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Med. Sci. 2019, 7(2), 27; https://doi.org/10.3390/medsci7020027

Regulation of Interaction Between the Upper and Lower Airways in United Airway Disease

1
Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University, Hirakata 573-1010, Japan
2
Allergy Center, Kansai Medical University, Hirakata 573-1010, Japan
3
Department of Otorhinolaryngology, Shimane University Faculty of Medicine, Izumo 693-0021, Japan
*
Author to whom correspondence should be addressed.
Received: 12 December 2018 / Revised: 8 February 2019 / Accepted: 8 February 2019 / Published: 11 February 2019
(This article belongs to the Special Issue Allergic Rhinitis: Epidemiology, Prevention and Management)
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Abstract

The concept of united airway disease comprises allergic rhinitis (AR) with asthma, and eosinophilic chronic rhinosinusitis (ECRS) with asthma. It embodies a comprehensive approach to the treatment of upper and lower airway inflammation. The treatment of upper airway inflammation reduces asthma symptoms and decreases the dose of inhaled corticosteroids (ICS) necessary to treat asthma. However, little is known about the mechanisms of interaction between upper and lower airway inflammation. Here we review these mechanisms, focusing on neural modulation and introduce a novel therapeutic approach to united airway disease using a fine-particle ICS. Our understanding of the relationship between the upper and lower airways and its contribution to T helper 2 (Th2)-skewed disease, such as AR and/or ECRS with asthma, has led us to this novel therapeutic strategy for a comprehensive approach to the treatment of upper airway inflammation with asthma. View Full-Text
Keywords: allergic rhinitis; asthma; eosinophil; nasal-bronchial reflex; united airway disease allergic rhinitis; asthma; eosinophil; nasal-bronchial reflex; united airway disease
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Kanda, A.; Kobayashi, Y.; Asako, M.; Tomoda, K.; Kawauchi, H.; Iwai, H. Regulation of Interaction Between the Upper and Lower Airways in United Airway Disease. Med. Sci. 2019, 7, 27.

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