Role of forced expiratory flow at 25–75% as an early marker of small airways impairment in subjects with allergic rhinitis

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Abstract:

A close link exists between allergic rhinitis and asthma. Small airway disease (SAD), defined by a reduction in forced expiratory flow at 25–75% of the pulmonary volume (FEF25–75) and normal spirometry (normal forced expiratory volume at 1 second [FEV1], forced vital capacity [FVC], and FEV1/FVC ratio), may be a marker for early allergic or inflammatory involvement of the small airways in subjects with allergic diseases and no asthma. The aim of this study was to determine if there is a relationship between SAD, the outcome variable, and several allergic predictors in patients without asthma but with allergic rhinitis. A cross-sectional study was performed. Two hundred eleven midshipmen attending the third and fifth course of the Navy Academy of Livorno were screened. Fifty-eight midshipmen showed slight spirometric anomalies. Thus, they were referred to the Navy Hospital of La Spezia for standardized tests: skin-prick test, nasal cytology, spirometry, and methacholine bronchial challenge. A reduced FEF25–75 was arbitrarily defined as <80% of predicted. All 58 subjects had a normal FEV1, FVC, and FEV1/FVC ratio. Twenty subjects had a reduced FEF25–75, consistent with the definition of SAD. A mean value of FEF25–75 of 70.3 (SD, 8.5) was measured in patients with a reduced FEF, and it was 108.0 (SD, 14.3) in patients with preserved FEF25–75. All the candidate allergic predictors appeared to be strongly associated with a reduced FEF25–75. The proportion of subjects with reduced FEF25–75 appeared to increase with increasing severity of the allergic predictors, and, correspondingly, the mean value of FEF25–75 appeared to decrease. This study provides evidence that there is a relationship between SAD and allergic parameters such as nasal symptoms and eosinophils.

Keywords: BRONCHIAL HYPERREACTIVITY; FEF25-75; RHINITIS; SMALL AIRWAYS DISEASE; SPIROMETRY

Document Type: Research Article

DOI: http://dx.doi.org/10.2500/aap.2007.28.2920

Affiliations: 1: Department of Pediatrics, IRCCS Policlinico San Matteo, University of Pavia, Italy 2: Navy Hospital, Medicine Department, La Spezia, Italy 3: Biometry and Clinical Epidemiology Service, IRCCS Policlinico San Matteo, Pavia, Italy 4: Istituto Giannina Gaslini, Genoa, Italy 5: Department of Pediatrics, University of Catania, Italy 6: Allergy, Head?Neck Department, San Martino Hospital, Genoa, Italy

Publication date: January 1, 2007

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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