Hens G, Hellings P W
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Catholic University of Leuven, Belgium.
Rhinology. 2006 Sep;44(3):179-87.
The nose is strategically placed at the entrance of the airway. Nose breathing takes place under physiologic circumstances and protects the lower airways from exposure to unconditioned air and exogenous particles. Alternatively, nasal disease may have a negative impact on lower airway biology, being involved in aggravation of bronchial disease. The interaction between upper and lower airway disease has been recognized for centuries. Due to the increase in prevalence of allergic diseases during the last decades, new interest has been gained in understanding the mechanisms underlying the interaction between rhinitis and asthma. Nowadays, allergic rhinitis and asthma are considered part of a global airway disease, with both diagnostic and therapeutic consequences for every day clinical practice. Besides allergy, other inflammatory conditions of the upper airways are associated with lower airway disease via unknown mechanisms. Viral rhinitis often coincides with exacerbations of bronchial disease, chronic sinus disease with or without nasal polyps frequently relates to bronchial dysfunction and occupational rhinitis and asthma are often present in the same individuals. In spite of the clinical relevance of considering the airway as one organ with major involvement of disease in upper, lower or both parts, many clues to understand the pathology still remain to be explored. This manuscript aims at providing a comprehensive overview of the current knowledge on the interaction between nasal disease and lower airway biology and stresses the importance of further research on this important matter.
鼻子位于气道入口的关键位置。在生理情况下进行鼻呼吸，可保护下呼吸道免受未经调节的空气和外来颗粒的侵害。反之，鼻腔疾病可能会对下呼吸道生物学产生负面影响，进而加重支气管疾病。上、下呼吸道疾病之间的相互作用已被认识了几个世纪。由于过去几十年过敏性疾病患病率的上升，人们对了解鼻炎和哮喘之间相互作用的潜在机制产生了新的兴趣。如今，过敏性鼻炎和哮喘被视为全球气道疾病的一部分，对日常临床实践的诊断和治疗都有影响。除了过敏之外，上呼吸道的其他炎症性疾病也通过未知机制与下呼吸道疾病相关。病毒性鼻炎常与支气管疾病的加重同时出现，伴有或不伴有鼻息肉的慢性鼻窦疾病常与支气管功能障碍有关，职业性鼻炎和哮喘也常出现在同一患者身上。尽管将气道视为一个整体，疾病主要累及上呼吸道、下呼吸道或两者的观点具有临床相关性，但仍有许多理解其病理的线索有待探索。本手稿旨在全面概述鼻腔疾病与下呼吸道生物学相互作用的现有知识，并强调对此重要问题进行进一步研究的重要性。
