Allergic respiratory disease as nosologic unit

Abstract

There is a growing epidemiological evidence of relation between upper and lower airways in rhinitis and asthma, suggesting that both entities occur as co-morbid conditions in most patients. Rhinitis is present in the majority of patients with asthma and some patients with rhinitis have concomitant asthma. Furthermore, rhinitis often precedes the onset of clinical asthma and its presence increases the risk for developing asthma by up to 3-fold. There are also anatomical, physiological and immunopathological reasons to consider both entities as distinct manifestations of the same airway disease rather than two different diseases. From the therapeutical point of view, additional support for the rhinitis-asthma link is provided by the fact that treatment of either condition may result in improvement of the other. Although several mechanisms have been proposed to explain the relation between the allergic inflammation of upper and lower airways, the precise pathophysiological mechanisms underlying the link rhinitis-asthma are not completely understood.