Pathogenesis of chronic rhinosinusitis with nasal polyp and a prominent T2 endotype

Shah, Said Ahmad; Kobayashi, Masayoshi

doi:10.1016/j.heliyon.2023.e19249

Cited by 8 publications

(6 citation statements)

References 83 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Airway allergic disease (AAD) is a class of allergic disease types characterized by infiltration of T helper 2 (Th2) cells; this mainly includes allergic rhinitis (AR), allergic asthma (AS), and chronic sinusitis (CRS) (especially CRS with nasal polyps) ( 1 , 2 ). Th1/Th2 immune imbalance is an important factor leading to AAD.…”

Section: Introductionmentioning

confidence: 99%

Pathogenic role of different phenotypes of immune cells in airway allergic diseases: a study based on Mendelian randomization

Xu,

Li,

Wang

et al. 2024

Front. Immunol.

View full text Add to dashboard Cite

BackgroundAirway allergic disease (AAD) is a class of autoimmune diseases with predominantly Th2-type inflammation, mainly including allergic rhinitis (AR), allergic asthma (AS), and chronic sinusitis (CRS). There are very complex regulatory mechanisms between immune cells and AAD; however, previous reports found that the functions of the same immune cells in AAD are not identical.ObjectiveThe aim of this study was to explore the causal relationship between different phenotypic immune cells and their association with AAD.MethodUtilizing the publicly available Genome-Wide Association Studies (GWAS) database, this study conducted a bidirectional Mendelian randomization (MR) to assess the causal relationship between immune cells of 731 different immunophenotypes and AAD. The primary assessment methods included inverse variance weighting, weighted median, and MR Egger. Additionally, sensitivity analyses such as MR-PRESSO, leave-one-out, and scatter plots were employed to eliminate the interference of heterogeneity and pleiotropy, ensuring the stability of the causal inference.ResultA total of 38 immune cells with different immunophenotypes were found to be positively and causally associated with AR, of which 26 were protective factors and 12 were risk factors. Positive associations were found between 33 immune cells and AS, of which 14 were protective factors and 19 were risk factors, as well as between 39 immune cells and CRS, of which 22 were protective factors and 17 were risk factors. Finally, the results of all relevant immune cells for the three diseases were taken and intersected, and it was found that CD3 on CD39+-activated Treg (IVWAR = 0.001, IVWCRS = 0.043, IVWAS = 0.027) may be the key immune cell that inhibits the development of AAD (ORAR = 0.940, ORAS = 0.967, ORCRS = 0.976).ConclusionThis study reveals that different immune phenotypes of immune cells are closely related to AAD at the genetic level, which provides a theoretical basis for future clinical studies.

show abstract

Section: Introductionmentioning

confidence: 99%

Pathogenic role of different phenotypes of immune cells in airway allergic diseases: a study based on Mendelian randomization

Xu,

Li,

Wang

et al. 2024

Front. Immunol.

View full text Add to dashboard Cite

show abstract

“…The inflammatory processes involved in AR, including eosinophilic infiltration and release of inflammatory mediators, contribute to the development and progression of NP. Furthermore, AR may exacerbate symptoms and promote the recurrence of NP through ongoing inflammation and tissue remodeling [ 4 ]. This comprehensive review explores the intricate relationship between AR and NP, elucidating the underlying mechanisms linking these two conditions.…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Review Exploring Allergic Rhinitis With Nasal Polyps: Mechanisms, Management, and Emerging Therapies

