Ciprandi Giorgio, Cirillo Ignazio
Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
J Allergy Clin Immunol. 2006 Nov;118(5):1105-9. doi: 10.1016/j.jaci.2006.05.010. Epub 2006 Jun 27.
There is a close link between allergic rhinitis (AR) and lower airways disorders, and this concept has been clarified and confirmed in several studies. AR constitutes a main risk factor for new-onset asthma. Furthermore, numerous epidemiologic surveys indicate that AR is very frequently associated with asthma. Bronchial hyperreactivity, a component of asthma, has often been reported to be present in patients with AR. Bronchial hyperreactivity in AR might represent a prognostic factor for further progress to asthma. In this regard forced expiratory flow at 25% and 75% of pulmonary volume has been proposed as an early marker of bronchial involvement in patients with AR who perceive only nasal symptoms. A close structural and functional relationship between the upper and lower airways has been recently demonstrated. Finally, adequate treatment of AR might positively affect the course of asthma. Taking these facts into consideration, a new diagnostic approach should be considered in managing patients with AR: a possible bronchial involvement must be sought in each patient.
变应性鼻炎（AR）与下气道疾病之间存在密切联系，这一概念已在多项研究中得到阐明和证实。AR是新发哮喘的主要危险因素。此外，大量流行病学调查表明，AR常与哮喘相关。哮喘的一个组成部分——支气管高反应性，在AR患者中也经常被报道存在。AR中的支气管高反应性可能是进一步发展为哮喘的一个预后因素。在这方面，对于仅表现出鼻部症状的AR患者，肺容积25%和75%时的用力呼气流量已被提议作为支气管受累的早期标志物。最近已证实上、下气道之间存在密切的结构和功能关系。最后，对AR进行充分治疗可能会对哮喘病程产生积极影响。考虑到这些事实，在管理AR患者时应考虑一种新的诊断方法：必须在每位患者中寻找可能的支气管受累情况。
