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Review
. 2024 Jan 5;25(2):730.
doi: 10.3390/ijms25020730.

Airways Type-2 Related Disorders: Multiorgan, Systemic or Syndemic Disease?

Francesco Giombi  1   2 , Gian Marco Pace  1   2 , Francesca Pirola  1 , Michele Cerasuolo  1   3 , Fabio Ferreli  1   2 , Giuseppe Mercante  1   2 , Giuseppe Spriano  1   2 , Giorgio Walter Canonica  2   4 , Enrico Heffler  2   4 , Sebastian Ferri  2   4 , Francesca Puggioni  2   4 , Giovanni Paoletti  2   4 , Luca Malvezzi  1   2   3
Affiliations
Review

Airways Type-2 Related Disorders: Multiorgan, Systemic or Syndemic Disease?

Francesco Giombi et al. Int J Mol Sci. .

Abstract

Chronic rhinosinusitis (CRS) has recently undergone a significant paradigm shift, moving from a phenotypical classification towards an "endotype-based" definition that places more emphasis on clinical and therapeutic aspects. Similar to other airway diseases, like asthma, most cases of CRS in developed countries exhibit a dysregulated type-2 immune response and related cytokines. Consequently, the traditional distinction between upper and lower airways has been replaced by a "united airway" perspective. Additionally, type-2 related disorders extend beyond respiratory boundaries, encompassing conditions beyond the airways, such as atopic dermatitis. This necessitates a multidisciplinary approach. Moreover, consideration of possible systemic implications is crucial, particularly in relation to sleep-related breathing diseases like Obstructive Sleep Apnoea Syndrome (OSAS) and the alteration of systemic inflammatory mediators such as nitric oxide. The trends in epidemiological, economic, and social burden are progressively increasing worldwide, indicating syndemic characteristics. In light of these insights, this narrative review aims to present the latest evidence on respiratory type-2 related disorders, with a specific focus on CRS while promoting a comprehensive perspective on the "united airways". It also introduces a novel concept: viewing these conditions as a multiorgan, systemic, and syndemic disease.

Keywords: asthma; atopic dermatitis; chronic rhinosinusitis; personalized medicine; type-2 inflammation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Broad view on type-2 related disorders from a multiorgan, systemic and syndemic perspective.
See this image and copyright information in PMC

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This research received no external funding.