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

Abstract

PurposeData 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.MethodsWe 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.ResultsThe 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).ConclusionsModerate 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.

Bisphenol A as a risk factor for allergic rhinitis in children

“…The AR and its impact on Asthma (ARIA) classification was introduced about 10 years ago and is continuously updated in different areas. 12,22 This classification gives the opportunity for a reliable evaluation of the disease severity of AR. We found BPA and IL-4 levels were significantly higher in moderate to severe group than mild group according to ARIA classification.…”

Trajectories of early‐onset rhinitis in the Singapore GUSTO mother‐offspring cohort

“…“Rhinitis” was defined by a positive response to the question “Has your child ever had sneezing, running nose, blocked or congested nose, snoring or noisy breathing during sleep or when awake that has lasted for 2 or more weeks duration?” This was also based on the World Health Organization and Global Allergy and Asthma European Network (GA(2)LEN) consensus statement on the ARIA guidelines which recommended that symptoms that persist longer than 2 weeks should prompt a search for a cause other than infection, 12 as upper respiratory infections in children rarely last beyond 14 days 14 . These questions have also been previously validated in children from 1 year of age in GUSTO as well as several other birth cohorts 11,15,16 …”

“…Interviewers gathered information on demographic characteristics, family history of allergy, social data, and lifestyle factors. Definitions of allergic outcomes were standardized in the questionnaires administered at 3 weeks, 3,6,9,12,15,18,24,36,48,60, and 72 months to ensure consistency during interviews and home visits. We used standardized questionnaires for evaluation of allergic symptoms and classified rhinitis symptoms according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines.…”

“…14 These questions have also been previously validated in children from 1 year of age in GUSTO as well as several other birth cohorts. 11,15,16 Physician-diagnosed eczema was defined by a positive answer to the question: "Has your child ever been diagnosed with eczema? "; "Wheezing" was defined by affirmative responses to both questions: "Has your child ever wheezed?"…”

Pharmacological Effects of Novel Peptide Drugs on Allergic Rhinitis at the Small Ribonucleic Acids Level

“…Allergic rhinitis (AR) ( Maoz-Segal et al, 2019 ) is defined as inflammation of the nasal mucosa induced by an allergic reaction; it is also known as anaphylaxis (allergy) ( Turner et al, 2019 ). Based on the clinical symptoms, AR can be classified into four groups based on its persistence and severity ( Settipane and Charnock, 2016 ; Jung et al, 2020 ). For instance, AR of > 4-week duration is classified as persistent and AR with only mild symptoms as mild.…”