Is there an association between bronchial asthma, food allergy/intolerance and analgesic intolerance?

We have read with great interest the article about food intolerance and respiratory symptoms in young adults by WOODS et al. [1]. We have conducted a survey, which has not yet been published, with the aim of comparing the clinical features of patients with bronchial asthma and those with analgesic intolerance accompanying asthma. We also asked the patients whether they ever had any reactions to food, what type of reaction occurred and what food was responsible. Group I included 132 patients with bronchial asthma and analgesic intolerance and group II included 103 patients with only bronchial asthma. The mean ages were 40.7613.0 yrs and 43.2614.0 yrs for groups I and II, respectively. There was a female predominance in both of the groups (70.5% in group I and 86.4% in group II). Food allergy/intolerance was significantly more common in group I (22.7 and 7.8% in groups I and II, respectively, p<0.05). The food reported to have caused the reaction and the type of reactions are shown in table 1. The food allergy/intolerance perception rate given in the survey by WOODS et al. [1] is between our figures. The food allergy/intolerance prevalence seems lower in Turkey than in other countries [2±4]. For example, in a survey including 4,331 Turkish university students with a mean age of 18.562.1 yrs, the current prevalence for food allergy/intolerance was reported as 4.5% [5]. The food types reported to have caused reactions are shown in table 2. Tomatoes and fruit most commonly caused symptoms in our survey of analgesic intolerance and fruit in the survey of university students, fruit being in accordance with the study by WOODS et al. [1]. Seafood allergy/ intolerance was very rare in both of our surveys compared with the survey by WOODS et al. [1]. The most common symptom appearing after ingestion of the responsible food was urticaria, followed by respiratory symptoms, in our survey of analgesic intolerance, whereas the most common symptoms were gastrointestinal in origin in the study by WOODS et al. [1]. These differences might be due to feeding habits and variations in the perception of various symptoms. In the survey of university students, the prevalence of current wheezing was 4.8% and current wheezing and food allergy/intolerance were strongly associated with each other (odds ratio=5.21; 95% confidence interval: 3.52± 7.72). Although WOODS et al. [1] mentioned that the patients with current asthma did not report more perceived food allergy/intolerance, we think that asthma could be a risk factor for perceived food allergy. This discrepancy between the find-ings of our survey and the survey by WOODS et al. [1] could be the result of differences in the age distribution and the selection of the two study populations. As a result, in our opinion asthma and analgesic intoler-ance may be two risk factors for food allergy/ intolerance; therefore, in future surveys on asthma and food allergy analgesic intolerance should also be taken into consideration.