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Tissue remodelling reported in upper airways include epithelial hyperplasia, increased matrix deposition in the nasal or paranasal lining, matrix degradation and accumulation of plasma proteins. Genetic influences, foetal exposures and early life events may contribute to structural changes such as subepithelial fibrosis from an early age. Other structural alterations are related to duration of the disease and long-term uncontrolled inflammation. Structural changes may increase alteration of the protective functions of the upper airways namely by affecting mucociliary clearance and conditioning of inspired air. The sequences of tissue changes during wound repair of upper airway mucosa after surgery are illustrative of the complexicity of tissue modelling and remodelling and could be considered as an important source of information for a better understanding of the complex relationship between inflammatory reaction, of the subsequent tissue damages and fibroblast metabolism of upper airways. [ABSTRACT FROM AUTHOR]

Epidemiological studies in many countries strongly suggest an increase in the prevalence of seasonal allergic rhinitis, particularly in urban communities. The mechanisms of allergic rhinitis have been the subject of much research, elucidating symptomatology and improving the focus of therapeutic strategies. Ideally, avoidance of the offending allergen may be undertaken but is often incompatible with normal activity. Thus, active therapy is usually required, selected from a range of pharmacologic agents. Choice is determined by the severity of the symptoms, the age and individual circumstances of the patients, and may vary considerably from country to country. The menu will primarily include rapid onset, oral non-sedating H1 antihistamines, topical nasal steroids and topical sodium cromoglycate to the nose, eyes or both. These medications may be given alone or in combination, usually under the direction of the primary care physician, and should be commenced in advance of exposure to the seasonal allergen. If this proves ineffective, specialist referral should be made for further management.