TY - JOUR

T1 - Rhinitis associated with asthma is distinct from rhinitis alone

T2 - The ARIA-MeDALL hypothesis

AU - Bousquet, J

AU - Melén, E

AU - Haahtela, T

AU - Koppelman, G H

AU - Togias, A

AU - Valenta, R

AU - Akdis, C A

AU - Czarlewski, W

AU - Rothenberg, M

AU - Valiulis, A

AU - Wickman, M

AU - Akdis, M

AU - Aguilar, D

AU - Bedbrook, A

AU - Bindslev-Jensen, C

AU - Bosnic-Anticevich, S

AU - Boulet, L P

AU - Brightling, C E

AU - Brussino, L

AU - Burte, E

AU - Bustamante, M

AU - Canonica, G W

AU - Cecchi, L

AU - Celedon, J C

AU - Chaves Loureiro, C

AU - Costa, E

AU - Cruz, A A

AU - Erhola, M

AU - Gemicioglu, B

AU - Fokkens, W J

AU - Garcia-Aymerich, J

AU - Guerra, S

AU - Heinrich, J

AU - Ivancevich, J C

AU - Keil, T

AU - Klimek, L

AU - Kuna, P

AU - Kupczyk, M

AU - Kvedariene, V

AU - Larenas-Linnemann, D E

AU - Lemonnier, N

AU - Lodrup Carlsen, K C

AU - Louis, R

AU - Makela, M

AU - Makris, M

AU - Maurer, M

AU - Momas, I

AU - Morais-Almeida, M

AU - Mullol, J

AU - Naclerio, R N

AU - Nadeau, K

AU - Nadif, R

AU - Niedoszytko, M

AU - Okamoto, Y

AU - Ollert, M

AU - Papadopoulos, N G

AU - Passalacqua, G

AU - Patella, V

AU - Pawankar, R

AU - Pham-Thi, N

AU - Pfaar, O

AU - Regateiro, F S

AU - Ring, J

AU - Rouadi, P W

AU - Samolinski, B

AU - Sastre, J

AU - Savouré, M

AU - Scichilone, N

AU - Shamji, M H

AU - Sheikh, A

AU - Siroux, V

AU - Sousa-Pinto, B

AU - Standl, M

AU - Sunyer, J

AU - Taborda-Barata, L

AU - Toppila-Salmi, S

AU - Torres, M J

AU - Tsiligianni, I

AU - Valovirta, E

AU - Vandenplas, O

AU - Ventura, M T

AU - Weiss, S

AU - Yorgancioglu, A

AU - Zhang, L

AU - Abdul Latiff, A H

AU - Aberer, W

AU - Agache, I

AU - Al-Ahmad, M

AU - Alobid, I

AU - Ansotegui, I J

AU - Arshad, S H

AU - Asayag, E

AU - Barbara, C

AU - Baharudin, A

AU - Battur, L

AU - Bennoor, K S

AU - Berghea, E C

AU - Bergmann, K C

AU - Bernstein, D

AU - Bewick, M

AU - Blain, H

AU - Bonini, M

AU - Braido, F

AU - Buhl, R

AU - Bumbacea, R S

AU - Bush, A

AU - Calderon, M

AU - Calvo-Gil, M

AU - Camargos, P

AU - Caraballo, L

AU - Cardona, V

AU - Carr, W

AU - Carreiro-Martins, P

AU - Casale, T

AU - Cepeda Sarabia, A M

AU - Chandrasekharan, R

AU - Charpin, D

AU - Chen, Y Z

AU - Cherrez-Ojeda, I

AU - Chivato, T

AU - Chkhartishvili, E

AU - Christoff, G

AU - Chu, D K

AU - Cingi, C

AU - Correia de Sousa, J

AU - Corrigan, C

AU - Custovic, A

AU - D'Amato, G

AU - Del Giacco, S

AU - De Blay, F

AU - Devillier, P

AU - Didier, A

AU - do Ceu Teixeira, M

AU - Dokic, D

AU - Douagui, H

AU - Doulaptsi, M

AU - Durham, S

AU - Dykewicz, M

AU - Eiwegger, T

AU - El-Sayed, Z A

AU - Emuzyte, R

AU - Fiocchi, A

AU - Fyhrquist, N

AU - Gomez, R M

AU - Gotua, M

AU - Guzman, M A

AU - Hagemann, J

AU - Hamamah, S

AU - Halken, S

AU - Halpin, D M G

AU - Hofmann, M

AU - Hossny, E

AU - Hrubiško, M

AU - Irani, C

AU - Ispayeva, Z

AU - Jares, E

AU - Jartti, T

AU - Jassem, E

AU - Julge, K

AU - Just, J

AU - Jutel, M

AU - Kaidashev, I

AU - Kalayci, O

AU - Kalyoncu, A F

AU - Kardas, P

AU - Kirenga, B

AU - Kraxner, H

AU - Kull, I

AU - Kulus, M

AU - La Grutta, S

AU - Lau, S

AU - Le Tuyet Thi, L

AU - Levin, M

AU - Lipworth, B

AU - Lourenço, O

AU - Mahboub, B

AU - Martinez-Infante, E

AU - Matricardi, P

AU - Miculinic, N

AU - Migueres, N

AU - Mihaltan, F

AU - Mohammad, Y

AU - Moniuszko, M

AU - Montefort, S

AU - Neffen, H

AU - Nekam, K

AU - Nunes, E

AU - Nyembue Tshipukane, D

AU - O'Hehir, R

AU - Ogulur, I

AU - Ohta, K

AU - Okubo, K

AU - Ouedraogo, S

AU - Olze, H

AU - Pali-Schöll, I

AU - Palomares, O

AU - Palosuo, K

AU - Panaitescu, C

AU - Panzner, P

AU - Park, H S

AU - Pitsios, C

AU - Plavec, D

AU - Popov, T A

AU - Puggioni, F

AU - Quirce, S

AU - Recto, M

AU - Repka-Ramirez, M S

AU - Robalo Cordeiro, C

AU - Roche, N

AU - Rodriguez-Gonzalez, M

AU - Romantowski, J

AU - Rosario Filho, N

AU - Rottem, M

AU - Sagara, H

AU - Serpa, F S

AU - Sayah, Z

AU - Scheire, S

AU - Schmid-Grendelmeier, P

AU - Sisul, J C

AU - Sole, D

AU - Soto-Martinez, M

AU - Sova, M

AU - Sperl, A

AU - Spranger, O

AU - Stelmach, R

AU - Suppli Ulrik, C

AU - Thomas, M

AU - To, T

AU - Todo-Bom, A

AU - Tomazic, P V

AU - Urrutia-Pereira, M

AU - Valentin-Rostan, M

AU - Van Ganse, E

AU - van Hage, M

AU - Vasankari, T

AU - Vichyanond, P

AU - Viegi, G

AU - Wallace, D

AU - Wang, D Y

AU - Williams, S

AU - Worm, M

AU - Yiallouros, P

AU - Yusuf, O

AU - Zaitoun, F

AU - Zernotti, M

AU - Zidarn, M

AU - Zuberbier, J

AU - Fonseca, J A

AU - Zuberbier, T

AU - Anto, J M

N1 - © 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - Humans

KW - Rhinitis/diagnosis

KW - Asthma/diagnosis

KW - Rhinitis, Allergic/complications

KW - Allergens

KW - Multimorbidity

U2 - 10.1111/all.15679

DO - 10.1111/all.15679

M3 - Review

C2 - 36799120

VL - 78

SP - 1169

EP - 1203

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

SN - 0105-4538

IS - 5

ER -