Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
Issued Date
2023-01-01
Resource Type
ISSN
01054538
eISSN
13989995
Scopus ID
2-s2.0-85151968548
Pubmed ID
36799120
Journal Title
Allergy: European Journal of Allergy and Clinical Immunology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Allergy: European Journal of Allergy and Clinical Immunology (2023)
Suggested Citation
Bousquet J., Melén E., Haahtela T., Koppelman G.H., Togias A., Valenta R., Akdis C.A., Czarlewski W., Rothenberg M., Valiulis A., Wickman M., Akdis M., Aguilar D., Bedbrook A., Bindslev-Jensen C., Bosnic-Anticevich S., Boulet L.P., Brightling C.E., Brussino L., Burte E., Bustamante M., Canonica G.W., Cecchi L., Celedon J.C., Chaves Loureiro C., Costa E., Cruz A.A., Erhola M., Gemicioglu B., Fokkens W.J., Garcia-Aymerich J., Guerra S., Heinrich J., Ivancevich J.C., Keil T., Klimek L., Kuna P., Kupczyk M., Kvedariene V., Larenas-Linnemann D.E., Lemonnier N., Lodrup Carlsen K.C., Louis R., Makela M., Makris M., Maurer M., Momas I., Morais-Almeida M., Mullol J., Naclerio R.N., Nadeau K., Nadif R., Niedoszytko M., Okamoto Y., Ollert M., Papadopoulos N.G., Passalacqua G., Patella V., Pawankar R., Pham-Thi N., Pfaar O., Regateiro F.S., Ring J., Rouadi P.W., Samolinski B., Sastre J., Savouré M., Scichilone N., Shamji M.H., Sheikh A., Siroux V., Sousa-Pinto B., Standl M., Sunyer J., Taborda-Barata L., Toppila-Salmi S., Torres M.J., Tsiligianni I., Valovirta E., Vandenplas O., Ventura M.T., Weiss S., Yorgancioglu A., Zhang L., Abdul Latiff A.H., Aberer W., Agache I., Al-Ahmad M., Alobid I., Ansotegui I.J., Arshad S.H., Asayag E., Barbara C., Baharudin A., Battur L., Bennoor K.S., Berghea E.C., Bergmann K.C., Bernstein D., Bewick M. Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis. Allergy: European Journal of Allergy and Clinical Immunology (2023). doi:10.1111/all.15679 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/81521
Title
Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis
Author(s)
Bousquet J.
Melén E.
Haahtela T.
Koppelman G.H.
Togias A.
Valenta R.
Akdis C.A.
Czarlewski W.
Rothenberg M.
Valiulis A.
Wickman M.
Akdis M.
Aguilar D.
Bedbrook A.
Bindslev-Jensen C.
Bosnic-Anticevich S.
Boulet L.P.
Brightling C.E.
Brussino L.
Burte E.
Bustamante M.
Canonica G.W.
Cecchi L.
Celedon J.C.
Chaves Loureiro C.
Costa E.
Cruz A.A.
Erhola M.
Gemicioglu B.
Fokkens W.J.
Garcia-Aymerich J.
Guerra S.
Heinrich J.
Ivancevich J.C.
Keil T.
Klimek L.
Kuna P.
Kupczyk M.
Kvedariene V.
Larenas-Linnemann D.E.
Lemonnier N.
Lodrup Carlsen K.C.
Louis R.
Makela M.
Makris M.
Maurer M.
Momas I.
Morais-Almeida M.
Mullol J.
Naclerio R.N.
Nadeau K.
Nadif R.
Niedoszytko M.
Okamoto Y.
Ollert M.
Papadopoulos N.G.
Passalacqua G.
Patella V.
Pawankar R.
Pham-Thi N.
Pfaar O.
Regateiro F.S.
Ring J.
Rouadi P.W.
Samolinski B.
Sastre J.
Savouré M.
Scichilone N.
Shamji M.H.
Sheikh A.
Siroux V.
Sousa-Pinto B.
Standl M.
Sunyer J.
Taborda-Barata L.
