EFFECT OF NASAL INFLAMMATION AND OF INTRANASAL ANTIINFLAMMATORY TREATMENT ON BRONCHIAL-ASTHMA

It is logical to look upon the nose and the bronchi as integrated part s of one 'united airway' and we would like to advance the hypothesis t hat optimal management of airway disease, caused by inhaled allergens, may necessitate control of inflammation in all parts of the airways. Nasal inflammation can aggravate asthma symptoms, and there is a ratio nale for giving intranasal anti-inflammatory treatment to patients wit h asthma. (i) Inhaled allergens are predominantly deposited in the nos e, whether a patient suffers from rhinitis, asthma or both. (ii) Antig en presentation consequently takes place in the nose, and the response of the airway immune system is thus initiated in the nasal mucous mem brane. (iii) Antigen presentation in the nose may possibly induce cell recruitment and activation not only in the nasal mucosa but also in t he lower airways. (iv) Suppression of nasal inflammation may therefore be necessary for optimal management of asthma.