The Relationship Between Rhinitis And Asthma

Rhinitis and asthma are very common diseases that frequently coexist. According to the consensus document Allergic Rhinitis and its Impact on Asthma (ARIA ) published in 2001, both pathologies are correlated with high morbidity (level of involvement of the patient) and notable socioeconomic costs.

In particular, it is estimated that there are around 150 million people with asthma around the world. Rhinitis is not an understatement, since it is estimated that it affects up to 20% of the population in countries like the United States.

Due to the epidemiological and clinical importance of both conditions, understanding the relationship between rhinitis and asthma is essential. What should you know about it? Coming up next, we tell you.

The economic impact of rhinitis and asthma

Before delving fully into the correlation between both pathologies, we find it particularly interesting to shed some data that frame these diseases of the respiratory tract from a socioeconomic point of view. Some surprising data, collected by official sources, are the following:

• In Europe, each asthma patient costs an average of $1,900 a year in treatment and absences from work.
• In the United States, it is estimated that allergic rhinitis causes a total of 811,000 lost working days.
• This same country reports that the annual costs to combat asthma are more than 430 million dollars. It is not for less, since 8% of Americans (26 million people) present this pathology at any given time.

Not everything is reduced to economic values, since the World Health Organization (WHO) reports that this type of respiratory tract diseases claim more than 400,000 lives each year.

Most of these deaths occur in low-income countries, due to the lack of means for diagnosis and treatment. Next, we show you the relationship between rhinitis and asthma.

The relationship between rhinitis and asthma

We are not moving on speculative terrain when affirming that rhinitis and asthma are related, as various studies confirm this. Epidemiological explorations report the following results:

• Most asthma patients have rhinitis. Specifically, 75% of those with allergic asthma and more than 80% of those with non-allergic asthma.
• Patients with rhinitis may or may not have asthma. In cases of seasonal rhinitis (inflammation of the mucous lining of the nose due to allergies) asthma is present in 10 to 15% of cases. These values ​​increase in cases of persistent severe rhinitis, as asthma appears with it up to 40% of the time.

We go further, since other bibliographic sources state that repeated allergic rhinitis is an important factor for the development of asthma. In children , this disease has been associated with twice the probability of suffering asthmatic processes at the age of 11 years.

Pathophysiological mechanisms

The numbers and percentages are very useful to check the correlations between both pathologies, but it is just as essential to try to understand why. It is not difficult to imagine the physiological synergy, because after all, both processes respond to inflammations of varying severity (rhinitis of the nasal tissue and asthma of the walls of the airways).

In addition, according to clinical studies, the immune response produced by the mucosa of the upper and lower airways is the same. These tissues react to the appearance of allergens through a hypersensitivity reaction mediated by immunoglobulins E (IgE), which produces the aforementioned inflammation.

We have to take into account that the nasal passages, nasopharynx, trachea and lungs are anatomically contiguous, which perhaps determines their frequent simultaneous involvement. Studies cited above explore these relationships:

• After provocations carried out with allergens in patients with allergic rhinitis, it was observed that there was an increase in bronchial hyperresponsiveness and changes in lung function.

• Other sources indicate that 100% of patients with severe asthma and 88% of those with the moderate variant had sinonasal abnormalities (polyps or paranasal tumors, for example).

Possible explanation for this correlation

We have seen the statistical and physiological correlations between both diseases, but what could be the mechanism that links both diseases?

One of the possible explanations is the theory of the “systemic dissemination of mediators’ , a mechanism by which white blood cells that fight the allergen is spread through the body by the blood vessels.

This would explain why, for example, an inflammatory response in the nose (rhinitis) will eventually cause another in the respiratory tissues (asthma).

What is there to remember about the relationship between rhinitis and asthma?

There is a close relationship between rhinitis and asthma. Although the mechanisms by which an inflammatory response in nasal tissue can also be expressed in lung tissue are not yet known exactly, the numbers speak for themselves.

Due to the similarities between the two diseases, treatments are based in both cases on the application of corticosteroids, drugs that reduce inflammation in the body. With proper intervention, both people with rhinitis and asthma can lead a healthy life free of serious problems.