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The impact of rhinosinusitis on asthma

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Abstract

The nasal cavity, paranasal sinuses, and lungs are considered separate organs of the respiratory tract. However, a growing body of evidence links the upper and lower airways. For example, the coexistence and impact of allergic and nonallergic rhinitis on asthma is now documented. In addition, inflammation of the nose (rhinitis) commonly is associated with inflammation of sinuses (sinusitis), as reflected in the term rhinosinusitis. In this paper, we review the impact of rhinosinusitis on asthma as it relates to the links between allergic and nonallergic rhinitis and asthma; viral upper respiratory tract infections and asthma; allergic and nonallergic infectious/inflammatory rhinosinusitis and allergic and nonallergic hyperplastic rhinosinusitis and asthma; and the aspirin-exacerbated respiratory disease syndrome and asthma.

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References and Recommended Reading

  1. Togias A: Rhinitis and asthma: evidence for respiratory system integration. J Allergy Clin Immunol 2003, 111:171–183. Excellent review on the association between allergic rhinitis and asthma.

    Article  Google Scholar 

  2. Simon FER: What’s in a name? The allergic rhinitis and asthma connection. Clin Exp All Rev 2003, 3:9–17.

    Article  Google Scholar 

  3. Borish L: Sinusitis and asthma: entering the realm of evidence-based medicine. J Allergy Clin Immunol 2002, 109:606–608. An excellent editorial that reviews the literature on the association of chronic hyperplastic sinusitis and asthma.

    Article  Google Scholar 

  4. Report of the rhinosinusitis task force committee. Otolaryngol Head Neck Surg 1997, 117:1–68.

  5. Dykewicz MS: Rhinitis and sinusitis. J Allergy Clin Immunol 2003, 111:520–529.

    Article  CAS  Google Scholar 

  6. Katelaris CH: Allergic rhinitis and asthma: epidemiologic evidence for the link. Clin Exp All Rev 2003, 3:5–8.

    Article  Google Scholar 

  7. Togias A: Functional relationships between allergic rhinitis and asthma. Clin Exp All Rev 2003, 3:18–22.

    Article  Google Scholar 

  8. Vinuya RZ: Upper airway disorders and asthma: a syndrome of airway inflammation. Ann Allergy Asthma Immunol 2002, 88:8–15.

    PubMed  Google Scholar 

  9. Szczeklik A, Stevenson DD: Aspirin-induced asthma: advances in pathogenesis, diagnosis, and management. J Allergy Clin Immunol 2003, 111:913–921. This comprehensive paper on the aspirin-exacerbated respiratory disorder reviews the science that defines the syndrome. The section on the genetic polymorphism of aspirin sensitivity is well written. Aspirin desensitization is explained in understandable detail.

    Article  PubMed  CAS  Google Scholar 

  10. Lemanske R, Dick EC, Swenson CA, et al.: Rhinovirus upper respiratory infection increases airway hyperreactivity and late asthmatic reactions. J Clin Invest 1989, 82:1–10.

    Article  Google Scholar 

  11. Slavin RG: Complications of allergic rhinitis: implications for sinusitis and asthma. J Allergy Clin Immunol 1998, 101:357–360.

    Article  Google Scholar 

  12. Denburg JA: The bone marrow and airway inflammation: evidence for allergy as a systemic disease. Clin Exp All Rev 2003, 3:23–27.

    Article  Google Scholar 

  13. Bresciani M, Paradis I, Des Roches A, et al.: Rhinosinusitis in severe asthma. J Allergy Clin Immunol 2001, 107:73–80.

    Article  PubMed  CAS  Google Scholar 

  14. Nakamura H, Kawasaki M, Higuchi Y, et al.: Effects of sinus surgery on asthma in aspirin triad patients. Acta Otolaryngol 1999, 119:592–598.

    Article  PubMed  CAS  Google Scholar 

  15. Senior BA, Kennedy DW: Management of sinusitis in the asthmatic patient. Ann Allergy Asthma Immunol 1996, 77:6–16.

    PubMed  CAS  Google Scholar 

  16. Passalacqua G, Canonica GW: The asthma-rhinitis association: between the clinical hypothesis and the scientific theory. Curr Allergy Asthma Rep 2003, 3:191–193.

