Rhinosinusitis and Asthma: A Very Long Engagement

Licari, Amelia; Caimmi, Silvia; Bosa, Luca; Marseglia, Alessia; Marseglia, Gian Luigi; Caimmi, Davide

doi:10.1177/039463201402700405

Cited by 40 publications

(19 citation statements)

References 44 publications

(94 reference statements)

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“…CRS is an inflammatory condition of the nose and paranasal sinuses, defined as a combination of clinical symptoms (nasal congestion or discharge, facial pain, loss of smell) present for at least 12 weeks together with a finding of inflamed mucosa by endoscopy, or a CT scan showing mucosal changes within the osteomeatal complex and/or sinuses (table 6) [121]. CRS is frequent in patients with asthma and allergy [121][122][123][124], and the combination of CRS and bronchiectasis is nearly universal in CF [125] and PCD [21,126]. In these entities, a common mechanism, e.g.…”

Section: Upper Airway Involvement In Bronchiectasismentioning

confidence: 99%

The overlap between bronchiectasis and chronic airway diseases: state of the art and future directions

et al. 2018

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Bronchiectasis is a clinical and radiological diagnosis associated with cough, sputum production and recurrent respiratory infections. The clinical presentation inevitably overlaps with other respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD). In addition, 4-72% of patients with severe COPD are found to have radiological bronchiectasis on computed tomography, with similar frequencies (20-30%) now being reported in cohorts with severe or uncontrolled asthma. Co-diagnosis of bronchiectasis with another airway disease is associated with increased lung inflammation, frequent exacerbations, worse lung function and higher mortality. In addition, many patients with all three disorders have chronic rhinosinusitis and upper airway disease, resulting in a complex "mixed airway" phenotype.The management of asthma, bronchiectasis, COPD and upper airway diseases has traditionally been outlined in separate guidelines for each individual disorder. Recognition that the majority of patients have one or more overlapping pathologies requires that we re-evaluate how we treat airway disease. The concept of treatable traits promotes a holistic, pathophysiology-based approach to treatment rather than a syndromic approach and may be more appropriate for patients with overlapping features.Here, we review the current clinical definition, diagnosis, management and future directions for the overlap between bronchiectasis and other airway diseases.

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Section: Upper Airway Involvement In Bronchiectasismentioning

confidence: 99%

The overlap between bronchiectasis and chronic airway diseases: state of the art and future directions

et al. 2018

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“…Moreover, the association between the severity of the upper airway diseases and the impact on asthma in the non-adjusted analysis seems to confirm the United Airways Diseases hypothesis [1,26]. After adjusting for potential confounders, the results show the presence of two different subsets of subjects within the AR group.…”

Section: Discussionmentioning

confidence: 56%

The Heterogeneity Hidden in Allergic Rhinitis and Its Impact on Co-Existing Asthma in Adults: A Population-Based Survey

Antonicelli

Marchetti

Accordini

et al. 2015

Int Arch Allergy Immunol

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Background: It has been suggested that there is some overlap between allergic rhinitis (AR), sinusitis and polyposis, but this has not been fully documented. The present study aimed to evaluate the prevalence of these co-existing diseases and their impact on bronchial asthma in the general population of Italy. Methods: Within the frame of the multicentre Gene Environment Interactions in Respiratory Diseases (GEIRD) study, a postal screening questionnaire including questions about self-reported symptoms of asthma, AR, AR with sinusitis without nasal polyps (AR + SsNP) and AR with sinusitis with nasal polyps (AR + SwNP) was administered. Random samples of subjects aged between 20 and 44 years (n = 5,162) answered the postal questionnaire in 4 Italian centres (Pavia, Sassari, Turin, Verona). In AR subjects, the association among AR only, AR + SsNP, AR + SwNP and bronchial asthma was estimated by the relative risk ratio (RRR) using multinomial regression models. Results: The prevalence of AR in the sample was 25.4% (95% CI 24.2-26.6). A self-reported diagnosis of AR + SsNP and AR + SwNP was reported by 5.7% (95% CI 5.0-6.3) and by 1.2% (95% CI 0.9-1.5) of the subjects, respectively. Current asthma was reported by 17.5% of the AR subjects. In the adjusted multivariate analysis, the risk of having current asthma (RRR = 2.31, 95% CI 1.29-4.15), of having at least 1 asthma attack per year (RRR = 2.30, 95% CI 1.19-4.46) and of having had an emergency department admission for respiratory diseases (RRR = 5.61, 95% CI 1.81-23.92) was higher for subjects with AR + SwNP than subjects with AR only. Conclusions: The diagnosis of AR in the epidemiological setting includes heterogeneous upper airway diseases that affect the clinical features of AR and its interactions with asthma.

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“…These symptoms are often endoscopically and radiologically confirmed (sinuses CT scan) [132]. Rhinosinusitis is frequently associated with asthma and allergy [133] because they have common etiopathogenetic features [4,132,[134][135][136]. The frequents of rhinosinusitis in bronchiectasis range from 34 to 75% [132,[137][138][139] even in absence of ciliary dyskinesia [140]; besides, rhinosinusitis is considered an important risk factor for exacerbations of lower respiratory infections [141][142][143], even if the mechanism is still unknown, as well as a worsening factor of quality of life [144].…”

Section: Chronic Rhinosinusitismentioning

confidence: 99%

The Link between Asthma and Bronchiectasis: State of the Art

et al. 2020

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The nonrecognition of asthma-associated comorbidities is often responsible for the therapeutic failure and the worsening of symptoms, and it is associated with frequent exacerbations, higher disease severity, and increased health costs. Bronchiectasis, one of the most frequent asthma-associated comorbidities, can increase airways inflammation and exacerbation rates and cause respiratory functional impairment. The aim of this article is to review the interactions between bronchiectasis and asthma, in order to better identify patients in the overlap between the 2 diseases and to select an "ad hoc" therapy. A literature search on PubMed/MEDLINE was performed using the following search terms: bronchiectasis in asthma, the association between asthma and bronchiectasis, comorbidities in asthma, and severe asthma. This review analyzed the following items: incorrect or underestimated diagnosis of asthma and bronchiectasis, prevalence of bronchiectasis in asthma, the impact of bronchiectasis in asthma, radiological imaging features of the 2 diseases, etiopathogenesis, and common causes (such as gastroesopha-geal reflux disease, immune deficits, chronic rhinosinusitis and allergic bronchopulmonary aspergillosis, and treatment of asthma and bronchiectasis). The concomitant presence of bronchiectasis and asthma should be suspected and investigated in patients with severe asthma, frequent exacerbations, and not responding to standard therapy. This clinical phenotype, characterized by a more severe disease, worse outcomes, and functional decline, must be readily recognized in order to choose the most appropriate therapeutic approach, able to potentially improve the management of bronchial asthma, to prevent the onset of exacerbations as well the functional decline, and to reduce health costs.

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Rhinosinusitis and Asthma: A Very Long Engagement

Cited by 40 publications

References 44 publications

The overlap between bronchiectasis and chronic airway diseases: state of the art and future directions

The overlap between bronchiectasis and chronic airway diseases: state of the art and future directions

The Heterogeneity Hidden in Allergic Rhinitis and Its Impact on Co-Existing Asthma in Adults: A Population-Based Survey

The Link between Asthma and Bronchiectasis: State of the Art

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