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Exercise-induced bronchial responsiveness in subjects with allergic rhinitis and allergic asthma

Background: Only few studies investigated bronchial reaction to exercise in subjects with allergic rhinitis. The aim of this study was to establish the difference in exercise-induced bronchial responsiveness in healty control subjects, subjects with allergic rhinitis and allergic asthma. Methods: This study included 16 control subjects (17-51 years), 16 subjects with allergic rhinitis (15-45 years) and 19 subjects with allergic asthma (15-48 years). All patients with allergic rhinitis had a positive history of rhinitis, a positive skin prick test (SPT) to at least one common inhalatory allergen (3 mm or larger than the negative control) (Alk-Abello, Denmark). All patients with allergic asthma had a positive history of asthma, a positive SPT to at least one allergen and positive histamine challenge test according to Chai (PD20FEV1<7, 8 &#956; mol). All subjects went through a submaximal constant exercise test (CET). Bronchial reaction to exercise was expressed as fall index FEV1(%), Area Under the time-response Curve AUC0-30(minx%), fall index FEF25-75(%) and fall index FEV1&#8805; 10% was considered as positive. Results: After CET, five subjects with allergic asthma had a fall index FEV1&#8805; 10%, which was not found in control subjects and subjects with allergic rhinitis. Patients with allergic rhinitis had a significantly lower bronchial reaction to exercise than subjects with allergic asthma expressed as fall index FEV1(2.9: 8.4%, p=0, 015), AUC0-30 (29.6: 127.7 min x %, p=0, 018) and fall index FEF25-75 (0.06 :14.6%, p<0, 001). No difference was found between subjects with allergic rhinitis and control subjects in fall index FEV1 (2.9: 2, 4, p=0, 65), AUC0-30 (29.6: 33.1min x %, p=0, 93) and fall index FEF25-75 (0.06: 1.9%, p=0, 61). Conclusion: CET induced significantly higher bronchial reaction in patients with asthma than in rhinitic patients. Such difference was not found between subjects with allergic rhinitis and healthy controls. bronchial hyperresponsiveness to exercise is a feature of patients with allergic asthma, but not patients with allergic rhinitis.

exercise challenge test; allergic rhinitis; allergic asthma; bronchial responsiveness

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