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Atopic march: link to upper airways.

Jonathan M Spergel1

  • 1Division of Allergy and Immunology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. spergel@email.chop.edu

Current Opinion in Allergy and Clinical Immunology
|January 12, 2005
PubMed
Summary
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Allergic rhinitis, an upper airway condition, is a significant risk factor for developing asthma. This condition can precede asthma, playing a key role in the atopic march progression.

Area of Science:

  • Immunology
  • Pulmonology
  • Allergy

Background:

  • The atopic march describes the progression of allergic diseases.
  • The relationship between upper airway inflammation and lower airway diseases is increasingly recognized.

Purpose of the Study:

  • To review the role of upper airway conditions in the atopic march.
  • To examine evidence supporting allergic rhinitis preceding asthma.
  • To evaluate allergic rhinitis as a potential endpoint in the atopic march.

Main Methods:

  • Literature review of studies on the atopic march and allergic rhinitis.
  • Analysis of evidence linking upper and lower airway inflammation.
  • Examination of longitudinal cohort studies.

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Main Results:

  • Nasal symptoms and inflammation markers correlate with lower airway inflammation and hyperresponsiveness.
  • Individuals with allergic rhinitis demonstrate an increased risk for asthma.
  • Atopic dermatitis may be linked to asthma but does not necessarily precede it.

Conclusions:

  • Allergic rhinitis is a confirmed risk factor for asthma development.
  • Allergic rhinitis can precede the onset of asthma within the atopic march.