Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of "one-airway-one-disease," coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases...

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Autores: Bousquet, Jean, Bustamante Pineda, Mariona, García Aymerich, Judith, Sunyer Deu, Jordi, Antó i Boqué, Josep Maria
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/57022
Acceso en línea:http://hdl.handle.net/10230/57022
http://dx.doi.org/10.1111/all.15679
Access Level:acceso abierto
Palabra clave:IL-33
Toll-like receptors
Asthma
Multimorbidity
Rhinitis
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spelling Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesisBousquet, JeanBustamante Pineda, MarionaGarcía Aymerich, JudithSunyer Deu, JordiAntó i Boqué, Josep MariaIL-33Toll-like receptorsAsthmaMultimorbidityRhinitisAsthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of "one-airway-one-disease," coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the "Epithelial Barrier Hypothesis." This review determined that the "one-airway-one-disease" concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme "allergic" (asthma) phenotype combining asthma, rhinitis, and conjunctivitis. Rhinitis alone and rhinitis and asthma multimorbidity represent two distinct diseases with the following differences: (i) genomic and transcriptomic background (Toll-Like Receptors and IL-17 for rhinitis alone as a local disease; IL-33 and IL-5 for allergic and non-allergic multimorbidity as a systemic disease), (ii) allergen sensitization patterns (mono- or pauci-sensitization versus polysensitization), (iii) severity of symptoms, and (iv) treatment response. In conclusion, rhinitis alone (local disease) and rhinitis with asthma multimorbidity (systemic disease) should be considered as two distinct diseases, possibly modulated by the microbiome, and may be a model for understanding the epidemics of chronic and autoimmune diseases.Wiley202320232023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/57022http://dx.doi.org/10.1111/all.15679reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésAllergy. 2023 May;78(5):1169-203© 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.http://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/570222026-06-12T07:21:37Z
dc.title.none.fl_str_mv Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
title Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
spellingShingle Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
Bousquet, Jean
IL-33
Toll-like receptors
Asthma
Multimorbidity
Rhinitis
title_short Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
title_full Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
title_fullStr Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
title_full_unstemmed Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
title_sort Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
dc.creator.none.fl_str_mv Bousquet, Jean
Bustamante Pineda, Mariona
García Aymerich, Judith
Sunyer Deu, Jordi
Antó i Boqué, Josep Maria
author Bousquet, Jean
author_facet Bousquet, Jean
Bustamante Pineda, Mariona
García Aymerich, Judith
Sunyer Deu, Jordi
Antó i Boqué, Josep Maria
author_role author
author2 Bustamante Pineda, Mariona
García Aymerich, Judith
Sunyer Deu, Jordi
Antó i Boqué, Josep Maria
author2_role author
author
author
author
dc.subject.none.fl_str_mv IL-33
Toll-like receptors
Asthma
Multimorbidity
Rhinitis
topic IL-33
Toll-like receptors
Asthma
Multimorbidity
Rhinitis
description Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of "one-airway-one-disease," coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the "Epithelial Barrier Hypothesis." This review determined that the "one-airway-one-disease" concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme "allergic" (asthma) phenotype combining asthma, rhinitis, and conjunctivitis. Rhinitis alone and rhinitis and asthma multimorbidity represent two distinct diseases with the following differences: (i) genomic and transcriptomic background (Toll-Like Receptors and IL-17 for rhinitis alone as a local disease; IL-33 and IL-5 for allergic and non-allergic multimorbidity as a systemic disease), (ii) allergen sensitization patterns (mono- or pauci-sensitization versus polysensitization), (iii) severity of symptoms, and (iv) treatment response. In conclusion, rhinitis alone (local disease) and rhinitis with asthma multimorbidity (systemic disease) should be considered as two distinct diseases, possibly modulated by the microbiome, and may be a model for understanding the epidemics of chronic and autoimmune diseases.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023
2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/57022
http://dx.doi.org/10.1111/all.15679
url http://hdl.handle.net/10230/57022
http://dx.doi.org/10.1111/all.15679
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Allergy. 2023 May;78(5):1169-203
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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