{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:24:04Z","timestamp":1792034644852,"version":"4.4.0"},"reference-count":299,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of \u201cone\u2010airway\u2010one\u2010disease,\u201d coined over 20\u2009years ago, is a simplistic approach of the links between upper\u2010 and lower\u2010airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper\u2010 and lower\u2010airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the \u201cEpithelial Barrier Hypothesis.\u201d This review determined that the \u201cone\u2010airway\u2010one\u2010disease\u201d concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme \u201callergic\u201d (asthma) phenotype combining asthma, rhinitis, and conjunctivitis. Rhinitis alone and rhinitis and asthma multimorbidity represent two distinct diseases with the following differences: (i) genomic and transcriptomic background (Toll\u2010Like Receptors and IL\u201017 for rhinitis alone as a local disease; IL\u201033 and IL\u20105 for allergic and non\u2010allergic multimorbidity as a systemic disease), (ii) allergen sensitization patterns (mono\u2010 or pauci\u2010sensitization versus polysensitization), (iii) severity of symptoms, and (iv) treatment response. In conclusion, rhinitis alone (local disease) and rhinitis with asthma multimorbidity (systemic disease) should be considered as two distinct diseases, possibly modulated by the microbiome, and may be a model for understanding the epidemics of chronic and autoimmune diseases.<\/jats:p>","DOI":"10.1111\/all.15679","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T04:14:08Z","timestamp":1676607248000},"page":"1169-1203","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":121,"title":["Rhinitis associated with asthma is distinct from rhinitis alone: The\n                    <scp>ARIA\u2010MeDALL<\/scp>\n                    hypothesis"],"prefix":"10.1111","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4061-4766","authenticated-orcid":false,"given":"J.","family":"Bousquet","sequence":"first","affiliation":[{"name":"Institute of Allergology Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"Allergology and Immunology Fraunhofer Institute for Translational Medicine and Pharmacology ITMP  Berlin Germany"},{"name":"University Hospital Montpellier  Montpellier France"},{"name":"Inserm, Equipe d\u2019Epid\u00e9miologie Respiratoire Int\u00e9grative, CESP  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8248-0663","authenticated-orcid":false,"given":"E.","family":"Mel\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education S\u00f6dersjukhuset, Karolinska Institutet  Stockholm Sweden"},{"name":"Sach\u00b4s Children and Youth Hospital, S\u00f6dersjukhuset  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4757-2156","authenticated-orcid":false,"given":"T.","family":"Haahtela","sequence":"additional","affiliation":[{"name":"Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8567-3252","authenticated-orcid":false,"given":"G. 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