Journal
LANCET
Volume 372, Issue 9643, Pages 1049-1057Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(08)61446-4
Keywords
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Categories
Funding
- Educational Grant
- UCB Institute
- Agence Nationale de la Recherche (ANR-SEST)
- Institut National de la Sante et de la Recherche Medicale-Assistatice Publique/Hopitaux de Paris
- European Commission
- Fondo de Investigaciones Santarias [97/0035-01, 99/0034-01, 99/0034-02]
- Hospital Universitario de Albacete
- Consejeria de Sanidad
- FWO (Fund for Scientific Research)-Flanders Belgium [G.0402.00]
- University of Antwerp
- Flemish Health Ministry
- SEPAR
- Public Health Service [ROI HL62633-01]
- CIRIT [1999SGR 00241]
- Swiss National Science Foundation [4026-28099]
- Swiss Federal Office for Education Science
- Swiss National Accident Insurance Fund (SUVA)
- Norwegian Research Council
- Norwegian Asthma & Allergy Association (NAAF)
- Glaxo Wellcome AS
- Norway Research Fund
- Institut Pneumologique d'Aquitaine
- GSF-National Research Centre for Environment Health
- Deutsche Forschungsgemeinschaft [FR 1526/1-1, MA 711/4-1]
- Basque Health Dept
- Swedish Heart Lung Foundation
- Swedish Foundation for Health Care Sciences & Allergy Reserch
- Swedish Asthma & Allergy Foundation
- Swedish Cancer & Allergy Foundation
- Programme Hospitalier de Recherche Clinique-DRC de Grenoble 2000 [2610]
- Ministry of Health, Direction de la Recherche Clinique
- Ministere de l'Emploi et de la Solidarite
- Direction Generale de la Saute
- CHU de Grenoble
- Comite des Maladies Respiratoires de l'lsere, Hamburg
- GSF-National Reasearch Centre for Environment Health
- Asthma UK (formerly known as National Asthma Campaign)
- Aventis (France)
- Direction Regionale des Affaires Sanitaires et Sociales Languedoc-Roussillon
- UCB-Pharma (France)
- Glaxo France
- Center of Clinical Investigations (CIC) of Bichat Teaching Hospital, Paris
- GlaxoSmithKline Italy
- Italian Ministry of University and Scientific and Technological Research (MURST)
- American Lung Association of Oregon
- Northwest Health Foundation
- Collins Foundation
- Merck Pharmaceutical
- Icelandic Research Counci
- Icelandic University Hospital Fund
- Estonian Science Foundation
- ASL 4 Regione Piemonte (Italy)
- AO CTO/ICORMA Regione Piemonte (Italy)
- Ministero dell' Universita e della Ricerca Scientifica (Italy)
- Glaxo Wellcome spa (Verona, Italy)
- Swedish Foundation for Health Care Sciences & Allergy Research
- University of Verona
- National Fund for Scientific Research
- Ministere de la Sante Glaxo France
- Insitut Pneumologique d'Aquitaine
- CNMATS
- CNMRT [901MR/10, 91AF/6]
- Ministre delegue de la sante
- RNSP, France
- GSF
- Bundesminister fur Forschung und Technologie, Bonn, Germany
- Ministero dell'Universita e della Ricerca Scientifica e Tecnologica
- CNR
- Regione Veneto grant [RSF n. 381/05.93]
- Norwegian Research Council [101422/310]
- Dutch Ministry of Wellbeing
- Public Health and Culture, Netherlands
- Ministero, Sanidad y Consumo FIS [#91/0016060/00E-05E, #93/0393]
- Hospital General de Albacete
- Hospital General Juan Ramon Jimenenz
- Consejeria de Sanidad Principado de Asturias, Spain
- The Swedish Medical Research Council
- Swedish Association against Asthma and Allergy
- National Asthma Campaign
- British Lung Foundation
- Department of Health
- South Thames Regional Health Authority, UK
- United States Department of Health, Education and Welfare Public Health Service [#2 S07 RR05521-28]
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Background A close relation between asthma and allergic rhinitis has been reported by several epidemiological and clinical studies. However, the nature of this relation remains unclear. We used the follow-up data from the European Community Respiratory Health Survey to investigate the onset of asthma in patients with allergic and non-allergic rhinitis during an 8 . 8-year period. Methods We did a longitudinal population-based study, which included 29 centres (14 countries) mostly in western Europe. Frequency of asthma was studied in 6461 participants, aged 20-44 years, without asthma at baseline. incident asthma was defined as reporting ever having had asthma confirmed by a physician between the two surveys. Atopy was defined as a positive skin-prick test to mites, cat, Alternaria, Cladosporium, grass, birch, Parietaria, olive, or 44 ragweed. Participants were classified into four groups at baseline: controls (no atopy, no rhinitis; n=3163), atopy only (atopy, no rhinitis; n=704), non-allergic rhinitis (rhinitis, no atopy; n=1377), and allergic rhinitis (atopy+rhinitis; 49 n=1217). Cox proportional hazards models were used to study asthma onset in the four groups. Findings The 8.8-year cumulative incidence of asthma was 2.2% (140 events), and was different in the four groups (1 . 1% (36), 1.9% (13), 3.1% (42), and 4.0% (49), respectively; p<0 . 0001). After controlling for country, sex, baseline age, body-mass index, forced expiratory volume in 1 s (FEV1), log total IgE, family history of asthma, and smoking, the adjusted relative risk for asthma was 1.63 (95% CI 0.82-3.24) for atopy only, 2.71 (1.64-4.46) for non-allergic rhinitis, and 3.53 (2.11-5.91) for allergic rhinitis. Only allergic rhinitis with sensitisation to mite was associated with increased risk of asthma independently of other allergens (2.79 [1.57-4.96]). Interpretation Rhinitis, even in the absence of atopy, is a powerful predictor of adult-onset asthma Funding UCB Institute of Allergy and Agence Nationale de la Recherche.
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