Neural control of the pathophysiology of allergic airway disease and its clinical implications: A focus on allergic rhinitis and asthma.

Abstract

Dysregulation of neuronal control of the upper and lower airways plays an important role in the pathogenesis of common allergic airway diseases, such as allergic rhinitis (AR) and asthma. Peripheral nervous system has been shown to regulate innate and adaptive immune responses by releasing neuropeptides and neurotransmitters in both the upper and lower airways. In addition, various airway nociceptors have been shown to mediate immune-inflammatory responses and influence type 2 immunity in patients with AR and asthma. Emerging evidence has suggested that pathophysiologic alterations in AR and asthma, such as mucosal inflammation, coughing, and upper and lower airway hyperreactivity, can be regulated by the nervous system. Targeting neural pathways has emerged as a promising strategy for achieving beneficial clinical efficacy in patients with AR and asthma. Understanding how neural control of the pathophysiology of allergic airway diseases will have significant implications for future translational studies. This review updates and highlights recent progress in research on the neural control of disease pathophysiology of AR and asthma and discusses clinical implications for future studies.