Department of Respiratory Medicine, Royal Brompton & Harefield Hospital NHS Foundation Trust, Hill End Road, Harefield, UK.
Imperial College, Harefield Hospital, Hill End Road, Harefield, UK.
Curr Allergy Asthma Rep. 2018 Mar 24;18(4):23. doi: 10.1007/s11882-018-0781-y.
To evaluate the impact of allergic rhinitis (AR) on the development of asthma and to update readers on recent literature suggesting that early treatment of allergic subjects with immunotherapy may prevent asthma onset.
AR is frequently associated with asthma, leading to the concept that these two conditions are different aspects of the same disease. There is increasing evidence that AR precedes the onset of asthmatic symptoms and current treatment strategies are beneficial in symptom control with no impact prevention. There is limited knowledge about the risk factors responsible for the progression of AR to asthma, though recent data supports the notion that it is possible to prevent asthma onset by allergen immunotherapy. Despite significant advances in specific immunotherapy (SIT) therapy strengthening its efficacy in AR and possible prevention of progression to asthma, the adoption of this therapeutic strategy is still restricted in comparison to therapies directed towards treatment of AR symptoms. Unlike corticosteroids and other symptomatic therapies, the benefit of SIT treatment in allergic individuals has been shown to prevent the development of allergic conditions. Hence, large well-conducted randomized clinical trials with long-term efficacy of SIT are required to confirm or refute the concept that SIT may abrogate the progression of AR to asthma in patients.
评估变应性鼻炎（AR）对哮喘发展的影响，并更新读者关于最近的文献，该文献表明，早期对变应性患者进行免疫治疗可能预防哮喘发作。
AR 常与哮喘相关，这导致了这两种疾病是同一疾病的不同方面的概念。越来越多的证据表明，AR 先于哮喘症状的出现，目前的治疗策略对控制症状有益，但对预防没有影响。对于导致 AR 向哮喘发展的危险因素知之甚少，尽管最近的数据支持这样一种观点，即通过过敏原免疫疗法有可能预防哮喘发作。尽管特异性免疫疗法（SIT）在 AR 中的疗效有所增强，并可能预防其进展为哮喘，但与针对 AR 症状的治疗相比，这种治疗策略的应用仍然受到限制。与皮质类固醇和其他对症治疗不同，SIT 治疗在过敏个体中的益处已被证明可预防过敏疾病的发展。因此，需要进行大型、精心设计的、具有长期疗效的 SIT 随机临床试验，以确认或反驳 SIT 可能阻止 AR 向哮喘进展的概念。