Toppila-Salmi S.
Torres M.J.
Tsiligianni I.
Valovirta E.
Vandenplas O.
Ventura M.T.
Weiss S.
Yorgancioglu A.
Zhang L.
Abdul Latiff A.H.
Aberer W.
Agache I.
Al-Ahmad M.
Alobid I.
Ansotegui I.J.
Arshad S.H.
Asayag E.
Barbara C.
Baharudin A.
Battur L.
Bennoor K.S.
Berghea E.C.
Bergmann K.C.
Bernstein D.
Bewick M.
Melén E.
Haahtela T.
Koppelman G.H.
Togias A.
Valenta R.
Akdis C.A.
Czarlewski W.
Rothenberg M.
Valiulis A.
Wickman M.
Akdis M.
Aguilar D.
Bedbrook A.
Bindslev-Jensen C.
Bosnic-Anticevich S.
Boulet L.P.
Brightling C.E.
Brussino L.
Burte E.
Bustamante M.
Canonica G.W.
Cecchi L.
Celedon J.C.
Chaves Loureiro C.
Costa E.
Cruz A.A.
Erhola M.
Gemicioglu B.
Fokkens W.J.
Garcia-Aymerich J.
Guerra S.
Heinrich J.
Ivancevich J.C.
Keil T.
Klimek L.
Kuna P.
Kupczyk M.
Kvedariene V.
Larenas-Linnemann D.E.
Lemonnier N.
Lodrup Carlsen K.C.
Louis R.
Makela M.
Makris M.
Maurer M.
Momas I.
Morais-Almeida M.
Mullol J.
Naclerio R.N.
Nadeau K.
Nadif R.
Niedoszytko M.
Okamoto Y.
Ollert M.
Papadopoulos N.G.
Passalacqua G.
Patella V.
Pawankar R.
Pham-Thi N.
Pfaar O.
Regateiro F.S.
Ring J.
Rouadi P.W.
Samolinski B.
Sastre J.
Savouré M.
Scichilone N.
Shamji M.H.
Sheikh A.
Siroux V.
Sousa-Pinto B.
Standl M.
Sunyer J.
Taborda-Barata L.
Toppila-Salmi S.
Torres M.J.
Tsiligianni I.
Valovirta E.
Vandenplas O.
Ventura M.T.
Weiss S.
Yorgancioglu A.
Zhang L.
Abdul Latiff A.H.
Aberer W.
Agache I.
Al-Ahmad M.
Alobid I.
Ansotegui I.J.
Arshad S.H.
Asayag E.
Barbara C.
Baharudin A.
Battur L.
Bennoor K.S.
Berghea E.C.
Bergmann K.C.
Bernstein D.
Bewick M.
Author's Affiliation
Uniwersytecki Szpital Kliniczny Nr 1 im. Norberta Barlickiego w Lodz
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Sydney Local Health District
Chiba Rosai Hospital
NIHR Imperial Biomedical Research Centre
Université Paris Cité
Institut pour l'Avancée des Biosciences
TUM Fakultät für Medizin
Edinburgh Medical School
IRCCS San Martino Polyclinic Hospital
Humanitas University
Medizinische Universitat Wien, Zentrum für Pathophysiologie, Infektiologie und Immunologie
Centre de Recherche en Épidémiologie et Santé des Populations
Instituto de Salud Global de Barcelona
Oslo Universitetssykehus
Université Grenoble Alpes
Skin and Allergy Hospital
Beijing Institute of Otorhinolaryngology
Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Luxembourg Institute of Health
Beatrix Kinderziekenhuis
Dar Al-Shifa Hospital
Medical University of Warsaw
Vilniaus Universitetas
Kuwait University
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
Centro Medico Teknon
University of Leicester
Universidade de Coimbra, Faculdade de Medicina
Universitat Pompeu Fabra Barcelona
Stanford University School of Medicine
Centre Hospitalier Universitaire de Montpellier
University of Central Lancashire
Scuola di Medicina
Cincinnati Children's Hospital Medical Center
Hospital Clinic Barcelona
Università degli Studi di Torino, Scuola di Medicina
Université de Versailles Saint-Quentin-en-Yvelines
National and Kapodistrian University of Athens
University of Coimbra, Coimbra Institute for Clinical and Biomedical Research
Universidad Autónoma de Madrid
Charité – Universitätsmedizin Berlin
University of Southampton, Faculty of Medicine
Humanitas Research Hospital
Helmholtz Center Munich German Research Center for Environmental Health
Universitatea Transilvania din Brasov
Hospital del Mar
Celal Bayar Üniversitesi Tip Fakültesi
Universitätsmedizin Mainz
Woolcock Institute of Medical Research
Centro Hospitalar e Universitário de Coimbra
