A Review of Classification Schemes for Chronic Rhinosinusitis with Nasal Polyposis Endotypes

Dennis, Steven K.; Lam, Kent; Luong, Amber U.

doi:10.1002/lio2.32

Cited by 100 publications

(109 citation statements)

References 37 publications

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“…Clinical symptoms include nasal congestion, postnasal drip, loss of sense of smell, facial pain/pressure, and headache . Using nasal endoscopy and/or radiological examinations, CRS can be divided into CRS without nasal polyposis (NP) and CRS with NP (CRSwNP) . Nasal polyps originate in the sinuses and can obstruct the sinuses and nasal passages …”

Section: Introductionmentioning

confidence: 99%

Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps

Villeneuve²,

et al. 2019

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Objectives/Hypothesis Establish treatment patterns and economic burden in US patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) versus without chronic rhinosinusitis (CRS). Determine comparative costs of subgroups with high clinical burden. Study Design Observational, retrospective, case‐control study. Methods This study matched patients with CRSwNP to patients without CRS (1:1) using the Truven Health MarketScan US claims database. Categorical and continuous variables were compared using McNemar test and paired t test (normal distribution) or Wilcoxon signed rank tests (non‐normal distribution). Within subgroups, χ2 and Wilcoxon or t tests were used (normal distribution). Results There were 10,841 patients with CRSwNP and 10,841 patients without CRS included. Mean age in the CRSwNP cohort was 45.8 years; 56.2% were male. During follow‐up, patients with CRSwNP had an increased diagnosis of asthma versus patients without CRS (20.8% vs. 8.1%, respectively; P < .001). Annual incremental costs were $11,507 higher for patients with CRSwNP versus those without CRS. Costs were higher in subgroups of patients with CRSwNP undergoing functional endoscopy sinus surgery (FESS), with a comorbid diagnosis of asthma, receiving oral corticosteroids, or macrolides versus the overall CRSwNP group. Patients with CRSwNP undergoing FESS had the highest costs of the four subgroups ($26,724, $22,456, $20,695, and $20,990, respectively). Conclusions Annual incremental costs were higher among patients with CRSwNP versus without CRS. Patients with CRSwNP with high clinical burden had higher overall costs than CRSwNP patients without. Level of Evidence NA Laryngoscope, 129:1969–1975, 2019

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Section: Introductionmentioning

confidence: 99%

Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps

Villeneuve²,

et al. 2019

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“…CRS is a heterogeneous disease and breaking down this complex disease by endotypes may lead to more targeted therapy. 36,37 Studies have implicated epithelial-derived cytokines, TSLP, IL-25, and IL-33, in a type-2 predominant eosinophilic endotype in asthma as well as CRS with nasal polyps. 38 …”

Section: Role Of Epithelial-derived Cytokines In Pathogenesis Of Airwmentioning

confidence: 99%

Sentinels at the wall: epithelial‐derived cytokines serve as triggers of upper airway type 2 inflammation

Patel

Kohanski

Maina

et al. 2018

Int Forum Allergy Rhinol

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Recent evidence has demonstrated an expanding role of respiratory epithelial cells in immune surveillance and modulation. Studies have been focusing on the earliest events that link epithelial injury to downstream inflammatory responses. Cytokines produced by and released from respiratory epithelial cells are among these early trigger signals. Epithelial-derived cytokines, namely thymic stromal lymphopoietin (TSLP), interleukin (IL)-25, and IL-33, have come to the forefront of recent investigations. Each of these 3 cytokines has been implicated in chronic rhinosinusitis (CRS), asthma, and atopy. Herein we review studies elucidating the roles of epithelial-derived cytokines in the pathobiology of upper airway disease, with particular emphasis on type 2 inflammatory conditions.

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“…Though a broad syndrome, CRS is often classified into two phenootypes based on the presence or absence of nasal polyps on nasal endoscopy. CRS without nasal polyps (CRSsNP) is characterized by a T helper type 1 (Th1) mediated pattern of inflammation and CRS with nasal polyps (CRSwNP) has greater propensity for a T helper type 2 (Th2) mediated immune response [3]. …”

Section: Introductionmentioning

confidence: 99%

Understanding the Role of Biofilms and Superantigens in Chronic Rhinosinusitis

Maina

Patel

Cohen

2018

Curr Otorhinolaryngol Rep

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Purpose of review: This review explores recent discoveries in our understanding of how biofilms and superantigens contribute to the pathogenesis of chronic rhinosinusitis (CRS). It also examines clinical implications and novel treatment approaches for biofilm associated CRS. Recent findings: While the role of biofilms in CRS has been studied for 14 years, research interest has now turned toward elucidating new methods of biofilm detection, microbial diversity, and novel treatment approaches. Recent studies on biofilm superantigens aim to clarify the immunological mechanisms of upper airway inflammation, particularly the type-2 response seen in nasal polyposis. Summary: Biofilms are a topic of research interest for their role in the pathogenesis of chronic rhinosinusitis, particularly when they elute superantigens. New studies on this topic focus on the molecular and cellular mechanisms at play.

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A Review of Classification Schemes for Chronic Rhinosinusitis with Nasal Polyposis Endotypes

Cited by 100 publications

References 37 publications

Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps

Cost burden and resource utilization in patients with chronic rhinosinusitis and nasal polyps

Sentinels at the wall: epithelial‐derived cytokines serve as triggers of upper airway type 2 inflammation

Understanding the Role of Biofilms and Superantigens in Chronic Rhinosinusitis

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