title: Pediatric allergic rhinitis and asthma: can the march be halted?
abstract: The strong epidemiologic and pathophysiologic link between allergic rhinitis (AR) and asthma has led to the concept of 'united airways disease' or 'respiratory allergy', implying that allergy, in its widest sense, underlies this clinical syndrome. Progression from AR to asthma is frequent and part of the 'atopic march'. Since pediatric immune responses are more adaptable and therefore may be more amenable to treatment, interventions at early childhood are characterized by a higher chance to affect the natural history of respiratory allergy. Although current treatments are quite effective in alleviating respiratory allergy symptoms, it has proven much more difficult to confirm any influence on the progression of the disease. Much more promising is the field of specific allergen immunotherapy, where current evidence, although not yet of ideal robustness, points towards a disease-modifying effect. In addition, newer or emerging, possibly more effective or more targeted interventions are promising in the preventive sense.
authors: Allergy Unit "D. Kalogeromitros," Medical School, "Attikon" University Hospital, 1, Rimini str, 124 62, Chaidari, Athens, Greece, ol.tsilochristou@gmail.com.
authors: Olympia A
authors: OA
authors: Tsilochristou
authors: Nikolaos
authors: N
authors: Douladiris
authors: Michael
authors: M
authors: Makris
authors: Nikolaos G
authors: NG
authors: Papadopoulos
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D002648:Child; D018450:Disease Progression; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D007167:Immunotherapy; D015995:Prevalence; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy
chemical_list: D006633:Histamine Antagonists
references: Ital J Pediatr. 2012 Oct 25;38:60
references: 23098057
references: Am J Respir Crit Care Med. 2001 Sep 1;164(5):858-65
references: 11549546
references: J Allergy Clin Immunol. 2004 Jan;113(1):115-9
references: 14699394
references: Allergy. 2006 Jul;61(7):855-9
references: 16792584
references: J Allergy Clin Immunol. 1993 Jan;91(1 Pt 1):97-101
references: 8423275
references: Clin Exp Allergy. 1995 Jun;25(6):568-73
references: 7648464
references: J Asthma. 2011 May;48(4):387-92
references: 21391878
references: Allergy. 1998 Apr;53(4):383-7
references: 9574880
references: Eur Respir J. 1997 Oct;10(10):2216-24
references: 9387943
references: Lancet. 2007 Oct 20;370(9596):1422-31
references: 17950857
references: Pediatr Pulmonol. 2009 Nov;44(11):1085-92
references: 19746439
references: J Allergy Clin Immunol. 2004 Jan;113(1):86-93
references: 14713912
references: J Allergy Clin Immunol. 2007 Oct;120(4):863-9
references: 17825896
references: J Allergy Clin Immunol. 2011 Nov;128(5):989-95.e1-8
references: 21958585
references: Ann Allergy. 1992 Mar;68(3):233-6
references: 1546818
references: Allergy. 2005 May;60(5):702-3
references: 15813820
references: Clin Exp Allergy. 2011 Sep;41(9):1177-200
references: 21848757
references: J Allergy Clin Immunol. 2002 Feb;109(2):274-80
references: 11842297
references: Allergy. 1983 Jan;38(1):25-9
references: 6837893
references: Pediatr Allergy Immunol. 2003 Dec;14(6):458-63
references: 14675473
references: J Allergy Clin Immunol. 2003 Jun;111(6):1171-83; quiz 1184
references: 12789212
references: Pediatr Res. 2007 Aug;62(2):215-20