Nippon Medical School
Università degli Studi di Palermo
University of Cincinnati College of Medicine
National Institute of Allergy and Infectious Diseases (NIAID)
Università degli Studi di Napoli Federico II
Faculdade de Medicina da Universidade do Porto (FMUP)
Centre Hospitalier Universitaire de Liege
Odense Universitetshospital
Universidade Federal da Bahia
École polytechnique
Hospital Regional Universitario Carlos Haya
Julius-Maximilians-Universität Würzburg
Universität Zürich
Gdanski Uniwersytet Medyczny
Karolinska Institutet
Channing Division of Network Medicine
Institut d'Investigacions Biomèdiques August Pi i Sunyer - IDIBAPS
İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine
National Heart and Lung Institute
Faculty of Medicine and Health
Pantai Holdings Sdn Bhd
Istituto di Scienze delle Produzioni Alimentari
Ospedale Mauriziano Umberto I
Universidade do Porto
Turun yliopisto
Medizinische Universität Graz
UPMC Children’s Hospital of Pittsburgh
Chiba University Hospital
Universitätsklinikum Gießen und Marburg, Standort Marburg
School of Medical Sciences, Universiti Sains Malaysia
Universiteit van Amsterdam
The University of Arizona Health Sciences
Universitat de Barcelona
University of Crete
Johns Hopkins School of Medicine
Universidade da Beira Interior
Université de Liège
Université Catholique de Louvain
Södersjukhuset
Klinikum der Universität München
6AM Data Mining
Pirkanmaa Welfare district
Paris Descartes University-Sorbonne Paris Cité
Mongolian Association of Hospital Managers
Agency of Health ASL
French Environment and Energy Management Agency
German Center of Lung Research (DZL)
David Hide Asthma and Allergy Research Centre
“Santa Maria della Speranza” Hospital
MASK-air
Médica Sur Clinical Foundation and Hospital
Medical Consulting Czarlewski
Hospital Quironsalud Bizkaia
Odense Research Center for Anaphylaxis
Portuguese National Programme for Respiratory Diseases
International Primary Care Respiratory Group IPCRG
USL Toscana Centro
Hospital CUF Descobertas
ARIA
Clinica Santa Isabel
IRBA (Institut de Recherche Bio-Médicale des Armées)
Christine Kühne-Center for Allergy Research and Education (CK-CARE)
Cova da Beira University Hospital Centre
Bavarian Health and Food Safety Authority
Institute of Clinical Medicine and Institute of Health Sciences
Centre Hospitalier Universitaire de Namur
Argentine Society of Allergy and Immunopathology
National Institute of Diseases of the Chest and Hospital
Eye and Ear University Hospital
Center for Rhinology and Allergology
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Sydney Local Health District
Chiba Rosai Hospital
NIHR Imperial Biomedical Research Centre
Université Paris Cité
Institut pour l'Avancée des Biosciences
TUM Fakultät für Medizin
Edinburgh Medical School
IRCCS San Martino Polyclinic Hospital
Humanitas University
Medizinische Universitat Wien, Zentrum für Pathophysiologie, Infektiologie und Immunologie
Centre de Recherche en Épidémiologie et Santé des Populations
Instituto de Salud Global de Barcelona
Oslo Universitetssykehus
Université Grenoble Alpes
Skin and Allergy Hospital
Beijing Institute of Otorhinolaryngology
Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Luxembourg Institute of Health
Beatrix Kinderziekenhuis
Dar Al-Shifa Hospital
Medical University of Warsaw
Vilniaus Universitetas
Kuwait University
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
Centro Medico Teknon
University of Leicester
Universidade de Coimbra, Faculdade de Medicina
