چکیده (انگلیسی):

This review discussed the contribution of eosinophilic upper airway inflammation includes allergic
rhinitis (AR) and chronic rhinosinusitis (CRS) to the pathophysiology and course of asthma, the representative
counterpart in the lower airway. The presence of concomitant AR can affect the severity of
asthma in patients who have both diseases; however, it is still debatable whether the presence of asthma
affects the severity of AR. Hypersensitivity, obstruction and/or inflammation in the lower airway can be
detected in patients with AR without awareness or diagnosis of asthma, and AR is known as a risk factor
for the new onset of wheeze and asthma both in children and adults. Allergen immunotherapy, pharmacotherapy
and surgery for AR can contribute to asthma control; however, a clear preventive effect on
the new onset of asthma has been demonstrated only for immunotherapy. Pathological similarities such
as epithelial shedding are also seen between asthma and CRS, especially eosinophilic CRS. Abnormal
sinus findings on computed tomography are seen in the majority of asthmatic patients, and asthmatic
patients with CRS show a significant impairment in Quality of Life (QOL) and pulmonary function as
compared to those without CRS. Conversely, lower airway inflammation and dysfunction are seen in nonasthmatic
patients with CRS. Treatments for CRS that include pharmacotherapy such as antileukotrienes,
surgery, and aspirin desensitization show a beneficial effect on concomitant asthma.
Acting as a gatekeeper of the united airways, the control of inflammation in the nose is crucial for
improvement of the QOL of patients with co-existing AR/CRS and asthma.