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From the Authors

Depts of ¹ Clinical Pharmacology and ² Occupational Therapy, University Hospital Lund, Sweden

From the authors:

We are grateful for these comments on our observations 1 regarding the potential involvement of nasal disease in asthma as well as chronic bronchitis/emphysema (CBE), and also for bringing to our attention the interesting report 2 on the identification of perennial rhinitis as an independent risk factor for nonatopic asthma. Incidentally, we have just finalized a second survey involving 9,300 responding subjects 3, 4 confirming our original observations 1. We think our findings may broaden the interest, not only in treating the nasal passages in patients suffering from different forms of obstructive airway diseases but also in using the human nose for safe and well-controlled studies of inflammatory responses of the human respiratory tract mucosa 5.

As suggested by Bousquet and colleagues we have now reanalysed our nasal symptom data with respect to different age groups. Thick yellow nasal discharge characteristically remains a risk factor for CBE (p<0.004–0.02) but not for asthma (p>0.05) in all age groups. Conversely, sneezing and/or itching remain exclusive risk factors for asthma (p<0.001–0.03) in all but the eldest age group (50–59 yrs). These findings strengthen our notion that the nasal symptomatology adds to the different nature of the two bronchial diseases. In response to the second point raised by Bousquet and colleagues our current analysis showed that self-reported "allergic eye-nose catarrh" was twice as common among subjects with self-reported asthma (14.5%) compared to subjects with self-reported CBE (7.3%). This observation agrees with our finding that symptom-provoking factors of an allergic nature were risk factors for asthma rather than CBE 1.

Importantly, we also demonstrated that exposure to nonallergic factors in general were more of a risk factor for chronic bronchitis/emphysema than for asthma 1.

References

1. Montnémery P, Svensson C, Ädelroth E, et al. Prevalence of nasal symptoms and their relation to self-reported asthma and chronic bronchitis/emphysema. Eur Respir J 2001;17:596–603.[Abstract/Free Full Text]
2. Leynaert B, Bousquet J, Neukirch C, Liard R, Neukirch F. Perennial rhinitis: An independent risk factor for asthma in nonatopic subjects. J Allergy Clin Immunol 1999;104:301–304.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
3. Montnémery P, Nihlén U, Löfdahl CG, et al. The association between asthma, chronic bronchitis/emphysema and rhinitis. Eur Respir J 2001;18:Suppl. 33, 201s.
4. Andersson M, Nihlén U, Greiff L, et al. Allergic rhinitis prevalence and incidence in southern Sweden 1992–2000. Eur Respir J 2001;18:Suppl. 33, 200s.
5. Persson CGA, Svensson C, Greiff L, et al. The use of the nose to study the inflammatory response of the respiratory tract. Thorax 1992;47:993–1000.[Free Full Text]

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