Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Catholic University of Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.
Immunol Allergy Clin North Am. 2009 Nov;29(4):733-40. doi: 10.1016/j.iac.2009.08.001.
The interaction between upper and lower airway disease has been recognized for centuries, with recent studies showing a direct link between upper and airway inflammation in allergic patients. The mechanisms underlying the interaction between nasal and bronchial inflammation have primarily been studied in allergic disease, showing systemic immune activation after allergen inhalation, induction of inflammation at a distance, and a negative impact of nasal inflammation on bronchial homeostasis. Therefore, allergic rhinitis and asthma are considered part of the global airway allergy syndrome. Besides allergy, other inflammatory conditions such as the common cold, acute rhinosinusitis, and chronic rhinosinusitis are associated with lower airway disease. Chronic sinus disease with or without nasal polyps are frequently found in patients with asthma and chronic obstructive pulmonary disease with improvement of bronchial symptoms and respiratory function by adequate medical and surgical therapy for rhinosinusitis. The resolution of sinonasal inflammation and hence sinonasal functions by medical or surgical treatment is considered responsible for the beneficial effect of treatment on bronchial disease. This article aims at providing a comprehensive overview of the current knowledge on the interaction between common cold, acute and chronic rhinosinusitis, and lower airway biology.
上呼吸道和下呼吸道疾病之间的相互作用已经被认识了几个世纪，最近的研究表明，过敏患者的上呼吸道和下呼吸道炎症之间存在直接联系。鼻和支气管炎症相互作用的机制主要在过敏性疾病中进行了研究，显示出吸入过敏原后全身免疫激活、远距离诱导炎症以及鼻腔炎症对支气管稳态的负面影响。因此，过敏性鼻炎和哮喘被认为是全球气道过敏综合征的一部分。除了过敏，其他炎症性疾病，如普通感冒、急性鼻-鼻窦炎和慢性鼻-鼻窦炎，也与下呼吸道疾病有关。慢性鼻-鼻窦炎伴或不伴鼻息肉在哮喘和慢性阻塞性肺疾病患者中很常见，通过对鼻-鼻窦炎进行充分的药物和手术治疗，可以改善支气管症状和呼吸功能。通过药物或手术治疗缓解鼻窦炎症，从而改善鼻窦功能，被认为是治疗对支气管疾病有益的原因。本文旨在提供对普通感冒、急性和慢性鼻-鼻窦炎以及下呼吸道生物学之间相互作用的最新知识的全面概述。
