About the question of comorbidity of bronchial asthma and allergic rhinitis at school age


  • Олена Костянтинівна Колоскова Bukovinian State Medical University 2 Theater squ., Chernivtsi, Ukraine, 58000, Ukraine
  • Галина Анатоліївна Білик Bukovinian State Medical University 2 Theater squ., Chernivtsi, Ukraine, 58000, Ukraine




bronchial asthma, comorbidity, allergic rhinitis, school-aged children, remodeling of bronchial tubes


The aim of research was to establish clinical and epidemiological features of bronchial tubes remodeling in schoolchildren with bronchial asthma with comorbid allergic pathology for optimization of the dynamic observation and management of the main disease.

Methods: There were examined 114 schoolchildren with bronchial asthma separated into 2 clinical groups depending on comorbid allergic pathology presence: 1 clinical group – 55 patients without comorbid allergic pathology, 11 group – patients with clinical sings of other forms of allergic pathology. Schoolchildren underwent the complex clinical examination: numerical score using constellational clinical and instrumental control scale of bronchial asthma (BA), spirograph examination, examination of the content of vascular endothelial growth factor (VEGF), extracellular cationic proteins in supernatant fluid of sputum, the general immunoglobulin of Е (IgE) class and interleukin-4 and -5 (Il-4, Il-5) in the serum of peripheral blood.

Results: There were detected the probable differences in clinical course of BA that indicated the heavier character of disease in the 11 group of comparison. The content of VEGF and eosinophilic cationic proteins (ECP) in sputum of patients with comorbid allergic rhinitis exceeded the mean indicators of 1 group in 1,4 times. In patients of 11 clinical group took place the tendency to prevalence of allergic inflammation markers IgE and IL-4, IL5in the blood serum.

Conclusions: Comorbid clinical course of allergic rhinitis in children with bronchial asthma favors the heavier and longer course of the main disease and activates the processes of neoanginogenesis of respiratory tracks with following remodeling of bronchial tubes. An examination of sputum for the content eosinophilic cationic proteins and vascular endothelial growth factor is necessary for schoolchildren with bronchial asthma with comorbid allergic rhinitis for optimization of basic anti-inflammatory treatment

Author Biographies

Олена Костянтинівна Колоскова, Bukovinian State Medical University 2 Theater squ., Chernivtsi, Ukraine, 58000

Professor, Doctor of medical sciences, head of the department

Department of Pediatrics and Pediatric Infectious Diseases

Галина Анатоліївна Білик, Bukovinian State Medical University 2 Theater squ., Chernivtsi, Ukraine, 58000

PhD student

Department of Pediatrics and Pediatric Infectious Diseases


Balabolkin, I. I. Yuhtina, N. V., Ryileeva, I. V. et. al. (2006). Kompleksnoe lechenie detey s dermorespiratornyim sindromom. [Comprehensive treatment of children with dermorespiratory syndrome] Moscow, 20.

Bachert, C., Vignola, A. M., Gevaert, P., Leynaert, B., Van Cauwenberge, P., Bousquet, J. (2004). Allergic rhinitis, rhinosinusitis, and asthma: one airway disease. Immunology and Allergy Clinics of North America, 24 (1), 19–43. doi: 10.1016/s0889-8561(03)00104-8

Lapshin, V. F., Umanets, T. R. (2009). Effektivnost primeneniya kompleksa polivitaminov u detey s allergicheskimi boleznyami [The effectiveness of multivitamins in children with allergic diseases]. Pediatricheskaya farmakologiya, 6 (6), 87–91.

Burgess, J. A., Walters, E. H., Byrnes, G. B., Matheson, M. C., Jenkins, M. A., Wharton, C. L. et. al. (2007). Childhood allergic rhinitis predicts asthma incidence and persistence to middle age: A longitudinal study. Journal of Allergy and Clinical Immunology, 120 (4), 863–869. doi: 10.1016/j.jaci.2007.07.020

Kapoor, R., Menon, C., Hoffstad, O., Bilker, W., Leclerc, P., Margolis, D. J. (2008). The prevalence of atopic triad in children with physician-confirmed atopic dermatitis. Journal of the American Academy of Dermatology, 58 (1), 68–73. doi: 10.1016/j.jaad.2007.06.041

Boulet, L-P., Boulet, V., Milot, J. (2002). How Should We Quantify Asthma Control? CHEST Journal, 122 (6), 2217–2223. doi: 10.1378/chest.122.6.2217

Li, J. T., Oppenheimer, J., Bernstein, I. L., Nicklas, R. A., Khan, D. A., Blessing-Moore, J. et. al. (2005). Attaining optimal asthma control: A practice parameter. Journal of Allergy and Clinical Immunology, 116 (5), 3–11. doi: 10.1016/j.jaci.2005.08.017

Pavord, I. D., Pizzichini, M. M., Pizzichini, E., Hargreave, F. E. (1997). The use of induced sputum to investigate airway inflammation. Thorax, 52 (6), 498–501. doi: 10.1136/thx.52.6.498

Ivanova, N. A. (2014). Komorbidnost allergicheskogo rinita i bronhialnoy astmyi u detey [Comorbidity of allergic rhinitis and asthma in children]. Meditsinskiy sovet, 6, 54–58.

Romanyuk, L. I. (2013). Allergicheskiy rinit kak komorbidnoe sostoyanie bronhialnoy astmy [Allergic rhinitis as a comorbid condition of asthma]. Astma ta alergiya, 2, 62–65.

Koh, G. C.-H., Shek, L. P.-C., Goh, D. Y.-T., Van Bever, H., Koh, D. S.-Q. (2007). Eosinophil cationic protein: Is it useful in asthma? A systematic review. Respiratory Medicine, 101 (4), 696–705. doi: 10.1016/j.rmed.2006.08.012

Jang, S., Park, J.-W., Cha, H. R., Jung, S. Y., Lee, J. E., Jung, S. S. et. al. (2012). Silver nanoparticles modify VEGF signaling pathway and mucus hypersecretion in allergic airway inflammation. International Journal of Nanomedicine, 7, 1329–1343. doi: 10.2147/ijn.s27159

Global strategy for asthma management and prevention (revision) (2014). Available at: http://www.ginasthma.org/documents/4

Abdel-Rahman, A. M. O., El-Sahrigy, A. F. S., Bakr, S. I. (2006). A comparative study of two angiogenic factors: vascular endothelial growth factor and angiogenin in induced sputum from asthmatic children in acute attack. CHEST Journal, 129 (2), 266–271. doi: 10.1378/chest.129.2.2666

Bousquet, J., Mantzouranis, E., Cruz, A. A., Aït-Khaled, N., Baena-Cagnani, C. E., Bleecker, E. R. et. al. (2010). Uniform definition of asthma severity, control, and exacerbations: Document presented for the World Health Organization Consultation on Severe Asthma. Journal of Allergy and Clinical Immunology, 126 (5), 926–938. doi: 10.1016/j.jaci.2010.07.019

Bateman, E. D., Reddel, H. K., Eriksson, G., Peterson, S., Östlund, O., Sears, M. R. et. al. (2010). Overall asthma control: The relationship between current control and future risk. Journal of Allergy and Clinical Immunology, 125 (3), 600–608.e6. doi: 10.1016/j.jaci.2009.11.033

Wu, A. C., Tantisira, K., Li, L., Schuemann, B., Weiss, S. T., Fuhlbrigge, A. L. et. al. (2011). Predictors of Symptoms Are Different From Predictors of Severe Exacerbations From Asthma in Children. CHEST Journal, 140 (1), 100. doi: 10.1378/chest.10-2794





Medical Science. Part 1