Narasimhan,

Deshmukh,

Gaurkar

et al. 2024

Cureus

View full text Add to dashboard Cite

Allergic rhinitis (AR) and nasal polyps (NP) are common inflammatory disorders of the upper airways that often coexist and significantly impact patients' quality of life. This comprehensive review explores the intricate relationship between AR and NP, elucidating the underlying mechanisms, clinical manifestations, and management strategies. Immunological mechanisms, genetic predispositions, and environmental factors contribute to the development and progression of both conditions. Pharmacological therapies, including intranasal corticosteroids and biologic agents, are cornerstone treatments for managing AR with NP. At the same time, surgical interventions such as functional endoscopic sinus surgery (FESS) may be necessary in refractory cases. Emerging therapies, including immunomodulatory agents and precision medicine approaches, hold promise in improving treatment outcomes. A multidisciplinary approach, personalized treatment plans, and patient education are essential for optimizing clinical practice. Future research should focus on identifying novel therapeutic targets, conducting large-scale clinical trials, exploring precision medicine approaches, and investigating the role of the microbiome. Addressing these research priorities and implementing evidence-based treatment strategies can improve outcomes for patients with AR and NP.

show abstract

“…Furthermore, when talking about severe asthma, a low adherence has been reported both before starting and during biologic therapy [6], although poor disease control and an increased risk of asthma exacerbation have been described as the consequence of inappropriate asthma management [7,8]. CRSwNP represents the most relevant comorbidity affecting severe asthma patients in terms of prevalence and the burden of the disease and it shares with asthma an eosinophilic inflammatory background as the major pathobiological driver [9,10]. Its prevalence in the general population is estimated to be around 3-4% with a variability based on geographical area, but it increases to 40-60% in patients suffering from severe eosinophilic asthma [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…CRSwNP represents the most relevant comorbidity affecting severe asthma patients in terms of prevalence and the burden of the disease and it shares with asthma an eosinophilic inflammatory background as the major pathobiological driver [9,10]. Its prevalence in the general population is estimated to be around 3-4% with a variability based on geographical area, but it increases to 40-60% in patients suffering from severe eosinophilic asthma [10,11]. Though this is not a life-threatening condition, it heavily impacts the quality of life of affected patients, particularly because of the nasal obstruction with concomitant hypo/anosmia and sleep disturbances it causes [12].…”

Section: Introductionmentioning

confidence: 99%

Adherence to Intranasal Steroids in Chronic Rhinosinusitis with Nasal Polyposis Prior to and during Biologic Therapy: A Neglected Matter

Norelli,

Schiappoli,

Senna

et al. 2024

JCM

View full text Add to dashboard Cite

Adherence to treatment is essential in chronic rhinosinusitis with nasal polyposis (CRSwNP). Intranasal corticosteroids (INCS) are the first-line therapy, followed by systemic corticosteroids and surgery if needed. In cases of refractory disease, biologics are added to conventional treatment, making adherence to INCS crucial in assessing eligibility for these targeted therapies. The purpose of this review is to examine INCS adherence assessment and rate, before starting and during biologic therapy. We conducted a comprehensive literature review focusing on INCS adherence in CRSwNP treated with biologics, including randomized controlled trials and real-life studies. The search extended to studies on allergic and non-allergic rhinitis to provide broader insights into tools to assess the INCS adherence. The result was that adherence to INCS in CRSwNP is underexplored, with only a few studies addressing it directly. Various tools for adherence assessment have been identified, but none are universally accepted as standard. The review also highlights the complexity of factors influencing adherence rates. Effective CRSwNP management requires a paradigm shift to prioritize adherence in treatment guidelines and clinical practice. The review advocates for improved adherence assessment tools, a deeper understanding of influencing factors, and the integration of personalized medicine approaches, especially for biologic therapies.

show abstract

Pathogenesis of chronic rhinosinusitis with nasal polyp and a prominent T2 endotype

Cited by 8 publications

References 83 publications

Pathogenic role of different phenotypes of immune cells in airway allergic diseases: a study based on Mendelian randomization

Pathogenic role of different phenotypes of immune cells in airway allergic diseases: a study based on Mendelian randomization

A Comprehensive Review Exploring Allergic Rhinitis With Nasal Polyps: Mechanisms, Management, and Emerging Therapies

Adherence to Intranasal Steroids in Chronic Rhinosinusitis with Nasal Polyposis Prior to and during Biologic Therapy: A Neglected Matter

Contact Info

Product

Resources

About