Rethinking neutrophils and eosinophils in chronic rhinosinusitis

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:148

Review

Delemarre, Tim¹  Bochner, Bruce S.²  Simon, Hans-Uwe^3,4,5  Bachert, Claus^1,6,7 

[1] Univ Ghent, Upper Airways Res Lab, Fac Med, Ghent, Belgium

[2] Northwestern Univ, Div Allergy & Immunol, Dept Med, Feinberg Sch Med, Chicago, IL USA

[3] Univ Bern, Inst Pharmacol, Bern, Switzerland

[4] Sechenov Univ, Dept Clin Immunol & Allergol, Moscow, Russia

[5] Kazan Fed Univ, Inst Fundamental Med & Biol, Lab Mol Immunol, Kazan, Russia

[6] Karolinska Inst, Div ENT Dis, CLINTEC, Stockholm, Sweden

[7] Sun Yat Sen Univ, Int Airway Res Ctr, Affiliated Hosp 1, Guangzhou, Peoples R China

关键词: Chronic rhinosinusitis;    type 2 inflammation;    eosino-phils;    neutrophils;    activation;    extracellular traps;    Charcot-Leyden crystals;    IL-17;    biologicals;   

DOI  :  10.1016/j.jaci.2021.03.024

来源: Elsevier

【 摘 要 】

Chronic rhinosinusitis (CRS) often is characterized by an eosinophilic inflammatory pattern, nowadays referred to as type 2 inflammation, although the mucosal inflammation is dominated by neutrophils in about a third of the patients. Neutrophils are typically predominant in 50% of patients with CRS without nasal polyps, but also are found to play a role in patients with severe type 2 CRS with nasal polyp disease. This review aims at summarizing the current understanding of the eosinophilic and neutrophilic inflammation in CRS pathophysiology, and provides a discussion of their reciprocal interactions and the clinical impact of the mixed presentation in patients with severe type 2 CRS with nasal polyps. A solid understanding of these interactions is of utmost importance when treating uncontrolled severe CRS with nasal polyps with biologicals that are preferentially directed toward type 2 inflammation. We here focus on recent findings on both eosinophilic and neutrophilic granulocytes, their subgroups and the activation status, and their interactions in CRS. (J Allergy Clin Immunol 2021;148:327-35.)

【 授权许可】

Free