Rhinitis and asthma: Evidence for respiratory system integration

Togias, Alkis

doi:10.1067/mai.2003.1592

Cited by 396 publications

(306 citation statements)

References 121 publications

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“…57,58 A considerable body of evidence suggests that rhinitis and asthma represent the manifestations of one airway disease of common pathogenic pathway with a wide spectrum of severity. 59 Increased FeNO in patients with AR probably reflects the extension of inflammation throughout the airways, a feature in the well-known concept of the 'united airway. ' It was reported that diffusing capacity of NO in the bronchial wall of patients with AR at the symptomatic stage was higher than that of healthy controls.…”

Section: Allergic Rhinitismentioning

confidence: 99%

Exhaled NO: Determinants and Clinical Application in Children With Allergic Airway Disease

Kim

Eckel

Kim

et al. 2016

Allergy Asthma Immunol Res

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Section: Allergic Rhinitismentioning

confidence: 99%

Exhaled NO: Determinants and Clinical Application in Children With Allergic Airway Disease

Kim

Eckel

Kim

et al. 2016

Allergy Asthma Immunol Res

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“…4 Several mechanisms have been postulated for this close association between upper and lower airway morbidity, including (1) aspiration of inflamed or infected secretions to the lower airway, (2) nasal blockage that leads to mouth breathing cold, dry air increasing allergen entry into the lower airway, (3) systemic absorption of inflammatory mediators in the nasal mucosa, or (4) a nasobronchial reflex. [5][6][7][8] AR practice guidelines highlight the need for allergy evaluation when rhinitis symptoms are persistent, moderate or severe, or impact quality of life. 1,9 Guidelines also recommend the integration of AR treatment in the management of asthma 1,4,[9][10][11] and highlight intranasal steroids as the optimal medication class for controlling AR symptoms.…”

Section: Introductionmentioning

confidence: 99%

Underdiagnosed and Undertreated Allergic Rhinitis in Urban School-Aged Children with Asthma

Esteban

Klein

Kopel

et al. 2014

Pediatric Allergy, Immunology, and Pulmonology

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Allergic rhinitis (AR) is a risk factor for the development of asthma, and if poorly controlled, it may exacerbate asthma. We sought to describe AR symptoms and treatment in a larger study about asthma, sleep, and school performance. We examined the proportion (1) who met criteria for AR in an urban sample of school children with persistent asthma symptoms, (2) whose caregivers stated that they were not told of their child's allergies, (3) who had AR but were not treated or were undertreated for the disease, as well as (4) caregivers and healthcare providers' perceptions of the child's allergy status compared with study assessment, and (5) associations between self-report of asthma and AR control over a 4-week monitoring period. One hundred sixty-six children with persistent asthma participated in a clinical evaluation of asthma and rhinitis, including allergy testing. Self-report of asthma control and rhinitis control using the Childhood Asthma Control Test (C-ACT) and Rhinitis Control Assessment Test (RCAT) were measured 1 month after the study clinic session. Persistent rhinitis symptoms were reported by 72% of participants; 54% of rhinitis symptoms were moderate in severity, though only 33% of the sample received adequate treatment. AR was newly diagnosed for 53% during the clinic evaluation. Only 15% reported using intranasal steroids. Participants with poorly controlled AR had poorer asthma control compared with those with well-controlled AR. This sample of urban school-aged children with persistent asthma had underdiagnosed and undertreated AR. Healthcare providers and caregivers in urban settings need additional education about the role of allergies in asthma, recognition of AR symptoms, and AR's essential function in the comanagement of asthma. Barriers to linkages with allergy specialists need to be identified.

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“…allergic rhinitis (AR) and asthma, and terms proposed to represent this unity are: ''one airway, one disease'' [2], ''allergic rhinobronchitis'' [3], and ''united airways disease'' [4]. Taking into consideration differences between upper and lower airway physiology and pathology, another holistic approach comes under the term ''chronic allergic respiratory syndrome'' [5] or ''respiratory allergy'' [6], which implies that allergy in its broadest sense is the major underlying pathophysiology. Progression from AR to asthma can occur and is described as the ''allergic'' or ''atopic march''.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Allergic Rhinitis and Asthma: Can the March be Halted?

et al. 2013

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The strong epidemiologic and pathophysiologic link between allergic rhinitis (AR) and asthma has led to the concept of 'united airways disease' or 'respiratory allergy', implying that allergy, in its widest sense, underlies this clinical syndrome. Progression from AR to asthma is frequent and part of the 'atopic march'. Since pediatric immune responses are more adaptable and therefore may be more amenable to treatment, interventions at early childhood are characterized by a higher chance to affect the natural history of respiratory allergy. Although current treatments are quite effective in alleviating respiratory allergy symptoms, it has proven much more difficult to confirm any influence on the progression of the disease. Much more promising is the field of specific allergen immunotherapy, where current evidence, although not yet of ideal robustness, points towards a disease-modifying effect. In addition, newer or emerging, possibly more effective or more targeted interventions are promising in the preventive sense.

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Rhinitis and asthma: Evidence for respiratory system integration

Cited by 396 publications

References 121 publications

Exhaled NO: Determinants and Clinical Application in Children With Allergic Airway Disease

Exhaled NO: Determinants and Clinical Application in Children With Allergic Airway Disease

Underdiagnosed and Undertreated Allergic Rhinitis in Urban School-Aged Children with Asthma

Pediatric Allergic Rhinitis and Asthma: Can the March be Halted?

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