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The Allergic Rhinitis and its Impact on Asthma system: a new classification of allergic rhinitis and nasal responsiveness

Published online by Cambridge University Press:  14 May 2007

Abstract

Objectives and hypothesis:

Allergic rhinitis has traditionally been classified into seasonal and perennial rhinitis. However, many subjects with dual sensitisation do not fit neatly into either category. Recently, the Allergic Rhinitis and its Impact on Asthma workshop has proposed a new allergic rhinitis classification, into intermittent and persistent forms. The purpose of the present study was to investigate whether the symptomatic and secretory responsiveness of allergic rhinitis sufferers correlated well with the Allergic Rhinitis and its Impact on Asthma classification, compared with the traditional classification.

Study design:

Experimental study.

Methods:

Forty subjects with allergic rhinitis and 13 normal controls underwent a unilateral nasal bradykinin challenge protocol. Symptom scores were recorded and secretion weights measured bilaterally using filter paper disks. The symptomatic and secretory responses of allergic subjects were analysed according to both the traditional and the Allergic Rhinitis and its Impact on Asthma classifications, and the two systems were compared.

Results:

For both classification systems, the two groups of allergic subjects were clearly demarcated by secretory responses. However, after classification according to the traditional system, there was a lack of clear demarcation between the groups as regards symptomatic response, whereas clear demarcation of symptomatic responses was seen after using the Allergic Rhinitis and its Impact on Asthma classification.

Conclusions:

In allergic rhinitis subjects, the degree of nasal responsiveness was closely related to their Allergic Rhinitis and its Impact on Asthma classification. Furthermore, this classification was not compromised by the inclusion of subjects with dual sensitisation. Thus, the Allergic Rhinitis and its Impact on Asthma classification may have advantages for future research studies on allergic rhinitis.

Type
Research Article
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Skoner, DP. Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol 2001;108(suppl 1):S28CrossRefGoogle ScholarPubMed
2 Boulet, LP, Turcotte, H, Laprise, C, Lavertu, C, Bedard, PM, Lavoie, A et al. Comparative degree and type of sensitization to common indoor and outdoor allergens in subjects with allergic rhinitis and/or asthma. Clin Exp Allergy 1997;27:52–9CrossRefGoogle ScholarPubMed
3 Bousquet, J, van Cauwenberge, P, Khaltaev, N. Aria Workshop Group: World Health Organization. Allergic rhinitis and its impact on asthma (ARIA). In collaboration with the World Health Organization. Allergy 2002;57:841–5510.1034/j.1398-9995.2002.23625.xCrossRefGoogle Scholar
4 Proud, D, Togias, A, Naclerio, RM, Crush, SA, Norman, PS, Lichtenstein, LM. Kinins are generated in vivo following nasal airway challenge of allergic individuals with allergen. J Clin Invest 1983;72:1678–85CrossRefGoogle ScholarPubMed
5 Dear, JW, Wirth, K, Scadding, GK, Foreman, JC. Characterization of the bradykinin receptor in the human nasal airway using the binding of [125I]-Hoe 140. Br J Pharmacol 1996;119:1054–62CrossRefGoogle ScholarPubMed
6 Austin, CE, Foreman, JC. A study of the action of bradykinin and bradykinin analogues in the human nasal airway. J Physiol 1994;478:351–6CrossRefGoogle ScholarPubMed
7 Proud, D, Reynolds, CJ, Lacapra, S, Kagey-Sobotka, A, Lichtenstein, LM, Naclerio, RM. Nasal provocation with bradykinin induces symptoms of rhinitis and a sore throat. Am Rev Respir Dis 1988;137:613–1710.1164/ajrccm/137.3.613CrossRefGoogle Scholar
8 Riccio, MM, Proud, D. Evidence that enhanced nasal reactivity to bradykinin in patients with symptomatic allergy is mediated by neural reflexes. J Allergy Clin Immunol 1996;97:1252–63CrossRefGoogle ScholarPubMed
9 Sheahan, P, McConn-Walsh, R, Walsh, MA, Costello, RW. Induction of secretory and congestive hyperresponsiveness by allergen challenge in allergic rhinitis: the role of afferent and efferent nerves. Clin Exp Allergy 2005;35:455110.1111/j.1365-2222.2004.02131.xCrossRefGoogle Scholar
10 Baroody, FM, Wagenmann, M, Nacleirio, RM. Comparison of the secretory response of the nasal mucosa to methacholine and histamine. J Appl Physiol 1993;74:2661–71CrossRefGoogle ScholarPubMed