Bergeron C, Hamid Q. Relationship between asthma and rhinitis: epidemiologic, pathophysiologic, and therapeutic aspects. Allergy Asthma Clin Immunol. 2005; 1:(2)81-87

Boulet LP. Asymptomatic airway hyperresponsiveness: a curiosity or an opportunity to prevent asthma?. Am J Respir Crit Care Med. 2003; 167:(3)371-378

Bourdin A, Gras D, Vachier I, Chanez P. Upper airway x 1: allergic rhinitis and asthma: united disease through epithelial cells. Thorax. 2009; 64:(11)999-1004

Bousquet J, Jacot W, Vignola AM, Bachert C, Van Cauwenberge P. Allergic rhinitis: a disease remodeling the upper airways?. J Allergy Clin Immunol. 2004; 113:(1)43-49

Bousquet J, Khaltaev N, Cruz AA Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008; 63:8-160

Carr W, Bernstein J, Lieberman P A novel intranasal therapy of azelastine with fluticasone for the treatment of allergic rhinitis. J Allergy Clin Immunol. 2012; 129:(5)1282-1289.e10

Cavaliere C, Begvarfaj E, Incorvaia C Long-term omalizumab efficacy in allergic rhinitis. Immunol Lett. 2020; 227:81-87

Derendorf H, Meltzer EO. Molecular and clinical pharmacology of intranasal corticosteroids: clinical and therapeutic implications. Allergy. 2008; 63:(10)1292-1300

Gandhi B, Chen C, Ali R. Barts Health Adult Allergic Rhinitis Guidelines.London: Barts Health NHS Trust; 2019

Horak F. Effectiveness of twice daily azelastine nasal spray in patients with seasonal allergic rhinitis. Ther Clin Risk Manag. 2008; 4:(5)1009-1022

Izuhara Y, Matsumoto H, Nagasaki T Mouth breathing, another risk factor for asthma: the Nagahama Study. Allergy. 2016; 71:(7)1031-1036

Jeffery PK, Haahtela T. Allergic rhinitis and asthma: inflammation in a one-airway condition. BMC Pulm Med. 2006; 6 Suppl 1

Lee TA, Pickard AS. Meta-analysis of azelastine nasal spray for the treatment of allergic rhinitis. Pharmacotherapy. 2007; 27:(6)852-859

Liu H, Farley JM. Effects of first and second generation antihistamines on muscarinic induced mucus gland cell ion transport. BMC Pharmacol. 2005; 5

Martin BG, Andrews CP, van Bavel JH Comparison of fluticasone propionate aqueous nasal spray and oral montelukast for the treatment of seasonal allergic rhinitis symptoms. Ann Allergy Asthma Immunol. 2006; 96:(6)851-857

Min YG. The pathophysiology, diagnosis and treatment of allergic rhinitis. Allergy Asthma Immunol Res. 2010; 2:(2)65-76

National Institute for Health and Care Excellence. Omalizumab for treating severe persistent allergic asthma [TA278]. 2013. (accessed 8 March 2022)

Riccioni G, Della Vecchia R, Castronuovo M Bronchial hyperresponsiveness in adults with seasonal and perennial rhinitis: is there a link for asthma and rhinitis?. Int J Immunopathol Pharmacol. 2002; 15:(1)69-74

Royal Pharmaceutical Society. Medicines Optimisation: Helping patients to make the most of medicines. 2013. (accessed 8 March 2022)

Scadding GK, Kariyawasam HH, Scadding G BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2017; 47:(7)856-889

Shamsi Z, Hindmarch I. Sedation and antihistamines: a review of inter-drug differences using proportional impairment ratios. Hum Psychopharmacol. 2000; 15:(S1)S3-S30<::AID-HUP247>3.0.CO;2-S

Tesch F, Sydendal Grand T, Wuestenberg E, Elliott L, Schmitt J, Kuster D. Healthcare costs associated with allergic rhinitis, asthma allergy immunotherapy. Eur Ann Allergy Clin Immunol. 2020; 52:(4)164-174

Thomas M. Allergic rhinitis: evidence for impact on asthma. BMC Pulm Med. 2006; 1

Togias A, Windom H. The impact of nasal function and dysfunction on the lower airways. In: Corren J, Togias A, Bousquet J, Lenfant C (eds). NY: Marcel Dekker; 2004

Tsabouri S, Tseretopoulou X, Priftis K, Ntzani EE. Omalizumab for the treatment of inadequately controlled allergic rhinitis: a systematic review and meta-analysis of randomized clinical trials. J Allergy Clin Immunol Pract. 2014; 2:(3)332-40.e1

Walker SM, Durham SR, Till SJ Immunotherapy for allergic rhinitis. Clin Exp Allergy. 2011; 41:(9)1177-1200

Wilson AM, O'Byrne PM, Parameswaran K. Leukotriene receptor antagonists for allergic rhinitis: a systematic review and meta-analysis. Am J Med. 2004; 116:(5)338-344

Allergic rhinitis and its impact on airways disease

02 April 2022
Volume 33 · Issue 4


Allergic rhinitis is linked to an increased risk of asthma development. Laia Castro Salvador et al discuss the impact of allergic rhinitis and how it can be managed

Allergic rhinitis is characterised by symptoms including rhinorrhoea, sneezing, nasal obstruction and itching, which have a great impact on the patient's quality of life. Allergic rhinitis can be classified depending on the frequency and severity of symptoms, and can be sub-divided into seasonal and perennial. Allergic rhinitis is linked to an increased risk of asthma development and both diseases are believed to be different expressions of the same inflammatory process. The aim of the treatment is improving the patient's quality of life by relieving symptoms. Management of allergic rhinitis will encompass a combination of allergen avoidance, pharmacological therapies and patient education and adherence.

Allergic rhinitis is described as an immunoglobulin E (IgE)-mediated inflammatory disorder of the nasal mucosa triggered by exposure to an allergen (Bousquet et al, 2008). It is characterised by symptoms including rhinorrhoea, sneezing, nasal obstruction and itching, which have a great impact on the patient's quality of life (Scadding et al, 2017). It is a global health problem that causes major disease and disability affecting work or school performance, social life and sleep (Bousquet et al, 2008).

Rhinitis affects 26% of adults and 10–15% of children in the UK, reaching its peak prevalence in adults aged between 30–40 years old and showing remission throughout adult life. In the UK and Western Europe, there has been a remarkable increase in the prevalence over the last four to five decades. Globally, there seems to be an association between economic and industrial development and the occurrence of allergic rhinitis (Scadding et al, 2017).

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