Chronic rhinosinusitis with and without nasal polyps: What is the difference?

Abstract

Chronic rhinosinusitis is a heterogeneous group of chronic sinus diseases that may consist of clearly different disease entities. Further investigation of the pathomechanisms of chronic rhinosinusitis and the introduction of appropriate disease markers have recently facilitated disease classification. Evaluation of inflammatory cell profiles, the differentiation of T-effector cells, characterization of remodeling processes such as fibrosis or edema formation, and innate or adaptive immunity products such as Toll-like receptors and immunoglobulins all provide tools to identify distinct disease entities within the group of chronic sinus diseases. This disease differentiation will not only increase our knowledge of the pathophysiology of sinusitis but may lead to new diagnostic and therapeutic strategies specifically targeted and adapted to the diagnosed disease entity.

High motility group box 1 (HMGB1) protein and its receptor for advanced glycation end products (RAGE) expression in chronic rhinosinusitis without nasal polyps

“…The prevalence of CRS has increased over the last decade and has become a serious health problem. CRS is associated with significant low quality of life index, comparable to levels noticed in patients with life-risk illnesses such as chronic obstructive pulmonary disease or congestive heart failure [16]. Although a number of contributing factors are recognized, the underlying cause and mechanism of this disease remain unknown, and definite curative treatment does not exist.…”

Glucocorticoid Resistance in the Upper Respiratory Airways

“…The histology of submucosal stroma demonstrates clear differences between CRSwNP and CRSsNP. In CRSwNP, the submucosal stroma usually is found with robust edema and low cellularity, in contrast to CRSsNP that characteristically involves more pronounced fibrosis and less edema [9].…”

“…Clinically, the differentiation of these two entities is made by the detection of nasal polyps by nasal endoscopy. However, the major differences between CRSsNP and CRSwNP concern histology and molecular biomarkers [9]. CRSsNP is characterized by neutrophil recruitment, light edema, increased remodelling [9] and a Th1-subset profile.…”

“…CRSsNP is characterized by neutrophil recruitment, light edema, increased remodelling [9] and a Th1-subset profile. In contrast, CRSwNP is characterized by an eosinophil recruitment, intense oedema, loose connective tissue and a Th1/Th2 mixed -subset profile, but with remarkable Th2 polarization [8][9][10].…”

The use of intranasal glucocorticosteroids in the treatment of rhinosinusitis: Focus on mometasone furoate

“…Прежде всего, его подразделяют на хронический РС без назальных полипов и полипозный РС. Хронический РС, включая ПРС, гистологически ха-рактеризуется повреждением эпителиального слоя, мета-плазией многорядного цилиндрического эпителия в мно-гослойный, лишенный ресничек, утолщением базальной мембраны, отеком подслизистого слоя и гиперплазией бокаловидных клеток [6], однако между этими формами существуют и четкие различия -при ПРС наблюдается более выраженный отек и низкая целлюлярность подсли-зистого слоя, в то время как при хроническом РС без по-липов -более выраженный фиброз и менее выраженный отек [25]. В свою очередь ПРС не является однородной патологией с точки зрения гистологического строения по-липов, особенностей клинических проявлений и возмож-ных этиологических факторов [7].…”