What Is The Link Between Rhinitis And Asthma?
Is there a link between rhinitis and asthma? It appears to be the case. Many people suffer from the same conditions almost in unison and are even given medications that can relieve similar symptoms.
The relationship between rhinitis and asthma has been known empirically in medical science for a long time. It is not uncommon for an asthmatic patient to present in the spring with signs of an allergy in the upper airways. The reverse is also true.
Now, where is this intrinsic connection? For some researchers, this is a common origin that is found in the immune system; for others, it is the similar form of respiratory mucosa that is shared between the bronchi and the nose. Let’s take a closer look.
What is rhinitis?
Rhinitis is an inflammation of the lining of the nose. It can respond to a variety of causative agents, but the end result is always an increase in the size of the mucosa due to an accumulation of fluids and inflammatory cells based on an external agent or internal stimulus.
There are infectious and non-infectious rhinitis. In the first case, a microorganism invades the nose and infects it, whether it is a virus or a bacteria. The body reacts to colonization and sets in motion mechanisms to expel the intrusive agent. This determines the inflammation.
In the case of non-infectious rhinitis, the most common form is the allergic form, which is the most common form in asthma patients. Without being a virus or a bacterium, the external agent is a particle recognized as foreign and which is attacked. In plant epidemics, pollen is usually one of the causes.
What is asthma?
Bronchial asthma is an inflammation of the mucous membrane of the bronchi with hyperreactivity of the bronchi. This means that, beyond the inflammatory process, the airways suddenly close and prevent the normal flow of air.
It is listed under the category of obstructive and chronic respiratory diseases. Its course evolves in the form of acute episodes over a long period of time. Some seizure triggers, such as cold weather or infections, are more common in winter, so this time of year is the one that most affects these people.
The diagnosis of pathology is usually made at an early age. These are children who start to suffer from bronchospasm when they are physically active or when the temperature drops. They are first treated with bronchodilators to assess their progress; if the attacks are repeated, asthma is diagnosed.
The gravity is not always the same, and the evolution is not linear. Some people suffer from mild forms of the disease, which may only have one attack per year, while others go through a state of almost persistent shortness of breath.
Why is there a link between rhinitis and asthma?
The reasons why asthma patients often suffer from rhinitis are varied. It is estimated that up to 75% of asthmatics have inflammation of the nasal lining. Conversely, people diagnosed with rhinitis have bronchospasm in 40% of cases. Let’s take a look at some theories on this link.
Unconditioned air
One of the reasons people with rhinitis also have asthma is the lack of sufficient flow through the nose. Since there is inflammation of the mucous membranes, these patients prefer to breathe through the mouth, which prevents humidification and warming of the air.
So when cold, dry air hits the bronchi, the airways tend to contract as this flow is identified as harmful. Several scientific studies have shown that bronchoconstriction increases when it is cold, for example, between snow sports and winter.
Communication between mucous membranes
Research carried out in both directions shows the relationship between all parts of the respiratory mucosa. If a person is stimulated by allergens in the nose, it is very likely that the cells in the bronchi will react in one way or another. Conversely, when the lower airways constrict, the nasal lining is changed.
Part of the pathophysiological mechanism is found in nerve communication and in the reactivity of blood vessels. This is what seems to be at the origin of asthma induced by physical exercise, regulated by the release of adrenaline and norepinephrine triggered by sports stimuli.
These neurotransmitters link rhinitis and asthma by producing a caliber of blood vessel closure. Throughout the respiratory mucosa, this narrowing reduces circulation and the ability to respond to external agents.
The immune system and the relationship between rhinitis and asthma
Eosinophils are a special type of white blood cell. They have a special role in mediating allergic reactions of the whole body. On the one hand, researchers know their role in rhinitis, on the other hand, their role in asthma is also known.
Since this is a similar mechanism, it is logical to assume that allergic reactions share the common pathway of these cells, and their increase in combat situations with external agents is essential.
In addition, inflammatory substances are not static, but use the bloodstream to move, so that they can pass from the nose to the bronchi.
Rhinitis and asthma: similar but different
The relationship between rhinitis and asthma can be explained by various hypotheses, but this does not mean that they are the same condition. Some of the drugs used are similar, although the approach does not have the same protocols for both.
It is essential that treating physicians distinguish one condition from another in order for the therapy to be correct. However, patients with asthma must learn to manage attacks of rhinitis, as they have a high likelihood of suffering from this disorder.
