Chronic rhinosinusitis pathogenesis

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:136

Article

Stevens, Whitney W.¹  Lee, Robert J.^3,4  Schleimer, Robert P.^1,2  Cohen, Noam A.^3,5,6 

[1] Northwestern Univ, Dept Med, Div Allergy Immunol, Feinberg Sch Med, Chicago, IL 60611 USA

[2] Northwestern Univ, Dept Otolaryngol, Feinberg Sch Med, Chicago, IL 60611 USA

[3] Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, Perelman Sch Med, Philadelphia, PA USA

[4] Univ Penn, Dept Physiol, Perelman Sch Med, Philadelphia, PA 19104 USA

[5] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA

[6] Monell Chem Senses Ctr, Philadelphia, PA 19104 USA

关键词: Chronic rhinosinusitis;    nasal polyps;    mucociliary clearance;    epithelial cells;    inflammation;    microbiome;   

DOI  :  10.1016/j.jaci.2015.10.009

来源: Elsevier

【 摘 要 】

There are a variety of medical conditions associated with chronic sinonasal inflammation, including chronic rhinosinusitis (CRS) and cystic fibrosis. In particular, CRS can be divided into 2 major subgroups based on whether nasal polyps are present or absent. Unfortunately, clinical treatment strategies for patients with chronic sinonasal inflammation are limited, in part because the underlying mechanisms contributing to disease pathology are heterogeneous and not entirely known. It is hypothesized that alterations in mucociliary clearance, abnormalities in the sinonasal epithelial cell barrier, and tissue remodeling all contribute to the chronic inflammatory and tissue-deforming processes characteristic of CRS. Additionally, the host innate and adaptive immune responses are also significantly activated and might be involved in pathogenesis. Recent advancements in the understanding of CRS pathogenesis are highlighted in this review, with special focus placed on the roles of epithelial cells and the host immune response in patients with cystic fibrosis, CRS without nasal polyps, or CRS with nasal polyps.

【 授权许可】

Free