Rhinitis symptoms and IgE sensitization as risk factors for development of later allergic rhinitis in adults

Background: Rhinitis symptoms and IgE-sensitization often mismatch. Asymptomatic sensitization is an established risk factor for later rhinitis, whereas it is not clear whether rhinitis is a risk factor for later development of IgE-sensitization. Objective: To investigate whether nonallergic rhinitis is a risk factor for later development of IgE-sensitization in adults during an 8-year follow-up period, and whether asymptomatic sensitization is a risk factor for later development of rhinitis. Methods: In a population-based study of 15-69 years olds in 1990, 734 subjects were re-examined in 1998. On both occasions questionnaires on rhinitis symptoms were completed and serum IgE (against birch, grass, mugwort, cat, dog, and Dermatophagoides pteronyssinus) were determined (positive if ≥0.35 kU_A/l). Asymptomatic sensitization: positive IgE levels without any rhinitis symptoms. Nonallergic rhinitis: rhinitis symptoms and no sensitization. Results: Asymptomatic sensitization to pollens, pets, or house dust mite was significantly associated with onset of rhinitis symptoms, also when changing baseline cut-off for sensitization to ≥0.1 or ≥0.7 kU_A/l. The 8-year incidence of pollen-related rhinitis was 15.1% and 2.6% in subjects sensitized and nonsensitized to pollens, respectively (odds ratio 6.1, 95% CI 2.3-16.0). Persistent or intermittent nonallergic rhinitis was not significantly associated with later sensitization, yet a positive trend for development was observed in nonallergic pollen-related rhinitis. Conclusion: Asymptomatic sensitization but not nonallergic rhinitis was a significant risk factor for later development of allergic rhinitis.