J Rhinol.  2007 May;14(1):5-8.

Coexisting Upper Airway Inflammation in Chronic Obstructive Pulmonary Disease: A Review of the Literature

  • 1Department of Otorhinolaryngology, Kyungpook Ntional University College of Medicine, Daegu, Korea. sookim@knu.ac.kr


This review explores the literature dealing with the relation between the chronic obstructive pulmonary disease (COPD) and upper airway inflammation. Dysfunction of the upper and lower airways frequently coexists, and they appear to share key elements of pathogenesis. A link between upper and lower airway is evident from epidemiologic, pathophysiologic, and clinical studies. Data from epidemiologic studies indicate that nasal symptoms are experienced by as many as 75% of patients with COPD and that lower airway symptom is experienced by as many as 36% of patients with sinusitis. The mechanism of upper and lower airway dysfunction is under investigation. They include naso-bronchial reflex, increased inflammation caused by smoking, mouth breathing caused by nasal obstruction, and pulmonary aspiration of nasal contents. Patients with chronic sinusitis commonly have nonspecific bronchial hyperresponsiveness, suggesting a neural reflex. Postnasal drainage of nasal inflammatory mediators during sleep also may increase lower airway responsiveness. Therapy of nasal and sinus disease is associated with improved pulmonary function in patients with COPD.


COPD; Sinusitis; Tobacco smoke; Rhinitis; Bronchial hyperresponsiveness
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