Chronic rhinosinusitis and psoriasis: do mutually exclusive systemic Th1 and Th2 disease patterns exist?

Abstract

Analysis of the data showed that occurrence of CRS rarely coincided with the occurrence of psoriasis and other such Th1 pathologies.

Increased risk of psoriasis following chronic rhinosinusitis without nasal polyps: a population-based matched-cohort study

“…One prior epidemiological study conducted on a retrospective electronic query of the medical records at Loyola University Hospital by Rashid et al. 9 further supported this understanding. From their analysis, they concluded that the occurrence of CRS rarely coincided with that of conditions with Th1 pathologies, including psoriasis.…”

“…It is possible that previous studies were not conducted investigating this association because of the prior understanding that CRS is a T helper (Th) 2 pathology. As psoriasis is a Th1 pathology, 9 it would be unlikely that the two conditions would be comorbid, as disorders associated with a bias towards Th1 immunity have been proposed to skew comorbidities away from manifestations conventionally attributed to Th2‐mediated pathways 15 . On the other hand, as the presence of one Th1 pathology has been demonstrated to be strongly associated with the presence/occurrence of other comorbid Th1 pathologies, 16 it would be more likely that CRS would be associated with other Th1 pathologies.…”

“…Psoriasis is another chronic, inflammatory, disease characterized by an exaggerated immune response to the microbiota residing on epithelial surfaces, 4 which typically presents with skin and joint manifestations 5–8 . Although psoriasis may very well share an underlying immune dysregulation with CRS as part of its pathology, only two studies investigating the immune responses of these conditions have been conducted to date 9,10 . Therefore, in order to expand the body of literature surrounding these two conditions and provide a real‐risk estimate for subsequent psoriasis among patients with CRS, this study was carried out to investigate the subsequent risk for psoriasis following a diagnosis of CRS by utilizing a cohort study design and population‐based dataset in Taiwan.…”

Chronic rhinosinusitis in the setting of other chronic inflammatory diseases

“…In contrast, a clear Th1 vs Th2 bias is not well demonstrated for other rheumatologic conditions, such as lupus and ankylosing spondylitis. A study by Rashid et al [6] suggested that autoimmune conditions may skew airway inflammatory disease away from Th2 pathways and would thus be associated with a decreased frequency of CRS. However, that study examined a limited sample of patients with autoimmune disorders (n = 1026 over a year period) and did not stratify CRS patients by NP status.…”

“…Other investigators have examined the hypothesis that the presence of comorbid autoimmune mediated conditions may also impact the prevalence of CRS subtypes [6]. Specifically, disorders associated with a bias toward Th1 immunity (eg, multiple sclerosis, psoriasis, rheumatoid arthritis) have been proposed to skew comorbidities away from manifestations conventionally attributed to Th2-mediated pathways [7].…”