Advances in rhinitis and rhinosinusitis in 2015

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:138

Article

Bachert, Claus^1,2,3  Gevaert, Elien^1,2 

[1] Ghent Univ Hosp, Upper Airways Res Lab, Ghent, Belgium

[2] Ghent Univ Hosp, ENT Dept, Ghent, Belgium

[3] Univ Stockholm, CLINTEC, Karolinska Inst, Div ENT Dis, S-10691 Stockholm, Sweden

关键词: Allergic rhinitis;    allergen components;    allergen-specific immunotherapy;    house dust mite;    chronic rhinosinusitis;    endotype;    type 2 cytokines;   

DOI  :  10.1016/j.jaci.2016.09.008

来源: Elsevier

【 摘 要 】

The last year has seen great progress in the understanding of upper airway disease and in its management. For allergic rhinitis, authors focused on the prediction of and effect on the natural course of disease. New evidence was published for the disease-modifying effect of allergen immunotherapy in terms of avoidance of new sensitizations and prevention of asthma in either randomized or real-life studies. Specifically, for patients with house dust mite allergies, which are often underestimated and difficult to diagnose, the efficacy of SQ house dust mite sublingual immunotherapy tablets has been demonstrated in patients with allergic rhinitis and asthma. For the first time, allergen immunotherapy significantly reduced asthma exacerbations. In patients with chronic rhinosinusitis, a novel endotyping approach purely based on T helper cell biomarkers has been developed and has shown clinical relevance through associations with asthma comorbidity and recurrence after surgery. Severe nasal polyposis with high risk for asthma comorbidity and disease recurrence is characterized by type 2 inflammatory patterns, including IgE antibodies to staphylococcal superantigens; several studies using biologic agents have targeted exactly this spectrum of mediators. This goes in parallel with new knowledge on even more type 2 mediators derived from epithelial cells, which will expand the number of possible candidates for innovative intervention.

【 授权许可】

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