    PubMed  Google Scholar 

  17. Bousquet J, Van Cauwenberge P, Khaltaev N: ARIA: allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001, 108:S147–333. This compendium of evidence-based knowledge pertaining to the relationship of allergic rhinitis and asthma is extensive and worth reading.

    Article  PubMed  CAS  Google Scholar 

  18. Greisner W, Settipane R, Settipane G, et al.: Co-existence of asthma and allergic rhinitis: a 23-year follow-up study of college students. Allergy Asthma Proc 1998, 19:185–188.

    Article  PubMed  Google Scholar 

  19. Horowitz E, Diemer FB, Poyser J, et al.: Asthma and rhinosinusitis prevalence in a Baltimore city public housing complex [abstract]. J Allergy Clin Immunol 2001, 107:280.

    Google Scholar 

  20. Guerra S, Sherrill D, Martinez F, et al.: Rhinitis is an independent risk factor for adult-onset asthma. J Allergy Clin Immunol 2002, 109:419–425.

    Article  PubMed  Google Scholar 

  21. Leynaert B, Bousquet J, Neukirch C, et al.: Perennial rhinitis: an independent risk factor for asthma in nonatopic subjects: results from the European Community Respiratory Health Survey. J Allergy Clin Immunol 1999, 104:301–304.

    Article  PubMed  CAS  Google Scholar 

  22. Townley R, Ryo U, Kolotin B, et al.: Bronchial sensitivity to methacholine in current and former asthmatics and allergic rhinitis patients and control subjects. J Allergy Clin Immunol 1975, 56:429–437.

    Article  PubMed  CAS  Google Scholar 

  23. Boulet LP, Morin D, Milot, et al.: Bronchial responsiveness increases after seasonal antigen exposure in non-asthmatic subjects’ pollen-induced rhinitis. Ann Allergy 1989, 63:114–119.

    PubMed  CAS  Google Scholar 

  24. Peat J, Tovey E, Toelle BG, et al.: House dust mite allergens: a major risk factor for childhood asthma in Australia. Am J Respir Crit Care Med 1996, 153:141–146.

    PubMed  CAS  Google Scholar 

  25. Pederson PA, Weeke ER: Asthma and allergic rhinitis in the same patients. Allergy 1983, 38:25–29.

    Article  Google Scholar 

  26. Settipane RJ, Hagy GW, Settipane GA, et al.: Long-term risk factors for developing asthma and allergic rhinitis: a 23-year follow-up study of college students. Allergy Proc 2000, 21:371–375.

    Article  Google Scholar 

  27. Rachelefsky G: National guidelines needed to manage rhinitis and prevent complications. Ann Allergy Asthma Immunol 1999, 82:296–305.

    Article  PubMed  CAS  Google Scholar 

  28. Braunstahl GJ, Overbeck S, Kleinjan A, et al.: Nasal allergen provocation induces adhesion molecule expression and tissue eosinophilia in upper and lower airways. J Allergy Clin Immunol 2001, 107:469–476.

    Article  PubMed  CAS  Google Scholar 

  29. Beeh KM, Beier J, Korrmann O, et al.: A single nasal allergen challenge increases induced sputum inflammatory markers in non-asthmatic subjects with seasonal allergic rhinitis: correlation with plasma interleukin-5. Clin Exp Allergy 2003, 33:475–482.

    Article  PubMed  CAS  Google Scholar 

  30. Braunstahl GJ, Kleinjan A, Overbeck S, et al.: Segmental bronchial provocation induces nasal inflammation in allergic rhinitis patients. Am J Respir Crit Care Med 2000, 161:2051–2057.

    PubMed  CAS  Google Scholar 

  31. Watson WT, Becker AB, Simons FE: Treatment of allergic rhinitis with intranasal corticosteroids in patients with mild asthma: effect on lower airway responsiveness. J Allergy Clin Immunol 1993, 91:97–101.