references: 17597643
references: Am J Respir Crit Care Med. 1998 Jul;158(1):115-20
references: 9655716
references: J Allergy Clin Immunol. 2011 Dec;128(6):1153-62
references: 21824648
references: Pediatr Allergy Immunol. 2001;12 Suppl 14:102-7
references: 11380910
references: Allergy. 2008 Apr;63 Suppl 86:8-160
references: 18331513
references: Allergy. 2013;68(5):569-79
references: 23590215
references: Clin Transl Allergy. 2011 Aug 17;1(1):8
references: 22409776
references: Allergy. 2007 Oct;62(10):1175-81
references: 17845588
references: J Investig Allergol Clin Immunol. 2005;15(1):9-16
references: 15864877
references: N Engl J Med. 2006 May 11;354(19):1985-97
references: 16687711
references: Thorax. 2000 Oct;55(10):826-32
references: 10992533
references: Ann Allergy Asthma Immunol. 2003 Aug;91(2):189-94
references: 12952114
references: J Asthma. 2009 May;46(4):413-20
references: 19484680
references: Allergy Asthma Proc. 2005 Jul-Aug;26(4):292-8
references: 16270723
references: Allergy Asthma Proc. 2003 Sep-Oct;24(5):323-9
references: 14619332
references: Drugs. 2007;67(6):887-901
references: 17428106
references: J Allergy Clin Immunol. 2002 Apr;109(4):636-42
references: 11941313
references: Allergy. 2012 Feb;67(2):158-65
references: 22103686
references: Clin Exp Allergy. 2009 Aug;39(8):1117-27
references: 19573037
references: Rhinology. 2007 Jun;45(2):112-21
references: 17708457
references: Allergy. 1999 Apr;54(4):358-65
references: 10371095
references: Allergy. 2000 Jan;55(1):11-5
references: 10696852
references: Pediatr Allergy Immunol. 2005 Aug;16(5):433-8
references: 16101937
references: Lancet. 1998 Apr 25;351(9111):1225-32
references: 9643741
references: Eur Respir J. 1998 Aug;12(2):315-35
references: 9727780
references: Clin Exp Allergy. 2003 Feb;33(2):206-10
references: 12580913
references: Am J Respir Crit Care Med. 2000 Jun;161(6):2051-7
references: 10852787
references: J Allergy Clin Immunol. 2001 Dec;108(6):929-37
references: 11742270
references: Pediatr Allergy Immunol. 2012 Jun;23(4):300-6
references: 22594930
references: J Allergy Clin Immunol. 2010 Sep;126(3):567-73.e1-8
references: 20816191
references: J Allergy Clin Immunol. 1992 Aug;90(2):215-24
references: 1354225
references: J Allergy Clin Immunol. 1998 Mar;101(3):410-20
references: 9525460
references: Chest. 1997 Feb;111(2 Suppl):11S-16S
references: 9042022
references: Clin Exp Allergy. 2008 Aug;38(8):1282-9
references: 18510694
references: Lancet. 2012 Aug 18;380(9842):651-9
references: 22901886
references: Respir Med. 2010 Oct;104(10):1577-80
references: 20637586
references: Clin Exp Allergy. 1997 Oct;27(10):1160-6
references: 9383256
references: Allergy Asthma Clin Immunol. 2009 Oct 22;5(1):4
references: 20016776
references: JAMA. 2001 Dec 19;286(23):2956-67
references: 11743836
references: J Allergy Clin Immunol. 2012 Feb;129(2):403-8
references: 22056609
references: Allergol Int. 2006 Dec;55(4):379-86
references: 17130680
references: Int J Pediatr Otorhinolaryngol. 2004 Aug;68(8):1007-15
references: 15236886
references: Pediatrics. 1994 Dec;94(6 Pt 1):895-901
references: 7971008
references: Ann Allergy Asthma Immunol. 2006 Jun;96(6):779-86
references: 16802764
references: Pediatrics. 2005 Jan;115(1):129-34
references: 15629992
references: J Allergy Clin Immunol. 2002 Nov;110(5):728-35
references: 12417881
