Upper and lower airways have to be looked at as a functional unit, as well as in allergic and intrinsic asthma. Intrinsic asthma is characterized by chronic eosinophilic inflammation of the bronchial mucosa of unknown origin. Often it is associated with non allergic rhinitis with eosinophilia syndrome (NARES), nasal polyposis and intolerance to Aspirin and NSAID's. NARE-syndrome may precede asthmatic symptoms for years. Treatment with nasal steroids and Aspirin desensitisation improve nasal and sinus symptoms and may have a positive effect on the underlying asthma.