Jenny Hallberg1,2,3, Natalia Ballardini1,2,4, Catarina Almqvist5,6, Marit Westman7,8, Marianne van Hage7, Gunnar Lilja2,3, Anna Bergström1,9, Inger Kull2,3, Erik Melén1,2. 1. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 2. Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden. 3. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. 4. St John's Institute of Dermatology, King's College London, London, UK. 5. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 6. Pediatric Allergy and Pulmonology Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden. 7. Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. 8. Department of Ear- Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden. 9. Center of Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
Abstract
BACKGROUND: Both allergic and non-allergic rhinitis are associated with worse asthma control. However, it is unclear how IgE sensitization and/or rhinitis are associated with lung function. We therefore evaluated the effect of rhinitis and sensitization on lung function, including the periphery of the airway system, and inflammatory biomarkers in individuals with and without asthma. METHODS: Participants in the BAMSE longitudinal birth cohort study underwent measures of spirometry, impulse oscillometry, and FeNO at age 16 years. Questionnaires were used to obtain data on asthma and rhinitis. Blood samples were analyzed for eosinophils and allergen-specific IgE. RESULTS: Groups based on the combination of asthma, rhinitis, and sensitization were compared to a healthy reference group. Lower FEV1 /FVC levels were seen for groups with asthma only (adjusted mean difference -2.8% units (95% CI -4.7; -1.0), P < 0.01), asthma with sensitization (-2.0 (-3.9; -0.2), P < 0.05), and asthma with sensitization and rhinitis (-2.5 (-3.6; -1.4), P < 0.001). The index of peripheral airway resistance R5-20 was higher in groups with asthma and sensitization (adjusted median difference 94.9 Pa L-1 s-1 (95% CI 60.4; 129.3), P < 0.001), as well as asthma with sensitization and rhinitis (36.9(15.0; 58.8), P < 0.01). These groups also had increased FeNO and blood eosinophil levels. CONCLUSIONS: We found signs of peripheral airway obstruction and increased levels of inflammatory biomarkers in the presence of allergic asthma, irrespective of rhinitis status. Despite having a reduced FEV1 /FVC, peripheral airway engagement was not seen in non-sensitized adolescents with asthma. We suggest that small airway disease is a feature related to the eosinophilic inflammation in allergic asthma in adolescence.
BACKGROUND: Both allergic and non-allergic rhinitis are associated with worse asthma control. However, it is unclear how IgE sensitization and/or rhinitis are associated with lung function. We therefore evaluated the effect of rhinitis and sensitization on lung function, including the periphery of the airway system, and inflammatory biomarkers in individuals with and without asthma. METHODS:Participants in the BAMSE longitudinal birth cohort study underwent measures of spirometry, impulse oscillometry, and FeNO at age 16 years. Questionnaires were used to obtain data on asthma and rhinitis. Blood samples were analyzed for eosinophils and allergen-specific IgE. RESULTS: Groups based on the combination of asthma, rhinitis, and sensitization were compared to a healthy reference group. Lower FEV1 /FVC levels were seen for groups with asthma only (adjusted mean difference -2.8% units (95% CI -4.7; -1.0), P < 0.01), asthma with sensitization (-2.0 (-3.9; -0.2), P < 0.05), and asthma with sensitization and rhinitis (-2.5 (-3.6; -1.4), P < 0.001). The index of peripheral airway resistance R5-20 was higher in groups with asthma and sensitization (adjusted median difference 94.9 Pa L-1 s-1 (95% CI 60.4; 129.3), P < 0.001), as well as asthma with sensitization and rhinitis (36.9(15.0; 58.8), P < 0.01). These groups also had increased FeNO and blood eosinophil levels. CONCLUSIONS: We found signs of peripheral airway obstruction and increased levels of inflammatory biomarkers in the presence of allergic asthma, irrespective of rhinitis status. Despite having a reduced FEV1 /FVC, peripheral airway engagement was not seen in non-sensitized adolescents with asthma. We suggest that small airway disease is a feature related to the eosinophilic inflammation in allergic asthma in adolescence.
Authors: Gang Wang; Jenny Hallberg; Dimitrios Charalampopoulos; Maribel Casas Sanahuja; Robab Breyer-Kohansal; Arnulf Langhammer; Raquel Granell; Judith M Vonk; Annemiek Mian; Núria Olvera; Lisbeth Mølgaard Laustsen; Eva Rönmark; Alicia Abellan; Alvar Agusti; Syed Hasan Arshad; Anna Bergström; H Marike Boezen; Marie-Kathrin Breyer; Otto Burghuber; Anneli Clea Bolund; Adnan Custovic; Graham Devereux; Gavin C Donaldson; Liesbeth Duijts; Ana Esplugues; Rosa Faner; Ferran Ballester; Judith Garcia-Aymerich; Ulrike Gehring; Sadia Haider; Sylvia Hartl; Helena Backman; John W Holloway; Gerard H Koppelman; Aitana Lertxundi; Turid Lingaas Holmen; Lesley Lowe; Sara M Mensink-Bout; Clare S Murray; Graham Roberts; Linnea Hedman; Vivi Schlünssen; Torben Sigsgaard; Angela Simpson; Jordi Sunyer; Maties Torrent; Stephen Turner; Maarten Van den Berge; Roel C H Vermeulen; Sigrid Anna Aalberg Vikjord; Jadwiga A Wedzicha; Anke H Maitland van der Zee; Erik Melén Journal: ERJ Open Res Date: 2021-12-06
Authors: Shadia Khan Sunny; Hongmei Zhang; Faisal I Rezwan; Caroline L Relton; A John Henderson; Simon Kebede Merid; Erik Melén; Jenny Hallberg; S Hasan Arshad; Susan Ewart; John W Holloway Journal: Respir Res Date: 2020-04-07