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

• Published in: Journal of laryngology and otology Vol. 122; no. 3; pp. 259 - 263
• Main Authors: Sheahan, P, McConn-Walsh, R, Walsh, M, Costello, R W
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.03.2008
• Subjects: Allergens; Allergic Rhinitis; Allergies; Asthma; Asthma - complications; Biological and medical sciences; Bradykinin; Case-Control Studies; Chronic obstructive pulmonary disease, asthma; Classification; Female; Hay fever; Humans; Male; Medical sciences; Nasal Provocation Tests - methods; Non tumoral diseases; Nose; Otorhinolaryngology. Stomatology; Pneumology; Rhinitis; Rhinitis, Allergic, Perennial - classification; Secretory Responses; Skin Tests - methods; Statistical analysis; Treatment Outcome; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Variance analysis; Vasodilator Agents; Allergic Rhinitis; Secretory Responses; Bradykinin; Classification; Immunopathology; Lung disease; Allergy; Nose disease; Vasodilator agent; Rhinitis; Respiratory disease; Secretion; Peptide hormone; ENT; Asthma; Nose; ENT disease; Bronchus disease; Obstructive pulmonary disease
• ISSN: 0022-2151; 1748-5460; 1748-5640
• DOI: 10.1017/S0022215107008298

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. Experimental study. 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. 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. 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.