The Nasal Passage of Subjects with Asthma Has a Decreased Ability to Warm and Humidify Inspired Air

Abstract

We previously showed that individuals with seasonal allergic rhinitis (SAR) had a reduced ability to condition air, which was improved by inflammation. We hypothesized that individuals with perennial allergic rhinitis (PAR) would condition air like SAR with inflammation. Because individuals with asthma usually have inflammation in the nose, we hypothesized that they would condition air like individuals with PAR. We performed a prospective, parallel study on 15 normal subjects, 15 subjects with SAR outside their allergy season, 15 subjects with PAR, and 15 subjects with asthma. Cold, dry air (CDA) was delivered to the nose and the temperature and humidity of the air were measured before entering and after exiting the nasal cavity. The total water gradient (TWG) was calculated and represents the nasal conditioning capacity. The TWG in the SAR group was significantly lower than that in normal subjects. There were no significant differences in TWG between the PAR and normal groups. Subjects with asthma had a significantly lower TWG than did normal subjects. There was a significant negative correlation between TWG and Aas score in the group with asthma (r(s) = -0.8, p = 0.0007). Our data show that subjects with asthma have a reduced ability of the nose to condition CDA compared with normal subjects, but which is similar to SAR out of season.

Evidence‐based recommendations regarding the differential diagnosis and assessment of nasal congestion: using the new GRADE system

“…Although used in research setting (43), no validation of these ratings in nasal pathology could be found in literature. Results have suggested that every nose is Ôindividually calibratedÕ, because of the interpatient variation, which makes interpatient comparisons less reliable but still significant (44,45).…”

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…Patients with chronic nasal disease suffer from decreased mucociliary clearance (2010) but no study exists showing its effect on the lower airways. The nasal passages of asthmatics have a decreased ability to warm and humidify inspired air (2011).…”

Allergic rhinitis and allergic asthma: a uniform airway disease?

“…This is possible because of the highly vascularized mucosa, with a large amount of secretory glands. The importance of the conditioning capacity of the nose in patients with asthma and seasonal allergic rhinitis has been studied by Assanasen et al (18). They found that noses of subjects with asthma were less able to condition inhaled cold dry air compared with controls.…”