Chronic rhinosinusitis: phenotypes and endotypes

Abstract

Purpose of review Chronic rhinosinusitis (CRS) is a broad classification of airway inflammation that affects a significant portion of the population. The current model of delineating patients suffering from CRS is dated and is no longer as simple as the presence of polyps or no polyps. Continued advances in the endotype descriptions of CRS have allowed for new phenotypic descriptions that aid in driving management and research efforts. Recent findings Geographic differences exist between patient presentations, which require a molecular evaluation of the driving forces. Increased understanding of these differences allows for patient-specific treatment decisions. Summary New descriptions of CRS phenotypes allow for more targeted therapy for patients, particularly to those with difficult to control disease. The previously broad classification of CRS with or without nasal polyps is no longer sufficient at driving these treatment decisions.

Tissue‐specific early and late activated lymphocytes immunophenotype in chronic rhinosinusitis with nasal polyps

“…Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex chronic inflammatory disease, with high socioeconomic and healthcare costs 1,2 . This pathology is characterized by a type 2 inflammatory response, involving innate inflammatory cells, differentiated Th2, 3 and regulatory T‐cells (Tregs) 4 . Our group demonstrated that in CRSwNP tissue, there is a higher percentage of CD3 + and CD8 + cells but a lower proportion of CD4 + cells than peripheral blood (PB).…”

Predictive Values of Serum IL-33 and sST2 in Endotypes and Postoperative Recurrence of Chronic Rhinosinusitis with Nasal Polyps

“…Chronic rhinosinusitis (CRS) is a common disease characterized by chronic sinonasal mucosal inflammation [ 1 ]. Recent epidemiological studies reported that CRS affected approximately 5.5–28% of the global population, and the prevalence continues to increase [ 2 – 4 ]. Based on the presence of nasal polyps, CRS is grouped into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) [ 5 ].…”

A Potential Role of B7-H4 Expression in Predicting the Recurrence of Chronic Rhinosinusitis with Nasal Polyps

“… 3–6 Previous studies have shown that CRSwNP was characterized by T helper 2 (Th2)-dominant inflammation and tissue eosinophils infiltration, which resulted in serious disease symptoms, poorer prognosis, and high recurrence rate of postoperative. 7 , 8 Recently, macrophages have been observed in nasal polyps, and the accumulation of mannose-receptor positive macrophages (M2 macrophages) was identified in nasal polyps in cell aggregates which suggests that they play a key role in the pathogen-macrophage interaction in CRSwNP. 9 Although medical treatment and nasal endoscopic surgery were the mainstream treatment in CRSwNP, there remains a large number of patients still suffer from relapse.…”