Hellings P W, Fokkens W J
Laboratory of Experimental Immunology, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
Allergy. 2006 Jun;61(6):656-64. doi: 10.1111/j.1398-9995.2006.01109.x.
Allergic rhinitis (AR) is a disease with growing impact on everyday medical practice, as its prevalence has steadily increased during the last decades. Immunoglobulin-E (IgE)-mediated airway inflammation may manifest itself as AR, asthma or both. Allergic inflammation in upper and lower airways is now considered as one airway disease, with manifestation of symptoms in upper, lower or global airway. This insight into allergic inflammation of the whole respiratory tract has consequences for the diagnostic and therapeutic approach of affected patients, as highlighted in the ARIA document. In contrast to asthma, the link between AR and associated conditions in the upper airways like rhinosinusitis, nasal polyps, recurrent viral infections, adenoid hypertrophy, tubal dysfunction, otitis media with effusion and laryngitis remains less explored. It is however of utmost importance to consider the aetiological role of IgE-mediated inflammation of the nasal mucosa in several diseases of the upper respiratory tract, as they represent a large body of patient population seen by the general practitioner as well as the paediatrician, allergologist and otorhinolaryngologist. We here aim at reviewing the current literature on the relationship between AR and conditions in upper airways frequently encountered in everyday clinical practice, and highlight the need for further studies exploring the role of allergic inflammation in the development of these diseases.
变应性鼻炎（AR）对日常医疗实践的影响日益增大，因为在过去几十年中其患病率稳步上升。免疫球蛋白E（IgE）介导的气道炎症可表现为AR、哮喘或两者兼有。现在认为上、下气道的变应性炎症是一种气道疾病，症状可表现在上气道、下气道或整个气道。正如变应性鼻炎及其对哮喘的影响（ARIA）文件所强调的，这种对整个呼吸道变应性炎症的认识对受影响患者的诊断和治疗方法具有重要意义。与哮喘不同，AR与上气道相关疾病如鼻窦炎、鼻息肉、复发性病毒感染、腺样体肥大、咽鼓管功能障碍、分泌性中耳炎和喉炎之间的联系仍有待进一步探索。然而，考虑IgE介导的鼻黏膜炎症在上呼吸道几种疾病中的病因学作用至关重要，因为这些疾病涵盖了全科医生、儿科医生、过敏症专科医生和耳鼻咽喉科医生所诊治的大量患者群体。我们旨在综述当前关于AR与日常临床实践中常见的上气道疾病之间关系的文献，并强调需要进一步研究探索变应性炎症在这些疾病发生发展中的作用。
