What is the connection between allergies and asthma? We asked James T. Li, M.D., a Mayo Clinic specialist in allergies, asthma and immunology.
Oasis: Who gets allergies?
Dr. Li: Some people have a tendency to develop a variety of allergies. The medical term for this tendency is atopy, and we call these individuals atopic. Atopy tends to run in families.
Oasis: Is atopy always inherited?
Dr. Li: That is a very complex question. There is clearly a genetic component, but the development of allergies is also determined by exposure to allergens during a person’s lifetime. Some people who don’t have a family history of atopy still develop allergies, and some people with a family history of atopy don’t develop allergies.
Oasis: What is the overlap between people with allergic rhinitis (hay fever) and those with asthma?
Dr. Li: Atopic people may have allergic rhinitis, they may have asthma triggered by allergies, and often they’ll have both. If you look at children with asthma, about 70 percent to 80 percent also have allergic reactions to common substances in the air such as pollen, mold, dust mites, animal dander and so on. When they inhale a substance that they are sensitive to, it can trigger an asthmatic reaction.
About 20 percent of children with asthma are not allergic to such things as pollens or molds. Their asthma may be turned on by other factors such as exercise, cold air or respiratory infection.
It’s estimated that 40 percent to 50 percent of adult asthmatics also have allergies. Often, this group has had asthma since childhood. About 50 percent to 60 percent of adult asthmatics do not have allergic triggers for their asthma.
Oasis: Not every child who has allergies will develop asthma?
Dr. Li: That’s right. Not every person, child or adult, who has allergic rhinitis will also have or develop asthma.
Oasis: Is sinusitis involved in any way in this link between allergic rhinitis and asthma?
Dr. Li: An indirect link between allergic rhinitis and asthma is that people with allergic rhinitis are at risk of developing sinusitis or other respiratory infections. In a person with allergic rhinitis who gets sinusitis, the sinusitis in turn can trigger a flare-up of asthma.
Oasis: In what ways is the management of allergies and asthma linked?
Dr. Li: That’s an area of intense interest. Basically, if a person has both allergic rhinitis and allergy-triggered asthma, then avoiding exposure to allergens can be beneficial for both problems. For example, if someone has pollen allergy, one of the things we’ll work on is eliminating pollen from the home by shutting windows and using ventilation systems and air filters. If someone’s allergic to dust mites, then taking measures to reduce dust mite exposure in the home would benefit both the allergic rhinitis and the allergic asthma.
In addition, a regimen of allergy shots is sometimes beneficial for people who have allergic rhinitis and allergic asthma. In many people, treatment with allergy shots will benefit both conditions.
But the area of more intensive interest is whether aggressively treating the allergic rhinitis will directly or indirectly improve the asthma. There is evidence that people who have both allergic rhinitis and asthma benefit from having appropriate and aggressive treatment of both conditions. Since available treatment for allergic rhinitis generally is both effective and safe, it’s important for these people not only to have good asthma care but to have allergic rhinitis and other respiratory allergies treated as well.
Oasis: Who gets allergies?
Dr. Li: Some people have a tendency to develop a variety of allergies. The medical term for this tendency is atopy, and we call these individuals atopic. Atopy tends to run in families.
Oasis: Is atopy always inherited?
Dr. Li: That is a very complex question. There is clearly a genetic component, but the development of allergies is also determined by exposure to allergens during a person’s lifetime. Some people who don’t have a family history of atopy still develop allergies, and some people with a family history of atopy don’t develop allergies.
Oasis: What is the overlap between people with allergic rhinitis (hay fever) and those with asthma?
Dr. Li: Atopic people may have allergic rhinitis, they may have asthma triggered by allergies, and often they’ll have both. If you look at children with asthma, about 70 percent to 80 percent also have allergic reactions to common substances in the air such as pollen, mold, dust mites, animal dander and so on. When they inhale a substance that they are sensitive to, it can trigger an asthmatic reaction.
About 20 percent of children with asthma are not allergic to such things as pollens or molds. Their asthma may be turned on by other factors such as exercise, cold air or respiratory infection.
It’s estimated that 40 percent to 50 percent of adult asthmatics also have allergies. Often, this group has had asthma since childhood. About 50 percent to 60 percent of adult asthmatics do not have allergic triggers for their asthma.
Oasis: Not every child who has allergies will develop asthma?
Dr. Li: That’s right. Not every person, child or adult, who has allergic rhinitis will also have or develop asthma.
Oasis: Is sinusitis involved in any way in this link between allergic rhinitis and asthma?
Dr. Li: An indirect link between allergic rhinitis and asthma is that people with allergic rhinitis are at risk of developing sinusitis or other respiratory infections. In a person with allergic rhinitis who gets sinusitis, the sinusitis in turn can trigger a flare-up of asthma.
Oasis: In what ways is the management of allergies and asthma linked?
Dr. Li: That’s an area of intense interest. Basically, if a person has both allergic rhinitis and allergy-triggered asthma, then avoiding exposure to allergens can be beneficial for both problems. For example, if someone has pollen allergy, one of the things we’ll work on is eliminating pollen from the home by shutting windows and using ventilation systems and air filters. If someone’s allergic to dust mites, then taking measures to reduce dust mite exposure in the home would benefit both the allergic rhinitis and the allergic asthma.
In addition, a regimen of allergy shots is sometimes beneficial for people who have allergic rhinitis and allergic asthma. In many people, treatment with allergy shots will benefit both conditions.
But the area of more intensive interest is whether aggressively treating the allergic rhinitis will directly or indirectly improve the asthma. There is evidence that people who have both allergic rhinitis and asthma benefit from having appropriate and aggressive treatment of both conditions. Since available treatment for allergic rhinitis generally is both effective and safe, it’s important for these people not only to have good asthma care but to have allergic rhinitis and other respiratory allergies treated as well.
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