Allergic rhinobronchitis: the asthma-allergic rhinitis link.

Area of Science:

• Immunology
• Pulmonology
• Allergy

Background:

• Allergic rhinitis and asthma frequently coexist and share commonalities in epidemiology, histology, physiology, and immunopathology.
• The respiratory epithelium lines and connects the upper and lower airways, suggesting a shared anatomical basis for these conditions.
• A nasobronchial reflex may physiologically link the upper and lower airways, contributing to their interconnectedness.

Purpose of the Study:

• To explore the shared characteristics and underlying inflammatory processes of allergic rhinitis and asthma.
• To emphasize the impact of allergic rhinitis management on asthma control.
• To propose a unifying term, 'allergic rhinobronchitis,' for the common inflammatory condition affecting the entire airway.

Main Methods:

• Review of epidemiologic, histologic, and physiologic data linking allergic rhinitis and asthma.
• Analysis of immunopathologic similarities, including early- and late-phase allergic responses.
• Evaluation of the therapeutic approach and outcomes for coexisting allergic rhinitis and asthma.

Main Results:

• Epidemiologic data show frequent co-occurrence of allergic rhinitis and asthma.
• Histologic and physiologic evidence supports a link between the upper and lower airways.
• Similar allergic responses and systemic reactions to allergens are observed in both conditions.
• Optimal treatment of allergic rhinitis can lead to improved asthma control.

Conclusions:

• The similarities between allergic rhinitis and asthma, particularly the shared allergic inflammation, are more significant than their differences.
• Effective management requires addressing chronic allergic inflammation in both the upper and lower airways.
• The term 'allergic rhinobronchitis' is proposed to better represent the unified inflammatory process and guide integrated treatment strategies.