When asthma and rhinitis coexist, could rhinitis reduce asthma control in children?

Vittori, Valentina De; Pacilio, A.; Indinnimeo, Luciana; Migliori, Massimiliano; Castro, Giovanna De; Brindisi, Giulia; Schiavi, L; Tosca, Mariangela; Duse, Marzia; Zicari, Anna Maria

doi:10.2500/aap.2019.40.4219

Cited by 18 publications

(19 citation statements)

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“…The control of asthma is an emerging problem worldwide A recent survey reports that 47% of US children aged 0 to 4 years, 38% of those aged 5 to 11 and 35% of those aged 12 to 17 have uncontrolled asthma [52]. Likewise, many Italian studies showed similar results [53,54]. Many factors contribute to poor disease control, such as overestimation of control, poor evaluation of symptom severity, poor adherence to therapy, often as a result of unfounded concerns about ICS toxicity [55].…”

Section: Bronchial Asthmamentioning

confidence: 99%

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Duse¹,

Santamaria²,

Verga³

et al. 2021

Ital J Pediatr

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Background In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research.

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Section: Bronchial Asthmamentioning

confidence: 99%

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Duse¹,

Santamaria²,

Verga³

et al. 2021

Ital J Pediatr

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“…However, uncontrolled asthma symptoms can represent a risk factor for the severity of SARS-COV-2 infection. Thus, the goal was to control the symptoms of allergic diseases in the daily clinical practice and also during the SARS-CoV-2 infection [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Updates on Children with Allergic Rhinitis and Asthma during the COVID-19 Outbreak

Brindisi

Vittori

Nola

et al. 2021

JCM

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Background: During the lockdown period caused by the SARS-CoV-2 pandemic, we monitored via online survey the trend of allergic symptoms and the therapeutic compliance in patients followed at our center. Material and methods: In June 2020, we selected children followed at the Allergy and Immunology Service of Umberto I Hospital, aged between 6 and 16 years old, diagnosed with asthma and/or rhinitis and sensitized to grass pollen or dust mite. We sent an email with 12 multiple-choice questions investigating several areas: type of disease and sensitization, recurrence of symptoms, medication use during lockdown compared to the same period of the previous year. Results: The results of 82 questionnaires showed that 17.8% of patients suffered from asthma, 24.4% from rhinitis, and 57.8% from both. Within the group of asthmatic children, most of them presented an improvement of their symptoms. Likewise, with regard to allergic rhinitis, most of them reported better clinical conditions. Regarding treatment, we observed a global decrease in the use of on-demand therapies (salbutamol, nasal corticosteroid, and antihistamine) for both pathologies. In addition, there was a reduction in the use of basal therapy for asthma and rhinitis from 2019 (23.3%) to 2020 (15.5%). Conclusions: Our data show a general trend of clinical improvement and a reduction in the use of on-demand and basal therapy in allergic children during the lockdown.

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“… 6 , 7 Since upper and lower airways represent a continuous entity, a high percentage of AR patients (up to 38%) have also asthma, and the early and correct therapeutic management of both the diseases seems to bring mutual benefits. 8 , 9 They share a common ethiopathogenesis, characterized by a T-helper 2 (Th2) inflammatory response with a release of many biomarkers, where nitric oxide (NO) is one of the most studied. 10 The measurement of NO in the respiratory tract provides information on the degree of eosinophilic inflammation and it can complete the clinical and non-invasive management of allergic diseases.…”

Section: Introductionmentioning

confidence: 99%

The Role of Nasal Nitric Oxide and Anterior Active Rhinomanometry in the Diagnosis of Allergic Rhinitis and Asthma: A Message for Pediatric Clinical Practice

Brindisi¹,

Vittori²,

Nola³

et al. 2021

JAA

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Background Allergic rhinitis (AR) and asthma are two common atopic diseases, often associated with a common ethiopathogenesis characterized by a Th2 inflammatory response with the release of many biomarkers, such as nitric oxide (NO). Purpose To evaluate and compare inflammatory (nFeNO and eFeNO) and functional (mNF and FEV1) parameters in AR children with or without asthma in comparison to controls. Secondly, we aimed to identify nFeNO cut-off values and verify their reliability to predict the presence of rhinitis or asthma alone or in combination. Patients and Methods We enrolled 160 children (6–12 years of age) with AR and/or asthma divided into four groups: controls, AR, asthma, and AR + asthma. All children underwent the following inflammatory and functional measurements: nFeNO, eFeNO, mNF and FEV1. Results We observed that levels of nFeNO were extremely higher in children with AR and even more in those with AR + asthma in respect to controls. Notably, all the pathological conditions, especially AR + asthma, showed significantly lower values of mNF compared to healthy children. A negative correlation linked mNF and nFeNO. Then, we found eFeNO values significantly higher in all the pathological groups compared to controls, with major values of this marker in patients affected by asthma and AR + asthma, as well as FEV1 values significantly lower in all the disease groups, especially in children with asthma and AR+ asthma. ROC curve analysis showed that nFeNO was a great predictor for rhinitis alone or with asthma, revealing an accurate cut-off of 662 ppb. Conclusion nFeNO measurement is non-invasive, easy to perform, economic and a valuable test in case of AR alone or in association with asthma. Thus, it should be used in patients with rhinitis, together with anterior active rhinomanometry (AAR) to diagnose and estimate the degree of nasal obstruction but also in children with asthma to assess their nasal involvement and improve the therapeutic management.

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When asthma and rhinitis coexist, could rhinitis reduce asthma control in children?

Cited by 18 publications

References 0 publications

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Updates on Children with Allergic Rhinitis and Asthma during the COVID-19 Outbreak

The Role of Nasal Nitric Oxide and Anterior Active Rhinomanometry in the Diagnosis of Allergic Rhinitis and Asthma: A Message for Pediatric Clinical Practice

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