Rhinitis persistence and asthma are associated with immunoglobulin E (IgE) sensitization as well as total levels of IgE, according to new findings.¹

This new data also indicated that those who experience persistent allergic disease showed higher levels of allergen sensitization and markers of type 2 inflammation at the outset of the study versus those who do not develop such conditions.

The study itself was authored by Viiu Blöndal, from the Department of Medical Sciences at Uppsala University in Sweden. Blöndal and the team sought to examine allergic disease over time in greater depth.

“The aim of this study was to look at the change in allergic disease over time and to better characterize factors contributing to remission or persistent disease with the help of background factors, lung function, allergic sensitisation and type-2 inflammation markers,” Blöndal and colleagues wrote.

Background and Findings

The research team’s data was drawn from the European Community Respiratory Health Survey (ECRHS), a study that was multi-center and involved 3 visits over the time periods of 1991-1992, 1999-2000, and 2011-2012. The methodology and design of ECRHS I, II, and III has already been published, the researchers noted.²

The team used 2 stages in which possible study participants did a brief questionnaire in the first stage, and in the second, a selected group of respondents were invited for a detailed clinical examination. Those who reported specific symptoms in stage 1 were also included in the research by the investigators.

Overall, the investigators used a cohort study with a total of 255 participants with or without asthma and rhinitis that had been enrolled in a population survey and followed up 10 years later.

The researchers evaluated the participants for allergic sensitization, multiplex allergen component analysis, total IgE, and markers of type-2 inflammation, which were said to have included exhaled nitric oxide, eosinophil cationic protein, and eosinophil-derived neurotoxin.

Over a 10-year period, the research team compared the ECRHS II and ECRHS III studies. They noted that among the 132 healthy participants at the point of baseline, 112 were found to have remained healthy, 16 developed rhinitis, and 4 developed a combination of asthma and rhinitis.

The investigators also found that out of the 82 participants with rhinitis, 26 were noted as having ended up in remission, 53 continued to be unchanged, and 3 developed both asthma and rhinitis.They added that none of the 41 that had combined asthma and rhinitis went into remission.

One major finding as well as that younger participants had a greater likelihood of persistent rhinitis and asthma, and this same fact was true of those with a family history of allergic disease and asthma.

The team added that those showing persistent disease ended up with lower lung function at the start of the ECRHS II study, especially participants that had concomitant asthma and rhinitis. They identified no difference in BMI, gender, or smoking status between the different groups.

Another major finding of the study was that individuals with persistent rhinitis and asthma had higher levels of total IgE, exhaled nitric oxide, eosinophil cationic protein at baseline and after 10 years compared to those who stayed healthy.

The most significant finding they noted was that participants with persistent rhinitis were more likely to be sensitized to grass pollen and reported higher total IgE levels than those who had gone into remission. They added that participants with persistent asthma were more likely to be sensitized to tree pollen and certain animals with fur than those with only persistent rhinitis.

“Identifying individuals at risk for continued rhinitis and asthma allows clinicians to better plan follow-up appointments and improve the selection of patients who might benefit from allergen immunotherapy or treatments targeting type-2 inflammation,” they wrote.

References

1. ^{Blöndal, V, Sundbom, F, Zhou, X, et al. Allergic sensitisation and type-2 inflammation is associated with new-onset and persistent allergic disease. Clin Transl Allergy. 2023;e12240. https://doi.org/10.1002/clt2.12240.}
2. ^{Burney PG, Luczynska C, Chinn S, Jarvis D. The European Community Respiratory Health Survey. Eur Respir J. 1994;7(5):954-960. https://doi.org/10.1183/09031936.94.07050954}