    Article  PubMed  CAS  Google Scholar 

  32. Wood RA, Eggleston PA: The effects of intranasal steroids on nasal and pulmonary responses to cat exposure. Am J Respir Crit Care Med 1995, 151:315–320.

    PubMed  CAS  Google Scholar 

  33. Adams RJ, Fuhlbrigge AL, Finkelstein JA, et al.: Intranasal steroids and the risk of emergency department visits for asthma. J Allergy Clin Immunol 2001, 109:36–42.

    Google Scholar 

  34. Greiff L, Andersson M, Svenson C, et al.: Effects of orally inhaled budesonide in seasonal allergic rhinitis. Eur Respir J 1998, 11:1268–1274.

    Article  PubMed  CAS  Google Scholar 

  35. Nayak AS: A common pathway: asthma and allergic rhinitis. Allergy and Asthma Proc 2003, 23:359–365.

    Google Scholar 

  36. Rak S, Heinrich C, Jacobsen L, et al.: A double-blinded comparative study of the effects of short preseason-specific immunotherapy and topical steroids in patients with allergic rhinoconjunctivitis and asthma. J Allergy Clin Immunol 2001, 108:921–928.

    Article  PubMed  CAS  Google Scholar 

  37. MacGlashan D: Anti-IgE antibody therapy. Clin Allergy Immunol 2002, 16:519–532.

    PubMed  CAS  Google Scholar 

  38. Moller C, Dreborg S, Fendousi HA, et al.: Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT study). J Allergy Clin Immunol 2002, 109:251–256.

    Article  PubMed  Google Scholar 

  39. Platts-Mills TAE, Vaughan JW, Carter MC, et al.: The role of intervention in established allergy: avoidance of indoor allergens in the treatment of chronic allergic disease. J Allergy Clin Immunol 2000, 106:787–804.

    Article  PubMed  CAS  Google Scholar 

  40. Fireman P: Virus-induced rhinitis and asthma in allergic patients. Clin Exp All Rev 2003, 3:33–39.

    Article  Google Scholar 

  41. Bhattacharyya N: Chronic rhinosinusitis: Is the nose really involved? Am J Rhinol 2001, 15:169–173.

    Article  PubMed  CAS  Google Scholar 

  42. Spector SL: The role of allergy in sinusitis in adults. J Allergy Clin Immunol 1992, 90:518–520.

    Article  PubMed  CAS  Google Scholar 

  43. Naclerio RM, ML, Baroody FM: Ragweed allergic rhinitis and the paranasal sinuses: a computed tomographic study. Arch Otolaryngol Head Neck Surg 1997, 123:193–196.

    PubMed  CAS  Google Scholar 

  44. Berrettini S: Perennial allergic rhinitis and chronic sinusitis: correlation with rhinologic risk factors. Allergy 1999, 54:242–249.

    Article  PubMed  CAS  Google Scholar 

  45. Emanual IA, Shah SB: Chronic sinusitis: allergy and sinus computed tomography relationships. Otolaryngol Head Neck Surg 2000, 123:687–693.

    Article  Google Scholar 

  46. Slavin RG: Asthma and sinusitis. J Allergy Clin Immunol 1992, 90:534–537.

    Article  PubMed  CAS  Google Scholar 

  47. ten Brinke A, Grootedorst DC, Schmidt JT, et al.: Chronic sinusitis in severe asthma is related to sputum eosinophilia. J Allergy Clin Immunol 2002, 109:621–626.

    Article  Google Scholar 

  48. Hamilos DL, Leung DYM, Wood R, et al.: Chronic hyperplastic sinusitis: association of tissue eosinophilia with mRNA expression of granulocyte-macrophage-stimulating factor and interleukin-3. J Allergy Clin Immunol 1993, 92:39–48.

    Article  PubMed  CAS  Google Scholar 

  49. Hamilos DL, Leung DYM, Wood R, et al.: Evidence for distinct cytokine expression in allergic versus nonallergic chronic sinusitis. J Allergy Clin Immunol 1995, 96:537–544.

