Nasal Pathophysiology Impacts Bronchial Reactivity in Asthmatic Patients with Allergic Rhinitis

Abstract

Galen was the first to notice a relationship between nasal pathology and asthma (1). Numerous studies have been done throughout the years which point to this rela tionship, but it is not routine for physicians to treat nasal inflammation with maintenance medications in patients with asthma. A recent article (2) in the New England Journal of Medicine reviewing the pathophysiology of asthma failed to mention the contributory role of inflammation in the nose and sinuses to hyperreactivity of the bronchi. Another review (3) of the relationship between asthma and sinusitis in the pediatric literature failed to mention the possibility that allergic rhinitis also might contribute to lung hyperreactivity. This review is undertaken to alert primary care physicians to the significance with which both allergic and perennial rhinitis and sinusitis contribute to the success or failure of a management program for certain patients with asthma.