上下气道炎症共病：鼻炎合并哮喘的流行病学、机制及治疗进展

文献信息

中文摘要

哮喘和鼻炎分别是下气道和上气道最常见的慢性炎症性疾病。这两种疾病常作为上下气道的炎症性疾病共存。临床数据普遍显示，哮喘患者合并鼻炎或鼻炎患者合并哮喘显著增加了患者的疾病负担。核心机制涉及2型炎症通路、神经反射联系和全身炎症播散。目前，鼻炎和哮喘共病的治疗已转向综合方法。鼻用和吸入性糖皮质激素联合是基础治疗，而白三烯受体拮抗剂是共病的优势药物。靶向生物制剂如抗免疫球蛋白E和抗白介素-4受体α单克隆抗体实现对关键通路的精准干预，而过敏原免疫治疗提供了病因治疗的可能性。本综述全面阐述了该共病的流行病学特征、病理生理机制和治疗进展，旨在为未来共病治疗提供理论依据。

英文摘要

Asthma and rhinitis are respectively the most common chronic inflammatory diseases of the lower airway and the upper airway. These two conditions often coexist as inflammatory disorders of the upper and lower airways. Clinical data generally show that the comorbidity of asthma patients with rhinitis or of patients with rhinitis having asthma significantly increases the disease burden of the patients. The core mechanism involves type 2 inflammatory pathways, neural reflex linkage, and systemic inflammatory dissemination. Currently, the treatment for the co-occurrence of rhinitis and asthma has shifted to an integrated approach. The combination of nasal and inhaled glucocorticoids serves as the basic treatment, while leukotriene receptor antagonists are the advantageous drugs for the comorbidity. Targeted biological agents such as anti- ‌immunoglobulin E and anti-interleukin-4 receptor α monoclonal antibodies achieve precise intervention on key pathways, while allergen immunotherapy offers the potential for etiological treatment. This review comprehensively elaborates on the epidemiological characteristics, pathophysiological mechanisms and treatment progress of this comorbidity, with the aim of providing a theoretical basis for future treatment of comorbidities.