The Roadmap From Allergic Rhinitis to Asthma

Upper and lower airways display some common characteristic described as a holistic model. Because rhinitis may proceed asthma, it is imperative to understand the mechanisms and risk factors responsible for the progression from rhinitis to asthma. Subclinical lower airway abnormalities have been observed in patients with rhinitis without asthma. Recent evidence indicates that these patients may have an increased risk of developing asthma. Environmental and genetic factors can contribute to enhance this possibility. The treatments of rhinitis have also been shown to be beneficial to the lower airway, and therefore potentially modify the natural evolution of the atopic march. Lower airway disease is a good predictor for the roadmap from rhinitis to asthma. The shared genetic link and environmental factors could be essential for this progression. Albeit treatment of rhinitis has a beneficial effect on lower airway defects, their role to prevent the progression to asthma remains yet to be confirmed.