In the last 30 years, the prevalence of both allergic rhinitis and bronchial asthma has increased, especially in developed countries. It is generally accepted that the chance of developing bronchial asthma in patients with allergic rhinitis is 4 times that of the normal population. In a prospective study that lasted for 23 years, it was determined that young people with allergic rhinitis during their high school years faced 3 times more asthma problems than those without rhinitis. Despite all these epidemiological studies, it is not easy to say that the problem starts from the nose in patients with respiratory system allergy or that allergic rhinitis plays a direct role in bronchial asthma. Although most of the patients have a family history, definitive genetic evidence is not yet available. Immunoglobulin-E' characteristic for allergic problems of the nose and lower respiratory tract. It has been shown that the release of mediators from mast cells due to slag, the source of the resulting mast cells is the release of histamine, arachidonic acid metabolites, quinine and tryptase. Although the general clinical opinion is that bronchial asthma symptoms regress with rhinitis treatment, this effect has only been investigated in controlled clinical studies in recent years.
In epidemiological studies, it is stated that allergic rhinitis and bronchial asthma can often be seen together. Some patients with allergic rhinitis have been shown to have non-specific bronchial hyperreactivity without bronchial asthma. The use of intranasal corticosteroids, antihistamines with or without decongestants in patients with allergic rhinitis with bronchial asthma also causes regression in bronchial asthma complaints. Although the physiopathological relationship between the nose and lower respiratory tract cannot be fully explained, various mechanisms that cause lower respiratory tract dysfunction and reveal the bronchial asthma clinic in patients with rhinitis have been described. Laboratory and clinical studies show that the treatment of rhinitis (allergic or non-allergic) also provides improvement in the clinic of bronchial asthma.
The general clinical experience is that rhinosinusitis also provokes bronchial asthma, and bronchial asthma complaints also regress with rhinosinusitis treatment. Studies examining the relationship between rhinosinusitis and bronchial asthma are hampered by exacerbations and spontaneous remissions of both diseases. Studies may not have optimal results due to the continuous developments in the medical treatment of bronchial asthma and rhinosinusitis and the difficulties in determining the severity of the diseases objectively. It is stated that lower respiratory tract complaints also regressed following the treatment of chronic rhinosinusitis, which causes bronchial hyperreactivity and exacerbates bronchial asthma symptoms, with sphenoethmoidectomy or endoscopic sinus surgery. 70% of patients with chronic rhinosinusitis and Stammberger intrinsic asthma
Source: allergic rhinitis.com