Can reversibility of nasal obstruction predict the grade of bronchial hyperreactivity?

Aim of the study was to reveal the connection between significance of nasal obstruction and bronchial hyperreactivity.

Allergic rhinitis is the most common IgE-mediated disease with progressively increasing prevalence in population. Chronic inflammation and remodelation of mucosa of the upper airways can be a part of generalized affection of respiratory system including lower airways. Severe inflammatory damage of nasal mucosa is connected with irreversibility of nasal obstruction, which is possible to verify by nasal decongestion test.

Bronchoprovocation test and rhinomanometry examination with decongestion test were performed in 57 patients. We analysed the grade of bronchial hyperreactivity and response of nasal mucosa to decongestion agent. Number of positive and negative decongestion tests were compared in a group of patients with mild bronchial hyperreactivity with the group of moderate and severe hyperreactivity.

Comparing the results of decongestion tests there has been a significant difference found between the group with mild hyperreactivity and the group with moderate and severe hyperreactivity.

The study points out to narrow relationship between bronchial asthma and allergic rhinitis, where patients with negative decongestion test showed significantly increased grade of bronchial hyperreactivity. Due to this patients with insufficient response of nasal mucosa to decongestive agent probably require more intensive antiinflammatory therapy compared to patients with positive response. Nasal decongestion tests can be used for examination of the effect of allergic inflammation of nasal mucosa on the lower airways and vice versa (Tab. 4, Ref. 27).