title: Improvement and prevention of asthma with concomitant treatment of allergic rhinitis and allergen-specific therapy.
abstract: BACKGROUND
  Asthma and allergic rhinitis are 2 of the most prevalent chronic medical diseases. Asthma is estimated to affect 8% of adults and 9% of children, with nearly 300 million people affected worldwide. Poorly controlled allergic rhinitis may be associated with worsening asthma symptoms over time. Various treatments have been proposed in the improvement and prevention of asthma in children and adults with allergic symptoms, which have included pharmacotherapy with antihistamines and topical intranasal corticosteroids, as well as allergen-specific immunotherapy.
  
  
  METHODS
  Articles were selected through PubMed and personal knowledge of the authors based on a comprehensive literature review examining whether treatment of allergic rhinitis improves and/or prevents concomitant symptoms of asthma. The largest and highest-quality studies were included in the literature review. The search selection was not standardized. Articles written in a language other than English were excluded.
  
  
  RESULTS
  Clinical trials have showed improvement in asthma symptoms with concomitant treatment of allergic rhinitis with antihistamines and topical intranasal corticosteroids, though improvement in objective pulmonary function parameters has not been uniformly demonstrated with antihistamine use alone. There is very strong evidence to suggest that subcutaneous and sublingual immunotherapy may in addition prevent the progression of asthma in high-risk atopic patients by inducing immunological tolerance.
  
  
  CONCLUSIONS
  Traditional pharmacotherapy with antihistamines and topical intranasal steroids has been shown to improve allergic rhinitis symptoms with concomitant allergic asthma; however, only allergen-specific immunotherapy offers long-term control in improving asthma symptoms, exacerbations, and likely ultimate prevention in developing asthma.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: David J
authors.initials: DJ
authors.lastname: Mener
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Sandra Y
authors.initials: SY
authors.lastname: Lin
mesh_terms: D000281:Administration, Intranasal; D000818:Animals; D001249:Asthma / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D003888:Desensitization, Immunologic; D005938:Glucocorticoids / Q000627:therapeutic use; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D011058:Pollen / Q000276:immunology; D039981:Pyroglyphidae / Q000276:immunology; D065631:Rhinitis, Allergic / Q000188:drug therapy / Q000628:therapy*
chemical_list: D005938:Glucocorticoids; D006633:Histamine Antagonists
keywords: allergen-specific immunotherapy; allergic rhinitis; antihistamines; asthma; intranasal corticosteroids; subcutaneous immunotherapy; sublingual immunotherapy