Treatment of allergic rhinitis with intranasal corticosteroids in patients with mild asthma: Effect on lower airway responsiveness

Watson, Wade; Becker, Allan B.; Simons, F. Estelle R.

doi:10.1016/0091-6749(93)90301-u

Cited by 317 publications

(174 citation statements)

References 30 publications

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“…Yet, corticosteroid treatment of concomitant AR in asthmatics is associated with significant riskreduction in asthma emergency room visits and hospitalizations [61]. Watson et al [62], exploring the effect in the lower airways of treating AR with intranasal corticosteroids, showed that less than 2 % was deposited in the chest area. Since intranasal corticosteroids have not been shown to result in significant deposition to the lungs, the reduction in asthma symptoms may be related to improvements in nasal function rather than any direct effects of the medication on the lower airway [63].…”

Section: Pharmacotherapymentioning

confidence: 99%

Pediatric Allergic Rhinitis and Asthma: Can the March be Halted?

et al. 2013

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The strong epidemiologic and pathophysiologic link between allergic rhinitis (AR) and asthma has led to the concept of 'united airways disease' or 'respiratory allergy', implying that allergy, in its widest sense, underlies this clinical syndrome. Progression from AR to asthma is frequent and part of the 'atopic march'. Since pediatric immune responses are more adaptable and therefore may be more amenable to treatment, interventions at early childhood are characterized by a higher chance to affect the natural history of respiratory allergy. Although current treatments are quite effective in alleviating respiratory allergy symptoms, it has proven much more difficult to confirm any influence on the progression of the disease. Much more promising is the field of specific allergen immunotherapy, where current evidence, although not yet of ideal robustness, points towards a disease-modifying effect. In addition, newer or emerging, possibly more effective or more targeted interventions are promising in the preventive sense.

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Section: Pharmacotherapymentioning

confidence: 99%

Pediatric Allergic Rhinitis and Asthma: Can the March be Halted?

et al. 2013

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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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“…Wrong food combinations (Viruddhaahara) having antagonist properties like fish with milk, fruit juice with milk, clarified butter with honey, ice cream after night meals, etc. leads to allergy 11 .…”

Section: Issn: 2320-5407mentioning

confidence: 99%