Influence of treatment on the nose and/or the lungs

The association of rhinitis and asthma in the same patient is frequent and requires an appropriate treatment strategy. Several studies have investigated the effect of antirhinitis treatment on concurrent asthma symptoms and pathophysiology. Most of these studies have been performed in patients with seasonal allergic rhinitis and asthma. Treatment with intranasal corticosteroids during the pollen season decreases asthma symptoms and prevents the increase in non-allergic bronchial hyperresponsiveness in patients with a combination of rhinitis and asthma symptoms. This treatment also inhibits the increase in bronchial hyperresponsiveness in patients with rhinitis symptoms alone. The observation that treatment with intranasal corticosteroids reduces non-allergic bronchial hyperresponsiveness in patients with rhinitis is remarkable and will stimulate thought about the mode of action of these drugs. Intranasal sodium cromoglycate has also been studied and, although effective, has been shown to be less effective than intranasal corticosteroids in controlling the accompanying asthma symptoms in patients with seasonal allergic rhinitis and asthma. Treatment with antihistamines also reduced the symptoms of rhinitis and asthma during the pollen season. However, the optimal therapy for patients with a history of seasonal allergic rhinitis and asthma remains to be established. Few data are available on the effect of treatment for perennial allergic rhinitis on perennial asthma. The rather frequent combination of rhinitis and asthma therefore warrants further study.