Nasal beclomethasone prevents the seasonal increase in bronchial responsiveness in patients with allergic rhinitis and asthma

Corren, Jonathan; Adinoff, Allen; Buchmeier, Andrea; Irvin, Charles G.

doi:10.1016/0091-6749(92)90079-h

Cited by 262 publications

(143 citation statements)

References 26 publications

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“…Epidemiologic (1), pathophysiologic (2,3), and clinical studies (4,5) strongly suggest a link between rhinitis and asthma. Asthma and rhinitis, which are considered to be manifestations of the atopic syndrome, often coexist and share a common genetic background.…”

mentioning

confidence: 99%

Segmental Bronchial Provocation Induces Nasal Inflammation in Allergic Rhinitis Patients

Braunstahl

KleinJan

Overbeek

et al. 2000

Am J Respir Crit Care Med

355

211

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Allergic rhinitis and asthma often coexist and share a genetic background. Pathophysiologic connections between the nose and lungs are still not entirely understood. This study was undertaken to compare allergic inflammation and clinical findings in the upper and lower airways after segmental bronchial provocation (SBP) in nonasthmatic allergic rhinitis patients. Eight nonasthmatic, grass pollen-sensitive patients with allergic rhinitis and eight healthy controls were included. Bronchial biopsies and blood samples were taken before (T 0 ) and 24 h (T 24 ) after SBP. Nasal biopsies were obtained at T 0 , 1 h after SBP (T 1 ), and T 24 . Immunohistochemical staining was performed for eosinophils (BMK13), interleukin (IL)-5, and eotaxin. The number of eosinophils increased in the challenged and unchallenged bronchial mucosa (p Ͻ 0.05) and in the blood (p ϭ 0.03) of atopic subjects at T 24 . We detected an increase of BMK13-positive and eotaxin-positive cells in the nasal lamina propria and enhanced expression of IL-5 in the nasal epithelium of atopic subjects only at T 24 (p Ͻ 0.05). SBP induced nasal and bronchial symptoms as well as reductions in pulmonary and nasal function in the allergic group. No significant changes could be observed in healthy controls. The study shows that SBP in nonasthmatic allergic rhinitis patients results in peripheral blood eosinophilia, and that SBP can induce allergic inflammation in the nose.Epidemiologic (1), pathophysiologic (2, 3), and clinical studies (4, 5) strongly suggest a link between rhinitis and asthma. Asthma and rhinitis, which are considered to be manifestations of the atopic syndrome, often coexist and share a common genetic background. Although several studies have shown that asthma and rhinitis are characterized by a similar inflammatory process (6-9), pathophysiologic interactions between upper and lower airways are not entirely understood. It is clear that the condition of the upper airways definitely influences the lower airways. In allergic rhinitis patients without bronchial hyperreactivity (BHR), signs of allergic inflammation of the lower airways have been found in induced sputum, bronchoalveolar lavage fluid (BALF), and bronchial biopsy specimens (10-13). The nasal-bronchial reflex, an altered breathing pattern, pulmonary aspiration of nasal contents, and increased levels of inflammatory factors in the blood are possible mechanisms for lower airway dysfunction among patients with rhinitis (14). To shed more light on the role of systemic induction in the allergic inflammatory response, we designed a study in which blood samples and nasal and bronchial mucosal biopsy specimens were taken from a group of nonasthmatic allergic rhinitis patients with an isolated grass pollen allergy after segmental bronchial provocation (SBP) at a time other than the grass pollen season. The aim of the study was to compare allergic mucosal inflammation and clinical findings in the upper and lower airways. Eosinophils, major effector cells in allergic inflammation, interleukin (I...

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mentioning

confidence: 99%

Segmental Bronchial Provocation Induces Nasal Inflammation in Allergic Rhinitis Patients

Braunstahl

KleinJan

Overbeek

et al. 2000

Am J Respir Crit Care Med

355

211

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“…Além dela, fatores genéticos e a hiper-responsividade das vias aéreas são outros determinantes dessa associação. Por exemplo, adultos com história familiar de asma e rinite apresentam um risco três a quatro vezes maior de desenvolver asma, e duas a seis vezes maior de desenvolver rinite do que adultos sem esses antecedentes [9][10][11] . Igualmente, a idade de início da atopia parece ser um fator determinante de rinite ou asma, já que sua aquisição antes de seis anos de idade foi considerada um fator preditivo positivo importante para persistência de asma, enquanto a atopia adquirida mais tardiamente esteve associada à rinite alérgi-ca sazonal 12 .…”

Section: Evidências Epidemiológicasunclassified

“…Vários estudos demonstraram que, em pacientes asmáticos, os corticóides intranasais reduzem a hiper-responsividade brônquica pré-existente, provocada em ambiente laboratorial pela inalação de metacolina ou carbacol 10,11,22,23 . Além disso, em estudo retrospectivo, Adams et al documentaram ser o tratamento com corticosteróide intranasal um fator de proteção para asma de maior gravidade 24 .…”

Section: Evidências Clínicasunclassified

Asma e rinite alérgica como expressão de uma única doença: um paradigma em construção

Camargos¹,

Rodrigues²,

Solé³

et al. 2002

J. Pediatr. (Rio J.)

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Objective: to describe current ideas about the relation between upper and lower respiratory tract and to review the epidemiological, immunological, and pathological aspects that support the paradigm of united airways disease.Sources: literature review using the Medline, MD Consult, HighWire, Medscape and Lilacs databases. We used allergic rhinitis and asthma as keywords, and searched articles published in the past 20 years.Summary of the findings: epidemiological evidence includes prevalence of allergic rhinitis in asthmatic patients and vice-versa, results of cross-sectional studies, bronchial hyperresponsiveness in patients with allergic rhinitis, importance of genetic and environmental factors, and the age of onset of atopic disease. Morphological and physiological aspects show structural differences between the nasal and bronchial mucosa, and the mechanisms that could explain the effect of rhinitis on asthma. Immunological aspects including the participation of bone marrow in the production of inflammatory cells and allergic reactions after allergen challenge are the same in allergic rhinitis and asthma. Finally, the results of the therapy for allergic rhinitis in bronchial hyperresponsiveness and in clinical and functional control of asthma are also reported.Conclusions: epidemiological evidence and immunological and pathological aspects suggest that there is a relation between allergic rhinitis and asthma. The paradigm of united airways disease suggests the implementation of an integrated therapeutic approach.

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“…Nasal therapy has a beneficial effect on bronchial hyperresponsiveness and airway inflammation. (Corren et al, 1992). In a recent study, the combination of intranasal and intrabronchial administration of corticosteroid preparation has been resulted in the highest reduction of blood eosinophil count and serum ECP, and better quality of life as well.…”

Section: Therapeutic Implicationsmentioning

confidence: 99%

The Impact of Allergic Rhinitis on Asthma: Current View

Sin¹

2012

Allergic Rhinitis

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Nasal beclomethasone prevents the seasonal increase in bronchial responsiveness in patients with allergic rhinitis and asthma

Cited by 262 publications

References 26 publications

Segmental Bronchial Provocation Induces Nasal Inflammation in Allergic Rhinitis Patients

Segmental Bronchial Provocation Induces Nasal Inflammation in Allergic Rhinitis Patients

Asma e rinite alérgica como expressão de uma única doença: um paradigma em construção

The Impact of Allergic Rhinitis on Asthma: Current View

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