Revisiting the link between allergic rhinitis and asthma

Abstract

Introduction Allergic rhinitis (AR) and asthma are the most common atopic diseases with an increasing prevalence during the last decade. Whereas AR is an immunoglobulin (Ig) E-mediated inflammation of the nasal mucosa, IgE-mediated inflammation of the airways can either manifest as AR, asthma, or both. In fact, the vast majority of patients with asthma have rhinitis, and rhinitis is a major independent risk factor for asthma in cross-sectional and longitudinal studies. Although the temporal relation of AR and asthma may be variable, AR often precedes asthma. This relationship between rhinitis and asthma has been further confirmed by functional and immunological evidence, challenge studies of the nose and the bronchi, and indirectly by observing the therapeutic effects of drugs used mainly for rhinitis on the symptoms of asthma. Moreover, this link also involves other aspects, such as viral infections and bronchial hyperreactivity, chronic hyperplastic eosinophilic sinusitis, nasal polyposis, and serous otitis media.