Multimorbidity in asthma, association with allergy, inflammatory markers and symptom burden, results from the Swedish GA 2 LEN study,Clinical & Experimental Allergy

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Multimorbidity in asthma, association with allergy, inflammatory markers and symptom burden, results from the Swedish GA 2 LEN study
Clinical & Experimental Allergy ( IF 6.3 ) Pub Date : 2020-10-25 , DOI: 10.1111/cea.13759
Viiu Blöndal ₁ , Andrei Malinovschi ₂ , Fredrik Sundbom ₁ , Anna James ₃ , Roelinde Middelveld ₃ , Karl A Franklin ₄ , Bo Lundbäck ₅ , Christer Janson ₁

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BACKGROUND Asthma is common worldwide and a large part of subjects with asthma have concomitant allergic multimorbidity in the form of rhinitis and/or eczema. OBJECTIVE The aim of this study is to investigate if the presence of allergic multimorbidity in asthma relates to allergic sensitisation, allergic and respiratory symptoms, quality of life, inflammatory markers, lung function, use of medication and background factors. METHODS A total of 437 asthmatics from the (GA2 LEN) cross-sectional survey in Sweden were grouped depending on the presence of rhinitis and/or eczema. The impact of allergic multimorbidity was assessed in terms of allergic sensitisation, allergic and respiratory symptoms, quality of life, type-2 inflammatory markers (exhaled nitric oxide, eosinophil activation markers, periostin), lung function, use of medication and background factors. RESULTS Subjects with asthma, rhinitis and eczema were more likely to be sensitised to seasonal allergens (67 vs 32%, p<0.001), food allergens (54 vs. 18%, p<0.001) and to have a higher degree of sensitisation than subjects with only asthma (23 vs 10%, p<0.001). Subjects with allergic multimorbidity more often had allergic reactions to food (28 vs 10%, p=0.002), more respiratory symptoms and anxiety/depression (40% vs, 14%, p<0.001) than subjects with only asthma, despite having similar levels of type 2 inflammatory markers. Individuals with allergic multimorbidity were more likely to be diagnosed with asthma before the age of 12 (48 vs. 27%, p=0.016) and to have maternal heredity for allergy (53 vs. 33%, p=0.011) than subjects with only asthma. CONCLUSION AND CLINICAL RELEVANCE Asthmatics with allergic multimorbidity are more likely to be sensitised to seasonal aeroallergens, food allergens and they have a higher degree of sensitisation compared with those with only asthma. Allergic multimorbidity is associated with respiratory and allergy symptoms, anxiety and/or depression.

更新日期：2020-10-25

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