Immunological Aspects of Chronic Rhinosinusitis

Czerwaty, Katarzyna; Piszczatowska, Katarzyna; Brzost, Jacek; Ludwig, Nils; Szczepański, Mirosław J.; Dżaman, Karolina

doi:10.3390/diagnostics12102361

Cited by 7 publications

(12 citation statements)

References 161 publications

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“…CRS was classified by ENT specialists as CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP). CRSwNP can be classified into eosinophilic CRSwNP (eosCRSwNP) or non-eosinophilic CRSwNP (non-eosCRSwNP) based on the extent of eosinophilic inflammation in the polyp tissues [1,2]. The diagnosis of CRS implicates medical history, physical examination with nasal endoscopy and, if necessary, imaging features of mucosal inflammation.…”

Section: Introductionmentioning

confidence: 99%

Biologics for Chronic Rhinosinusitis—A Modern Option for Therapy

Cergan,

Berghi,

Dumitru

et al. 2023

Life

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Chronic rhinosinusitis (CRS) is an important ENT pathology which affects about 5–12% of the general population. The treatment of CRS can be pharmacological (nasal sprays, douches, systemic antibiotics and steroids), surgical (endoscopic sinus surgery) or immunological according to established algorithms. CRS was divided for many years into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). New ways of classifying CRS by endotypes (presence of neutrophilia, eosinophilia, fibrosis, glandular hypertrophy and epithelial dysmorphisms) appeared after the most recent understandings of the pathophysiology of the disease. Other classifications divide CRS into primary and secondary forms, localized/diffuse types and anatomical presentation. A new type of treatment has been administered in the last years, biologics. For the moment, biologics are indicated just in the cases of the patients who have undergone ESS or have contraindications for surgery and have bilateral polyps and meet a minimum of three of the following criteria: the necessity for systemic therapies with oral or parenteral corticosteroids or contraindications to systemic steroids, significant loss of smell or impaired QoL score, comorbid asthma and type 2 inflammation. This article aims to present the most relevant studies which used the three types of biologics (anti-IgE, anti-IL5 and anti-IL4/IL3) and wishes to increase the awareness of this new type of treatment that can be used in some CRS cases.

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Section: Introductionmentioning

confidence: 99%

Biologics for Chronic Rhinosinusitis—A Modern Option for Therapy

Cergan,

Berghi,

Dumitru

et al. 2023

Life

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“…82,83 In addition, IL-25 (also known as IL-17E) is a cytokine belonging to the IL-17 family that can be produced by Th2 cells and plays an important role in promoting Th2-mediated inflammation. 84 Studies have shown that IL-25 can directly promote the increase in MUC5AC expression by activating hypoxia-inducing factor 1α, 85 and indirectly promote the secretion of MUC5AC and MUC5B by promoting the production of IL-4, IL-5, IL-13. 86 2.2.2 | IL-5 and mucin IL-5 is mainly produced by Th2 cells and ILC2 cells, and partially by mast cells and natural killer cells.…”

Section: Tnf-α and Mucinmentioning

confidence: 99%

Characteristics of mucin hypersecretion in different inflammatory patterns based on endotypes of chronic rhinosinusitis

Zhai,

Shao,

et al. 2024

Clinical & Translational All

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BackgroundChronic rhinosinusitis (CRS) is usually accompanied by mucin hypersecretion that can lead to mucus accumulation and impair nasal mucociliary clearance, thus exacerbating airway inflammation. Abnormal mucin hypersecretion is regulated by different T helper (Th) cytokines, which are associated with different endotype‐driven inflammatory responses. Therefore, it is of great significance to understand how these factors regulate mucin hypersecretion to provide precise treatment strategies for different endotypes of CRS.BodyThus far, the most common endotypes of CRS are classified as type 1, type 2, or type 3 immune responses based on innate and adaptive cell‐mediated effector immunity, and the representative Th cytokines in these immune responses, such as IFN‐γ, TNF‐α, IL‐4, IL‐5, IL‐13, IL‐10, IL‐17, and IL‐22, play an important regulatory role in mucin secretion. We reviewed all the related literature in the PubMed database to determine the expression of these Th cytokines in CRS and the role they play in the regulation of mucin secretion.ConclusionWe believe that the main Th cytokines involved in specific endotypes of CRS play a key role in regulating abnormal mucin secretion, which contributes to better understanding of the pathogenesis of CRS and provides therapeutic targets for airway inflammatory diseases associated with mucin hypersecretion.

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“…The non-type 2 classification includes all other unknown factors regarding inflammation and may change over time [43]. There are also literature works that divide non-type 2 inflammatory endotypes into type 1 and type 3 endotypes [48].…”

Section: Endotypementioning

confidence: 99%

“…Genomics and proteomics studies, which can examine the entire genetic information in an unbiased and independent manner [180], are effective ways to determine the pathogenesis of non-type 2 endotype in the future. In addition, further studies on the pathogenesis of non-type 2 endotype in CRS are needed at least in the following aspects [46,48], as shown in Table 2 [46,65,78,79,103,106,181,182].…”

Section: Future Research Directionsmentioning

confidence: 99%

A Decade of Pathogenesis Advances in Non-Type 2 Inflammatory Endotypes in Chronic Rhinosinusitis: 2012–2022

Cui,

Zhu,

Zhao

et al. 2023

Int Arch Allergy Immunol

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Chronic rhinosinusitis (CRS) is a heterogeneous disease characterized by localized inflammation of the upper airways. CRS includes two main phenotypes, namely, CRS with nasal polyps and CRS without nasal polyps. The phenotype-based classification method cannot reflect the pathological mechanism. The endotype-based classification method has been paid more and more attention by researchers. It is mainly divided into type 2 and non-type 2 endotypes. The mechanism driving the pathogenesis of non-type 2 inflammation is currently unknown. In this review, the PubMed and Web of Science databases were searched to conduct a critical analysis of representative literature works on the pathogenesis of non-type 2 inflammation in CRS published in the past decade. This review summarizes the latest evidence that may lead to the pathogenesis of non-type 2 inflammation. It is the main method that analyzing the pathogenesis from the perspective of immunology. Genomics and proteomics technique provide new approaches to the study of the pathogenesis. Due to differences in race, environment, geography, and living habits, there are differences in the occurrence of non-type 2 inflammation, which increase the difficulty of understanding the pathogenesis of non-type 2 inflammation in CRS. Studies have confirmed that non-type 2 endotype is more common in Asian patients. The emergence of overlap and unclassified endotypes has promoted the study of heterogeneity in CRS. In addition, as the source of inflammatory cells and the initiation site of the inflammatory response, microvessels and microlymphatic vessels in the nasal mucosal subepithelial tissue participate in the inflammatory response and tissue remodeling. It is uncertain whether CRS patients affect the risk of infection with SARS-CoV-2. In addition, the pathophysiological mechanism of non-type 2 CRS combined with COVID-19 remains to be further studied, and it is worth considering how to select the befitting biologics for CRS patients with non-type 2 inflammation.

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Immunological Aspects of Chronic Rhinosinusitis

Cited by 7 publications

References 161 publications

Biologics for Chronic Rhinosinusitis—A Modern Option for Therapy

Biologics for Chronic Rhinosinusitis—A Modern Option for Therapy

Characteristics of mucin hypersecretion in different inflammatory patterns based on endotypes of chronic rhinosinusitis

A Decade of Pathogenesis Advances in Non-Type 2 Inflammatory Endotypes in Chronic Rhinosinusitis: 2012–2022

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