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The relationships between atopy, rhinitis and asthma: pathophysiological considerations.
Marie-Eve Boulay1, Louis-Philippe Boulet
1Laval University Cardio-Thoracic Institute, Laval Hospital, Quebec City, Canada.
Current Opinion in Allergy and Clinical Immunology
|February 13, 2003
Summary
Atopy, allergic rhinitis, and asthma are interconnected. Early environmental exposures may protect against these allergic diseases, while indoor allergens are key risk factors for asthma development.
Area of Science:
- Immunology
- Allergology
- Pulmonology
Background:
- Atopy, allergic rhinitis, and asthma are closely related conditions.
- Understanding their interactions is crucial for developing effective management strategies.
Purpose of the Study:
- To review recent data on the interactions between atopy, allergic rhinitis, and asthma.
- To explore how these conditions influence one another.
Main Methods:
- Review of recent scientific literature and data.
- Analysis of observational studies and findings on risk factors and protective elements.
Main Results:
- Atopic dermatitis and rhinitis often precede or accompany asthma development.
- Early-life exposure to farming environments and large families may be protective, modulated by genetics.
- House-dust-mite sensitization in childhood is a major asthma risk factor in atopic dermatitis patients.
- Indoor allergens (house-dust-mite, cat) show the strongest association with airway hyperresponsiveness.
- Allergen exposure impacts upper and lower airways, supporting the 'united airways' concept.
Conclusions:
- Atopy, rhinitis, and asthma may represent a single systemic condition with varied manifestations.
- Imbalances in T helper cell populations, influenced by early environmental factors, may underlie these conditions.
- Inflammatory processes in the upper and lower airways are interconnected, reinforcing the 'united airways' hypothesis.