Manifesto on united airways diseases (UAD): an Interasma (global asthma association - GAA) document

Angelica Tiotiu, Department of Pulmonology, University Hospital of Nancy, Nancy, France.
Plamena Novakova, Clinic of Clinical Allergy, Medical University Sofia, Sofia, Bulgaria.
Ilaria Baiardini, Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Andras Bikov, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Herberto Chong-Neto, Division of Allergy and Immunology, Department of Pediatrics, Federal University of Paraná, Curitiba, Brazil.
Jaime Correia- de-Sousa, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
Alexander Emelyanov, Department of Respiratory Medicine, North-Western Medical University named after I.I.Mechnikov, St-Petersburg, Russia.
Enrico Heffler, Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Guillermo Guidos Fogelbach, Clinic of Clinical Allergy, Medical University Sofia, Sofia, Bulgaria.
Krzysztof Kowal, Department of Allergology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.
Marina Labor, Värnamo Hospital, Jönköping district, Sweden.
Stefan Mihaicuta, Pulmonology Department, Cardio Prevent Foundation, University of Medicine and Pharmacy "Dr Victor Babes", Timisoara, Romania.
Denislava Nedeva, Clinic of Clinical Allergy, Medical University Sofia, Sofia, Bulgaria.
Sylvia Novakova, Allergy Unit of Internal Consulting Department, University Hospital "St. George", Plovdiv, Bulgaria.
Paschalis Steiropoulos, Department of Respiratory Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Ignacio J. Ansotegui, Hospital Quirónsalud Bizkaia, Bilbao, Spain.
Jonathan A. Bernstein, Department of Internal Medicine, Division of Immunology, Allergy Section University of Cincinnati, Cincinnati, OH, USA.
Louis-Philippe Boulet, Québec Heart and Lung Institute-Laval University, Québec City, Canada.
Giorgio Walter Canonica, Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Lawrence Dubuske, Division of Allergy and Immunology, Department of Internal Medicine, George Washington University School of Medicine and Health Sciences, George Washington University Medical Faculty Associates, Washington, DC, USA.
Carlos Nunes, Centro de ImmunoAlergologia de Algarve, Porto, Portugal.
Juan Carlos Ivancevich, Immunology Department, Faculty of Medicine, del Salvador University, Buenos Aires, Argentina.
Pierachille Santus, Department of Biomedical and Clinical Sciences, University of Milan, Division of Respiratory Diseases "L. Sacco" Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
Nelson Rosario, Federal University of Paraná (UFPR), Curitiba, Brazil.
Tommaso Perazzo, Department of Internal Medicine, University of Genoa, Genova, Italy.
Fulvio Braido, Department of Internal Medicine, University of Genoa, Genova, Italy.

Document Type

Journal Article

Publication Date

4-1-2022

Journal

The Journal of asthma : official journal of the Association for the Care of Asthma

Volume

59

Issue

4

DOI

10.1080/02770903.2021.1879130

Keywords

Interasma; United Airways Diseases; consensus; manifesto

Abstract

OBJECTIVE: The large amount of evidence and the renewed interest in upper and lower airways involvement in infectious and inflammatory diseases has led Interasma (Global Asthma Association) to take a position on United Airways Diseases (UAD). METHODS: Starting from an extensive literature review, Interasma executive committee discussed and approved this Manifesto developed by Interasma scientific network (INES) members. RESULTS: The manifesto describes the evidence gathered to date and defines, states, advocates, and proposes issues on UAD (rhinitis, rhinosinusitis and nasal polyposis), and concomitant/comorbid lower airways disorders (asthma, chronic obstructive pulmonary disease, bronchiectasis, cystic fibrosis, obstructive sleep apnoea) with the aim of challenging assumptions, fostering commitment, and bringing about change. UAD refers to clinical pictures characterized by the coexistence of upper and lower airways involvement, driven by a common pathophysiological mechanism, leading to a greater burden on patient's health status and requiring an integrated diagnostic and therapeutic plan. The high prevalence of UAD must be taken into account. Upper and lower airways diseases influence disease control and patient's quality of life. CONCLUSIONS: Patients with UAD need to have a timely and adequate diagnosis, treatment, and, when recommended, referral for management in a specialized center. Diagnostic testing including skin prick or serum specific IgE, lung function, fractional exhaled nitric oxide (FeNO), polysomnography, allergen-specific immunotherapies, biological therapies and home based continuous positive airway pressure (CPAP) whenever these are recommended, should be part of the management plan for UAD. Education of medical students, physicians, health professionals, patients and caregivers on the UAD is needed.

Department

Medicine

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