Combined airways: impact of upper airway on lower airway
Abstract
PURPOSE OF REVIEW: This article reviews recent literature on the important relationship between the nose, paranasal sinuses and lungs. Recent advances in the understanding of the pathophysiological mechanisms underlying the association between upper and lower airways are discussed. RECENT FINDINGS: Epidemiological, clinical, and immunopathological data demonstrate an important link between upper and lower airways beyond the well recognized association of allergic rhinitis and asthma. Other upper airway diseases including occupational rhinitis, chronic rhinosinusitis, nasal polyposis with or without aspirin sensitivity, and obstructive sleep apnea have all been linked to asthma and/or asthma severity, as well as other lower airway diseases. Although the underlying mechanisms to explain these associations are unclear, recent work suggests the presence of systemic inflammation triggered by both the adaptive and innate immune system as a major driving force in combined airway diseases. SUMMARY: Epidemiological data, clinical observations, and immunopathological studies demonstrate an important link between upper and lower airways. An understanding of how the upper airway impacts on lower airway disease has important diagnostic, therapeutic and prognostic implications.
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Steroid-based therapies have recognized disappointing or incomplete protection in asthma exacerbations which are of viral etiology.
“Also of note is the recognized disappointing or incomplete protection of steroid-based therapies in asthma exacerbations (64, 197, 295) which are of viral etiology.”
From The airway epithelium: soldier in the fight against respiratory viruses (2011) · cites this paper as [64]
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Gupta, G., Thapa, R., Bhat, A. A., Rawat, S., Dhaundhiyal, K., Dhramshaktu, I. S., & Ojha, A. (2024) · Springer eBooks · doi:10.1007/978-981-97-1953-2_2
Frequency of asthma in patients with chronic rhinosinusitis and nasal polyposis
Aleksić, A., Vranješ, D., Novaković, Z., Gnjatić, M., & Ljuboja, O. (2025) · Respiratio · doi:10.5937/respira2502046a
- Authors
- Fasano, M. B.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Fasano, Mary Beth
- ORCID
- Fasano, Mary Beth
- Venue
- Current Opinion in Otolaryngology & Head & Neck Surgery
- Published
- 2010-02
- Volume
- 18
- Issue
- 1
- Pages
- 15-20
- ISSN
- 1068-9508 (ISSN-L)
- OpenAlex
- W1971169931
- Cited by
- 38
- References
- 57
- Citations by year
- 2025: 1 · 2024: 3 · 2021: 4 · 2020: 1 · 2018: 2 · 2017: 3 · 2014: 4 · 2013: 3 · 2012: 7
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Otolaryngology & Head & Neck Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Keywords
- allergic rhinitis, asthma, chronic rhinosinusitis, nasal polyps, aspirin intolerance, obstructive sleep apnea, occupational rhinitis, systemic inflammation, innate immunity, adaptive immunity, asthma severity
- MeSH terms
- Asthma, Rhinitis, Allergic, Seasonal, Humans, Immunoglobulin E, Interferon-gamma, Nasal Polyps, Occupational Diseases, Tumor Necrosis Factor-alpha, Nasal Obstruction, Interleukin-4, Interleukin-5, Th2 Cells, Interleukin-12, Pulmonary Disease, Chronic Obstructive
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