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Difficult asthma: possible association with rhinosinusitis

D G Peroni1, G L Piacentini, R Ceravolo

  • 1Department of Paediatrics, University of Verona, Italy. peroni.diego@tiscalinet.it

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|December 6, 2007
PubMed

Insights

In children with difficult-to-control asthma, rhinosinusitis may be a contributing factor. Treating chronic sinus disease in asthmatic children can improve asthma symptoms and lung function.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Otolaryngology

Background:

  • Difficult-to-control asthma in children necessitates reassessment of diagnosis and risk factors.
  • Epidemiologic data suggest a link between rhinosinusitis and bronchial asthma, though the exact relationship remains debated.
  • Nasal sinus disease may impede asthma control, particularly in severe cases, with CT scans showing more sinus abnormalities.

Purpose of the Study:

  • To explore the association between rhinosinusitis and childhood asthma.
  • To investigate the potential impact of nasal sinus disease on asthma control and exacerbations.
  • To evaluate the therapeutic implications of addressing sinusitis in asthmatic children.

Main Methods:

  • Review of epidemiologic data and clinical observations regarding the co-occurrence of asthma and rhinosinusitis.
  • Analysis of pathogenetic mechanisms, including shared inflammatory mediators and cellular infiltrates (e.g., eosinophils).
  • Evaluation of the effects of antibiotic treatment for chronic sinus disease on asthmatic children's symptoms and lung function.

Main Results:

  • Shared inflammatory pathways and cellular infiltrates (eosinophils) are implicated in both asthma and sinusitis.
  • Antibiotic treatment for chronic sinus disease in asthmatic children has shown improvements in subjective asthma symptoms, lung function, and bronchial hyperreactivity.
  • Patients with severe asthma exhibit more significant paranasal sinus abnormalities on CT scans.

Conclusions:

  • A significant association exists between asthma and sinusitis in children, relevant for diagnosis and treatment.
  • Addressing chronic rhinosinusitis may be a crucial component in managing difficult-to-control childhood asthma.
  • Further research into the pathogenetic links and therapeutic interventions for comorbid asthma and sinusitis is warranted.

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