234 / 236
Comorbidities of asthma and the unified airway
remodeling. Remodeling involves tissue injury and subse-
quent repair. The pathophysiologic events included in this
phenomenon are mucosa edema, vasodilation, cellular infil-
tration, epithelial injury, smooth muscle and mucous gland
hypertrophy, angiogenesis, collagen deposition, basement
membrane thickening, and subepithelial fibrosis in the lam-
ina reticularis
50,60–62
(Table 1). Similar findings are seen
in chronic rhinosinusitis although the reticular basement
membrane thickening is not as pronounced in the nasal
epithelium as it is in the bronchial epithelium.
It is important to note than even when symptoms appear
to be under control, the inflammatory process in asthma
can be ongoing and progressive.
72
Conclusion
It is essential that otolaryngologists, head and neck sur-
geons, and allergists become familiar with the unified
airway concept when managing our patients with AR.
Asthma and AR are closely related epidemiologically and
biologically.
1–12
Early and aggressive therapy to treat AR
may prevent the progression of the disease to asthma.
Healthcare providers who are aware of the close relation-
ship of AR to asthma may be able to identify the early signs
of asthma, enabling prompt treatment and preventing dis-
ease progression. Furthermore, appropriate management of
AR has been shown to improve asthma control.
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