nose and lungs holding hands

United Airway Disease

I have been on a quest to learn a bit more about the United Airway Disease concept. I am trying to learn more about the connection between my lungs and my nose. It was originally thought that my sinus inflammation was intermittent, connected to allergen exposure and limited. It looks like that may be changing, my ENT suggested that we may need to start thinking about my disease not just being in my lungs. Have you heard about this concept? Any experience with it? I would love to hear if you have been dealing with this?

Did you know that there is a concept called "United Airway Disease"?

Here are few things to know:

  • The concept is still in development and not all is yet understood.
  • This is treated by both lung specialists: (Pulmonologist/Respirologist and ENT and encompasses both allergic rhinitis and asthma, that are considered to be the same disease 1. They are considered to be the same due to the similar inflammatory presentation.
  • Allergic Rhinitis is a disease of the nasal mucous membranes, induced by an IgE-dependent inflammation after the exposure to allergens.4
  • The respiratory tree is divided into upper and lower tract. The upper airway consists of the nose, pharynx, and larynx. The lower respiratory tract consist of consist of the trachea, bronchioles, alveolar duct and alveoli.1
  • The nose is thought to filter out foreign substances from the lower tract.2
  • The lower airways also filter out inhaled particles that are trapped and cleared by mucous. (sputum, fun fact!)
  • Upper airway obstruction is linked to vasodilation and edema. Lower airway obstruction is connected to smooth muscle function, similar to bronchospasm.

Concepts of United Airway Disease

  • Changes in upper and lower airways can lead to more systemic responses.
  • The nose is usually the first site of exposure and researchers hypothesize that nasal mucosa may have a protective mode that minimizes remodeling and cellular regeneration.3
  • Remodeling tends to be more significant in the lower airways than the upper airways. An integrated diagnostic and therapeutic approach is needed for more holistic disease control.

Treatment for United Airway Disease?

  • Avoiding allergens, this may also involve testing to identify allergens.
  • Typically oral or intranasal antihistamines and nasal corticosteroids.5

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