From Nose to Lung: Advancing Integrated Care for Rhinitis and Asthma Across Disciplines

Rhinitis and asthma are the two most prevalent chronic airway diseases worldwide and co-occur in a substantial proportion of patients, yet they have historically been diagnosed and managed in separate clinical silos. The concept of the “united airway” reflects growing recognition that the upper and lower respiratory tracts function as a single anatomical and immunological unit, in which inflammation in one compartment influences disease activity in the other. Despite this, the clinical consequences of this interconnection remain incompletely translated into practice. Patients with both conditions carry a disproportionate burden: their disease is more severe, harder to control, and more costly to manage, yet existing guidelines and care pathways rarely account for the complexity of co-existing disease.This gap is not primarily a mechanistic one. Significant progress has been made on the shared immunological underpinnings of upper and lower airway inflammation, including Type 2 cytokine pathways, eosinophilic inflammation, and IgE-mediated responses. What remains underexplored is the clinical dimension: how different specialties like rhinology, allergy, pulmonology, paediatrics, primary care, and otolaryngology conceptualise, investigate, and treat the rhinitis–asthma patient, and what can be gained by closer alignment between them. Questions of particular relevance include how diagnostic criteria differ across specialties, which phenotypes and comorbidity patterns predict poor outcomes, and how integrated care models perform compared to single-specialty management.This Research Topic invites contributions from clinicians and clinical researchers across rhinology, allergy, pulmonology, paediatrics, and primary care. Its objective is to consolidate real-world clinical evidence and cross-specialty perspectives on the diagnosis, phenotyping, and management of patients with concurrent rhinitis and asthma, with the ultimate aim of informing more integrated, patient-centred care. It complements, rather than duplicates, existing Research Topics focusing on Type 2 inflammatory mechanisms, biologic selection, and immunomodulation by foregrounding the clinical, epidemiological, and health systems dimensions of the rhinitis–asthma relationship.We welcome submissions addressing, but not limited to, the following themes:• The united airway in clinical context: epidemiological evidence on co-prevalence, progression, and phenotypes of rhinitis and asthma across age groups and populations• Cross-specialty diagnosis: how rhinitis and asthma are identified, classified, and staged in different clinical settings, and where diagnostic gaps arise in patients with both conditions• Impact of comorbidity on outcomes: disease burden, symptom control, quality of life, and healthcare utilisation in patients with co-existing rhinitis and asthma• Integrated and interdisciplinary care models: real-world evidence on the effectiveness of unified care pathways, multidisciplinary clinics, and cross-specialty collaboration• Paediatric considerations: the natural history of rhinitis–asthma co-morbidity from childhood through to adulthood, and implications for early intervention• Primary care and community perspectives: how the rhinitis–asthma overlap is recognised and managed at the primary care level, and barriers to optimal care• Environmental and occupational determinants: the role of allergen exposure, air quality, and occupational triggers in driving disease across both airways• Patient-reported outcomes and shared decision-making: tools and strategies for capturing patient priorities in the context of complex, multi-system airway disease• Cross-specialty consensus and guideline development: progress and gaps in developing unified diagnostic and management frameworks for rhinitis and asthmaWe encourage submissions of original research, systematic reviews, narrative reviews, clinical trial reports, perspective articles, and case series that reflect the cross-specialty ethos of this collection. Topic editors: Diego Marcelo Conti, Giovanni Paoletti, Stefano Settimi, Eleonora M.C. Trecca Source: https://www.frontiersin.org/research-topics/76081/from-nose-to-lung-advancing-integrated-care-for-rhinitis-and-asthma-across-disciplines