Universitat Pompeu Fabra Barcelona
Stanford University School of Medicine
Centre Hospitalier Universitaire de Montpellier
University of Central Lancashire
Scuola di Medicina
Cincinnati Children's Hospital Medical Center
Hospital Clinic Barcelona
Università degli Studi di Torino, Scuola di Medicina
Université de Versailles Saint-Quentin-en-Yvelines
National and Kapodistrian University of Athens
University of Coimbra, Coimbra Institute for Clinical and Biomedical Research
Universidad Autónoma de Madrid
Charité – Universitätsmedizin Berlin
University of Southampton, Faculty of Medicine
Humanitas Research Hospital
Helmholtz Center Munich German Research Center for Environmental Health
Universitatea Transilvania din Brasov
Hospital del Mar
Celal Bayar Üniversitesi Tip Fakültesi
Universitätsmedizin Mainz
Woolcock Institute of Medical Research
Centro Hospitalar e Universitário de Coimbra
Nippon Medical School
Università degli Studi di Palermo
University of Cincinnati College of Medicine
National Institute of Allergy and Infectious Diseases (NIAID)
Università degli Studi di Napoli Federico II
Faculdade de Medicina da Universidade do Porto (FMUP)
Centre Hospitalier Universitaire de Liege
Odense Universitetshospital
Universidade Federal da Bahia
École polytechnique
Hospital Regional Universitario Carlos Haya
Julius-Maximilians-Universität Würzburg
Universität Zürich
Gdanski Uniwersytet Medyczny
Karolinska Institutet
Channing Division of Network Medicine
Institut d'Investigacions Biomèdiques August Pi i Sunyer - IDIBAPS
İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine
National Heart and Lung Institute
Faculty of Medicine and Health
Pantai Holdings Sdn Bhd
Istituto di Scienze delle Produzioni Alimentari
Ospedale Mauriziano Umberto I
Universidade do Porto
Turun yliopisto
Medizinische Universität Graz
UPMC Children’s Hospital of Pittsburgh
Chiba University Hospital
Universitätsklinikum Gießen und Marburg, Standort Marburg
School of Medical Sciences, Universiti Sains Malaysia
Universiteit van Amsterdam
The University of Arizona Health Sciences
Universitat de Barcelona
University of Crete
Johns Hopkins School of Medicine
Universidade da Beira Interior
Université de Liège
Université Catholique de Louvain
Södersjukhuset
Klinikum der Universität München
6AM Data Mining
Pirkanmaa Welfare district
Paris Descartes University-Sorbonne Paris Cité
Mongolian Association of Hospital Managers
Agency of Health ASL
French Environment and Energy Management Agency
German Center of Lung Research (DZL)
David Hide Asthma and Allergy Research Centre
“Santa Maria della Speranza” Hospital
MASK-air
Médica Sur Clinical Foundation and Hospital
Medical Consulting Czarlewski
Hospital Quironsalud Bizkaia
Odense Research Center for Anaphylaxis
Portuguese National Programme for Respiratory Diseases
International Primary Care Respiratory Group IPCRG
USL Toscana Centro
Hospital CUF Descobertas
ARIA
Clinica Santa Isabel
IRBA (Institut de Recherche Bio-Médicale des Armées)
Christine Kühne-Center for Allergy Research and Education (CK-CARE)
Cova da Beira University Hospital Centre
Bavarian Health and Food Safety Authority
Institute of Clinical Medicine and Institute of Health Sciences
Centre Hospitalier Universitaire de Namur
Argentine Society of Allergy and Immunopathology
National Institute of Diseases of the Chest and Hospital
Eye and Ear University Hospital
Center for Rhinology and Allergology
Other Contributor(s)
Abstract
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.