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A Journal on Diseases of the Respiratory System


Official Journal of the Italian Society of Thoracic Endoscopy
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Minerva Pneumologica 2007 June;46(2):135-42

language: Italian

Upper and lower airways: evidences of functional integration in respiratory allergies

Failla M., Mastruzzo C., Vancheri C., Crimi N.

Sezione di Malattie Respiratorie e Allergologia Dipartimento di Medicina Interna e Medicina Specialistica, Università degli Studi di Catania, Catania


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The anatomical integrity between upper and lower airways is a very broadly acquired concept. Recently, the functional integrity between the two districts has evoked much interest from the physiological and pathological point of view. In this respect, allergic respiratory diseases represents an interesting model to study upper and lower airways functional integrity because of the common etiopathogenesis and high prevalence in the population. Rhinitis, either allergic or not, is frequently associated with asthma. Furthermore, isolated bronchial hyperreactivity in rhinitic patients, might be considered a negative prognostic factor for asthma progression. Recent evidence suggests that both districts react to diverse irritants, including allergens, similarly in the upper and in the lower airway district. Finally, from a therapeutic point of view, it has been demonstrated that rhinitis treatment may influence beneficially asthma primary and secondary outcomes. In summary, upper and lower airways respond unanimously to inflammatory stimuli. Therefore, an essential point in the clinical care for respiratory allergies is nowadays represented by the integrated evaluation of both districts from the diagnostic, therapeutic and preventive perspective.

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