general population-based birth cohort study.
METHODS
We enrolled 606 children aged 7 years from the Panel Study of Korean Children. The AR phenotype was assigned in accordance with the ARIA classification in children. Skin prick tests and Provocholine provocation test were performed. Risk factors and comorbidities for AR phenotypes were then analyzed.
RESULTS
The prevalence of mild and moderate to severe AR in our study cohort was 37.2% and 8.8%, respectively. Recent use of analgesics or antipyretics and current cat ownership were associated with the risk of mild persistent AR. Sensitizations to Dermatophagoides Pteronyssinus (Der p), Japanese hop and cat were associated with moderate to severe persistent AR. Children with moderate to severe AR had a higher risk of current asthma and BHR compared to mild AR cases (adjusted odds ratio [aOR], 5.26; 95% confidence interval [CI], 1.77-15.62). Moderate to severe AR with allergic sensitization was associated with the highest risk of BHR (aOR, 11.77; 95% CI, 3.40-40.74).
CONCLUSIONS
Moderate to severe-persistent AR is more closely related to respiratory comorbidities and sensitizations than mild AR. Stratifying the AR phenotype by ARIA classification may assist in disease management.

Keyword

Allergic rhinitis; classification; risk factor; child; phenotype; bronchial hyperreactivity; cohort study; prevalence

MeSH Terms

Allergens
Analgesics
Animals
Antipyretics
Asian Continental Ancestry Group
Asthma
Bronchial Hyperreactivity
Cats
Child*
Classification*
Cohort Studies
Comorbidity*
Dermatophagoides pteronyssinus
Disease Management
Humans
Methacholine Chloride
Odds Ratio
Ownership
Parturition
Phenotype*
Prevalence
Rhinitis, Allergic*
Risk Factors*
Skin
Allergens
Analgesics
Antipyretics
Methacholine Chloride

Figure

• 

  Fig. 1 Flow chart of the study subjects. PSKC, Panel Study on Korean Children; AR, allergic rhinitis; ARIA, Allergic Rhinitis and its Impact on Asthma.

• 

  Fig. 2 Prevalence of AR in 7-year-old children according to their Allergic Rhinitis and its Impact on Asthma classification. AR, allergic rhinitis.

• 

  Fig. 3 Adjusted odds ratio and 95% confidence intervals for the risk of bronchial hyperresponsiveness according to the AR phenotype by Allergic Rhinitis and its Impact on Asthma classification. AR, allergic rhinitis.

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