Khan David A
Division of Allergy and Immunology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Allergy Asthma Proc. 2014 Sep-Oct;35(5):357-61. doi: 10.2500/aap.2014.35.3794.
Allergic rhinitis and asthma are common diseases that frequently occur together. This concept has been referred to in the literature as united airway disease. Epidemiological studies have shown that the majority of patients with asthma have concomitant rhinitis and the presence of rhinitis is an increased risk factor for development of asthma. Patients with asthma and rhinitis share common physiology including heightened bronchial hyperresponsiveness and heightened reactivity to a variety of stimuli. Immunopathology of allergic rhinitis is also similar with the predominance of T-helper type 2 inflammation and tissue eosinophilia. Although several mechanisms have been proposed to explain the united airway theory, some of the best lines of evidence suggest that local airway inflammation can result in a systemic inflammatory response. Pharmacotherapeutic studies have shown that the treatment of rhinitis can improve asthma and vice versa. Nevertheless, systemic approaches such as immunotherapy lead to better outcomes for treating both disease states simultaneously. This article will focus on the data supporting the common epidemiology, shared pathophysiology, and therapeutic interventions aimed at allergic rhinitis and asthma as united airway diseases.
变应性鼻炎和哮喘是常见疾病，且常同时发生。这一概念在文献中被称为联合气道疾病。流行病学研究表明，大多数哮喘患者伴有鼻炎，而鼻炎的存在是哮喘发病的一个风险增加因素。哮喘和鼻炎患者具有共同的生理特征，包括支气管高反应性增强以及对多种刺激的反应性增强。变应性鼻炎的免疫病理学也相似，以2型辅助性T细胞炎症和组织嗜酸性粒细胞增多为主。尽管已提出多种机制来解释联合气道理论，但一些最有力的证据表明，局部气道炎症可导致全身炎症反应。药物治疗研究表明，鼻炎的治疗可改善哮喘，反之亦然。然而，免疫疗法等全身性方法在同时治疗这两种疾病状态时能取得更好的效果。本文将重点关注支持变应性鼻炎和哮喘作为联合气道疾病的共同流行病学、共同病理生理学以及治疗干预措施的数据。
