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Sex and atopy influences on the natural history of rhinitis

Kurukulaaratchy, Ramesh J.; Karmaus, Wilfried; Arshad, Syed Hasan

Current Opinion in Allergy and Clinical Immunology: February 2012 - Volume 12 - Issue 1 - p 7–12
doi: 10.1097/ACI.0b013e32834ecc4e
RHINITIS, SINUSITIS AND UPPER AIRWAY DISEASE: Edited by Ruby Pawankar and David P. Skoner

Purpose of review Rhinitis is a common condition associated with significant under-recognized morbidity and impaired quality of life. The natural history of rhinitis is poorly characterized. Better understanding of its natural history and associated risk factors would improve the ability to effectively manage rhinitis in clinical practice. This review focuses on the current research findings on the natural history of rhinitis and how that is influenced by atopy and sex.

Recent findings Recent work from the Isle of Wight Birth Cohort Study has demonstrated that the prevalence of atopic rhinitis increases steadily in the first 18 years of life in both sexes. However, nonatopic rhinitis behaves differently during adolescence. Its prevalence decreases in boys but continues to increase in girls resulting in a female predominance after puberty. Numerous recent studies have proposed potential roles for sex-related and adipose-related hormonal changes in influencing the course of allergic disease. Further research is needed to establish mechanisms that could underlie such findings.

Summary Rhinitis becomes increasingly common through childhood, with prevalence during adolescence being mediated by differential effects of sex and atopy. Mechanisms to explain these findings await elucidation.

aThe David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight

bInfection, Inflammation and Immunity Division, University of Southampton School of Medicine, Southampton, United Kingdom

cDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA

Correspondence to Professor S. Hasan Arshad, DM, FRCP, The David Hide Asthma & Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, PO30 5TG, UK. Tel: +44 1983 534373; fax: +44 1983 822928; e-mail:

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