Relationships between indoor allergens, sensitization, and allergic asthma and rhinitis symptoms

INTRODUCTION: There is a strong and consistent association between immediate hypersensitivity, asthma and exposure to allergens. However, the role that the inhaled allergen plays and the timing of events related to sensitization are still controversial. BACKGROUND: Information obtained by studies of the follow-up of cohorts underlines the fact that there is no continuum between specific IgE responses and the development of childhood asthma. Allergic rhinitis and asthma result from a complex and multifactorial interaction between genetic factors, exposure to allergens, and many biological or chemical co-factors. However, when the child is exposed to an allergen, sensitization to the allergen is a risk factor for childhood asthma and severity of the disease. CONCLUSIONS AND VIEWPOINTS: Despite numerous epidemiological studies, the association and links between atopy, allergens, environment, sensitization and allergic rhinitis and/or asthma remain difficult to evaluate and poorly understood. Complementary studies are also necessary for the standardization of therapeutic strategies.     

Place de l’Anaforcal dans l’enseignement post-universitaire de la rhinite allergique

The National Association of Continuing Medical Education in Allergy (Anaforcal) proposes, for the year 2008, a teaching module on the theme of allergic rhinitis aimed at general practitioners in 50 French cities. The choice of this theme is based on the frequency and the impact of this condition on public health. This teaching module will include three simple, didactic clinical cases. In addition, it contains the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) report on allergic rhinitis, with various documents on its diagnosis and therapy. The document strongly emphasizes the originality of this training in terms of its organization, conception and interactive teaching method.     

Enquête sur le poids de la rhinite allergique en France

Background

This paper presents the results from France of a prospective, cross-sectional, international survey conducted among patients and physicians to identify symptom perception and the impact of allergic rhinitis on health-related quality of life.

Methods

Data about the presence, severity and impact of symptoms were recorded by 504 patients and matched with data from their physicians. Health-related quality of life was assessed using the Mini Rhinoconjunctivitis Quality of Life Questionnaire.

Results

According to the physicians’ assessments, a large proportion (71%) of patients had moderate or severe disease, persistent disease (48.3%), and comorbidities such as asthma (32.3%) and anxiety (19%). Persistent disease was present in 55.3% of patients with perennial allergic rhinitis and 44.9% with seasonal allergic rhinitis. Physicians tended to underestimate the incidence of some symptoms reported by the patients, most notably cough, headache, and itchy eyes. Health-related quality of life was negatively correlated with disease severity and number of symptom-free days. Allergic rhinitis had a significantly greater impact on patients with more persistent disease compared with those with intermittent disease (2.0 ± 1.3 versus 1.8 ± 1.2; p < 0.05); nevertheless, 73.9% of patients with intermittent disease reported some impairment of their daily life.

Conclusions

Allergic rhinitis remains a significant health problem in France due to the high prevalence of moderate or severe, persistent disease in patients presenting during routine care as well as to the impact of the disease on health-related quality of life. Patients and physicians differed significantly in their perception of disease severity and in the reporting of some symptoms, including ocular symptoms and cough.