references: Clin Exp Allergy. 2004 Dec;34(12):1883-9
references: 15663563
references: Pediatr Allergy Immunol. 2008 Aug;19 Suppl 19:51-9
references: 18665963
references: J Allergy Clin Immunol. 1995 May;95(5 Pt 1):923-32
references: 7751511
references: Pediatrics. 2000 Feb;105(2):E22
references: 10654982
references: J Immunol. 2013 Jan 15;190(2):539-48
references: 23241885
references: Pediatr Allergy Immunol. 2007 Sep;18(6):523-7
references: 17680911
references: Allergy. 2006 May;61(5):556-62
references: 16629784
references: J Allergy Clin Immunol. 2004 Oct;114(4):851-7
references: 15480326
references: Allergy. 2009 Jan;64(1):81-4
references: 19076535
references: J Allergy Clin Immunol. 1998 Feb;101(2 Pt 2):S352-6
references: 9500726
references: Am J Respir Crit Care Med. 2008 Oct 15;178(8):854-60
references: 18583576
references: Expert Rev Respir Med. 2013 Feb;7(1):13-7
references: 23362812
references: J Allergy Clin Immunol. 2001 Mar;107(3):469-76
references: 11240947
references: Front Biosci (Landmark Ed). 2012 Jan 01;17:430-7
references: 22201753
references: Allergy. 2007 Mar;62(3):310-6
references: 17298349
references: J Allergy Clin Immunol. 2000 Aug;106(2):253-9
references: 10932067
references: Clin Transl Allergy. 2012 Nov 02;2(1):21
references: 23121771
references: Eur Respir J. 1998 Jun;11(6):1268-73
references: 9657565
references: Chest. 2008 Nov;134(5):1037-1043
references: 18988778
references: J Allergy Clin Immunol. 2002 Feb;109(2):251-6
references: 11842293
references: J Allergy Clin Immunol. 1999 Sep;104(3 Pt 1):534-40
references: 10482824
references: Allergol Int. 2013 Mar;62(1):21-8
references: 23439055
references: Am J Respir Crit Care Med. 1999 Feb;159(2):588-95
references: 9927377
references: Pediatr Allergy Immunol. 2010 Feb;21(1 Pt 2):e119-26
references: 19744219
references: Ann Allergy Asthma Immunol. 2006 Dec;97(6):767-74
references: 17201236
references: J Allergy Clin Immunol. 2012 May;129(5):1282-1289.e10
references: 22418065
references: Clin Ther. 2011 Oct;33(10):1537-46
references: 21999887
references: Lancet. 2006 Aug 26;368(9537):754-62
references: 16935686
references: Clin Exp Allergy. 2004 Jul;34(7):1079-85
references: 15248853
references: Allergy Asthma Proc. 2002 Nov-Dec;23(6):407-13
references: 12528607
references: Ann Allergy Asthma Immunol. 2006 May;96(5):723-30
references: 16729787
references: Allergy. 2005 Mar;60(3):338-42
references: 15679719
references: Am J Med. 2004 Mar 1;116(5):338-44
references: 14984820
references: Am J Rhinol Allergy. 2011 Sep-Oct;25(5):e186-90
references: 22186236
references: Allergy. 2007 Sep;62(9):1051-6
references: 17686108
references: Ann Allergy Asthma Immunol. 2003 Aug;91(2):160-7
references: 12952110
references: Allergy. 2007 Aug;62(8):943-8
references: 17620073
references: BMC Pulm Med. 2006 Nov 30;6 Suppl 1:S4
references: 17140422
references: Pediatr Pulmonol. 2004 Sep;38(3):186-92
references: 15274095
references: J Allergy Clin Immunol. 1997 Dec;100(6 Pt 1):781-8
references: 9438487
references: Pediatr Allergy Immunol. 2007 Sep;18(6):535-42
references: 17561929
references: J Allergy Clin Immunol. 2005 Jan;115(1):142-8
references: 15637561
references: Curr Opin Allergy Clin Immunol. 2001 Feb;1(1):7-13
references: 11964663
references: N Engl J Med. 2006 May 11;354(19):1998-2005
references: 16687712
references: Allergy. 2004 Sep;59(9):973-9
references: 15291906