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BioMed Research International
Volume 2013 (2013), Article ID 539290, 7 pages
Clinical Study

Is Health-Related Quality of Life Associated with Upper and Lower Airway Inflammation in Asthmatics?

1Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Sezione di Pneumologia, University of Palermo, 90146 Palermo, Italy
2Allergy & Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, 16132 Genova, Italy
3Dipartimento di Medicina e Chirurgia, University of Salerno, 84081 Salerno, Italy

Received 30 April 2013; Accepted 29 July 2013

Academic Editor: Surinder K. Jindal

Copyright © 2013 Nicola Scichilone et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Allergic diseases impair health-related quality of life (HR-QoL). However, the relationship between airway inflammation and HR-QoL in patients with asthma and rhinitis has not been fully investigated. We explored whether the inflammation of upper and lower airways is associated with HR-QoL. Methods. Twenty-two mild allergic asthmatics with concomitant rhinitis (10 males, 38 ± 17 years) were recruited. The Rhinasthma was used to identify HR-QoL, and the Asthma Control Test (ACT) was used to assess asthma control. Subjects underwent lung function and exhaled nitric oxide (eNO) test, collection of exhaled breath condensate (EBC), and nasal wash. Results. The Rhinasthma Global Summary score (GS) was 25 ± 11. No relationships were found between GS and markers of nasal allergic inflammation (% eosinophils: , ; ECP: , ) or bronchial inflammation (pH of the EBC: , ; bronchial NO: , ; alveolar NO: , ). The mean ACT score was 18. When subjects were divided into controlled (ACT ≥ 20) and uncontrolled (ACT < 20), the alveolar NO significantly correlated with GS in uncontrolled asthmatics ( , ). Conclusions. Upper and lower airways inflammation appears unrelated to HR-QoL associated with respiratory symptoms. These preliminary findings suggest that, in uncontrolled asthma, peripheral airway inflammation could be responsible for impaired HR-QoL.