    Article  PubMed  CAS  Google Scholar 

  50. Hamilos DL: Chronic sinusitis. J Allergy Clin Immunol 2000, 106:231–227.

    Article  Google Scholar 

  51. Ferguson BJ, Johnson JT: Allergic rhinitis and rhinosinusitis: Is there a connection between allergy and infections? Postgrad Med 1999, 105:55–64.

    Article  PubMed  CAS  Google Scholar 

  52. Steinke JW, Bradley D, Arango P, et al.: Cysteinyl leukotriene expression in chronic hyperplastic sinusitis-nasal polyposis: importance to eosinophilia and asthma. J Allergy Clin Immunol 2003, 111:342–349.

    Article  PubMed  CAS  Google Scholar 

  53. Hamilos DL, Leung DY, Wood R, et al.: Eosinophilic infiltration in nonallergic chronic hyperplastic sinusitis with nasal polyps is associated with endothelial VCAM-1 upregulatation and expression of TNF-alpha. Am J Respir Cell Mol Biol 1996, 15:443–450.

    PubMed  CAS  Google Scholar 

  54. Bachert C, Wagenmann M, Hauser U, et al.: IL-5 synthesis is upregulated in human nasal polyp tissue. J Allergy Clin Immunol 1997, 99:837–842.

    Article  PubMed  CAS  Google Scholar 

  55. Minshall EM, Cameron L, Lavigne F, et al.: Eotaxin mRNA and protein expression in chronic sinusitis and allergen-induced nasal responses in seasonal allergic rhinitis. Am J Resp Cell Mol Biol 1997, 17:683–690.

    CAS  Google Scholar 

  56. Gylifors P, Bochenek G, Overholt J, et al.: Biochemical and clinical evidence that aspirin-intolerant asthmatic subjects tolerate the cyclooxygenase 2-selective analgesic drug celecoxib. J Allergy Clin Immunol 2003, 111:1116–1121.

    Article  CAS  Google Scholar 

  57. Szezklik A: The cyclooxygenase theory of aspirin-induced asthma. Eur Respir J 1990, 3:588–593.

    Google Scholar 

  58. Daffern PJ, Muilenburg D, Hugli TE, Stevenson DD: Association of urinary leukotriene E4 excretion during aspirin challenges with severity of respiratory responses. J Allergy Clin Immunol 1999, 104:559–564.

    Article  PubMed  CAS  Google Scholar 

  59. Sanak M, Simon HW, Szezeklik A: Leukotriene C4 synthease promoter polymorphism and risk of aspirin-induced asthma. Lancet 1997, 350:1599–1600.

    Article  PubMed  CAS  Google Scholar 

  60. Samson AP, Siddiqui S, Buchanann D, et al.: Variant LTC4 synthase allele modifies cysteinyl leukotriene synthesis in eosinophils and predicts clinical response to zafurlukast. Thorax 2000, 55:528–531.

    Google Scholar 

  61. Sanak M, Pierzchalska M, Bazan-Socha S, et al.: Enhanced expression of the leukotriene C4 synthase due to overactive transcription of an allelic variant associated with aspirinintolerant asthma. Am J Respir Cell Mol Biol 2000, 23:290–296.

    PubMed  CAS  Google Scholar 

  62. Sousa AR, Parkih A, Scadding G, et al.: Leukotriene-receptor expression on nasal mucosal inflammatory cells in aspirinsensitive rhinosinusitis. N Engl J Med 2002, 347:1493–1499.

    Article  PubMed  CAS  Google Scholar 

  63. Chavis C, Vachier J, Godard P, et al.: Lipoxins and other arachidonic-derived mediators in bronchial asthma. Thorax 2000, 55:38–41.

    Article  Google Scholar 

  64. Arm JP, Austen KF: Leukotriene receptors and aspirin sensitivity. N Engl J Med 2002, 347:1524–1526.

    Article  PubMed  Google Scholar 

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Fox, R.W., Lockey, R.F. The impact of rhinosinusitis on asthma. Curr Allergy Asthma Rep 3, 513–518 (2003). https://doi.org/10.1007/s11882-003-0063-0

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