Role of forced expiratory flow at 25–75% as an early marker of small airways impairment in subjects with allergic rhinitis
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.
SMALL AIRWAYS DISEASE;
Document Type: Research Article
Department of Pediatrics, IRCCS Policlinico San Matteo, University of Pavia, Italy
Navy Hospital, Medicine Department, La Spezia, Italy
Biometry and Clinical Epidemiology Service, IRCCS Policlinico San Matteo, Pavia, Italy
Istituto Giannina Gaslini, Genoa, Italy
Department of Pediatrics, University of Catania, Italy
Allergy, Head?Neck Department, San Martino Hospital, Genoa, Italy
Publication date: January 1, 2007
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Allergy and Asthma Proceedings
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Marseglia, Gian Luigi
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