Fasano Mary Beth
University of Iowa Hospitals and Clinics, Division of Allergy-Immunology, Department of Internal Medicine & Pediatrics, University of Iowa, Iowa City, Iowa 52242, USA.
Curr Opin Otolaryngol Head Neck Surg. 2010 Feb;18(1):15-20. doi: 10.1097/MOO.0b013e328334aa0e.
This article reviews recent literature on the important relationship between the nose, paranasal sinuses and lungs. Recent advances in the understanding of the pathophysiological mechanisms underlying the association between upper and lower airways are discussed.
Epidemiological, clinical, and immunopathological data demonstrate an important link between upper and lower airways beyond the well recognized association of allergic rhinitis and asthma. Other upper airway diseases including occupational rhinitis, chronic rhinosinusitis, nasal polyposis with or without aspirin sensitivity, and obstructive sleep apnea have all been linked to asthma and/or asthma severity, as well as other lower airway diseases. Although the underlying mechanisms to explain these associations are unclear, recent work suggests the presence of systemic inflammation triggered by both the adaptive and innate immune system as a major driving force in combined airway diseases.
Epidemiological data, clinical observations, and immunopathological studies demonstrate an important link between upper and lower airways. An understanding of how the upper airway impacts on lower airway disease has important diagnostic, therapeutic and prognostic implications.
本文综述了近期关于鼻、鼻窦与肺之间重要关系的文献。讨论了对上、下呼吸道关联背后病理生理机制理解的最新进展。
流行病学、临床和免疫病理学数据表明，除了已被充分认识的变应性鼻炎与哮喘的关联外，上、下呼吸道之间还存在重要联系。其他上呼吸道疾病，包括职业性鼻炎、慢性鼻 - 鼻窦炎、伴或不伴阿司匹林敏感性的鼻息肉病以及阻塞性睡眠呼吸暂停，均与哮喘和/或哮喘严重程度以及其他下呼吸道疾病有关。尽管解释这些关联的潜在机制尚不清楚，但近期研究表明，由适应性和先天性免疫系统触发的全身炎症是联合气道疾病的主要驱动力。
流行病学数据、临床观察和免疫病理学研究表明上、下呼吸道之间存在重要联系。了解上呼吸道如何影响下呼吸道疾病具有重要的诊断、治疗和预后意义。
