Revisiting Asian chronic rhinosinusitis in the era of type 2 biologics

2021 ◽  
Author(s):  
Yin Yao ◽  
Ming Zeng ◽  
Zheng Liu
Keyword(s):  
Chronic Rhinosinusitis

scholarly journals Transcriptional Changes in Chronic Rhinosinusitis with Asthma Favor a Type 2 Molecular Endotype Independent of Polyp Status

2021 ◽  
Vol Volume 14 ◽  
pp. 405-413
Author(s):  
Amarbir S Gill ◽  
Abigail Pulsipher ◽  
Jorgen S Sumsion ◽  
Gretchen M Oakley ◽  
Laurie W Leclair ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Transcriptional Changes

Biological therapy of chronic rhinosinusitis

2021 ◽  
Vol 70 (2) ◽  
pp. 109-114
Author(s):  
Zuzana Balatková ◽  
Zdeněk Knížek ◽  
Jan Vodička ◽  
Jan Plzák
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Biological Therapy ◽  
Immunoglobulin E ◽  
Sinus Surgery ◽  
Therapeutic Choice ◽  
First Choice ◽  
Intranasal Steroids

The aim of this paper is to present an up-to-date information about therapeutical options in chronic rhinosinusitis with nasal polyps. First choice therapy is a long term regular application of intranasal steroids in combination with salinic solution douches. If this treatment is not eff ective enough, then the pulses of systemic steroids are indicated. If the sufficient control of the disease is not achieved, then surgery is a therapeutic choice; it means functional endoscopic sinus surgery in the extent corresponding to the extension of the sinus disease. However, there remains a certain group of patients in whom the results with this treatment are not optimal. The type 2 immunopathological response affects relevantly the course of the disease. Nowadays, the research is done in this field. Specific agents, which are able to block circulating inflammatory mediators or bind receptors for these mediators are developed and studied. The results of the studies having been completed by now are promising. Keywords: biological therapy – chronic rhinosinusitis – nasal polyps – dupilumab – immunoglobulin E – interleukin

scholarly journals Clinical Significance of Cytoplasmic IgE-Positive Mast Cells in Eosinophilic Chronic Rhinosinusitis

2020 ◽  
Vol 21 (5) ◽  
pp. 1843 ◽  
Author(s):  
Yuka Gion ◽  
Mitsuhiro Okano ◽  
Takahisa Koyama ◽  
Tokie Oura ◽  
Asami Nishikori ◽  
...  
Keyword(s):  
Mast Cell ◽  
Mast Cells ◽  
Chronic Rhinosinusitis ◽  
Clinical Significance ◽  
Severity Score ◽  
Cell Infiltration ◽  
Ige Receptor ◽  
Total Ige ◽  
Eosinophilic Chronic Rhinosinusitis

Cross-linking of antigen-specific IgE bound to the high-affinity IgE receptor (FcεRI) on the surface of mast cells with multivalent antigens results in the release of mediators and development of type 2 inflammation. FcεRI expression and IgE synthesis are, therefore, critical for type 2 inflammatory disease development. In an attempt to clarify the relationship between eosinophilic chronic rhinosinusitis (ECRS) and mast cell infiltration, we analyzed mast cell infiltration at lesion sites and determined its clinical significance. Mast cells are positive for c-kit, and IgE in uncinated tissues (UT) and nasal polyps (NP) were examined by immunohistochemistry. The number of positive cells and clinicopathological factors were analyzed. Patients with ECRS exhibited high levels of total IgE serum levels and elevated peripheral blood eosinophil ratios. As a result, the number of mast cells with membranes positive for c-kit and IgE increased significantly in lesions forming NP. Therefore, we classified IgE-positive mast cells into two groups: membrane IgE-positive cells and cytoplasmic IgE-positive cells. The amount of membrane IgE-positive mast cells was significantly increased in moderate ECRS. A positive correlation was found between the membrane IgE-positive cells and the radiological severity score, the ratio of eosinophils, and the total serum IgE level. The number of cytoplasmic IgE-positive mast cells was significantly increased in moderate and severe ECRS. A positive correlation was observed between the cytoplasmic IgE-positive cells and the radiological severity score, the ratio of eosinophils in the blood, and the total IgE level. These results suggest that the process of mast cell internalization of antigens via the IgE receptor is involved in ECRS pathogenesis.

P505 DUPILUMAB EFFECT ON TYPE 2 INFLAMMATION BIOMARKERS IN CHRONIC RHINOSINUSITIS WITH NASAL POLYPS AND NSAID-ERD

2020 ◽  
Vol 125 (5) ◽  
pp. S48
Author(s):  
A. White ◽  
S. Fujieda ◽  
T. Takabayashi ◽  
N. Daizadeh ◽  
Y. Deniz ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Type 2 Inflammation

scholarly journals Dupilumab: new opportunities for the treatment of asthma and chronic rhinosinusitis with nasal polyps

2021 ◽  
Vol 18 (1) ◽  
pp. 18-31
Author(s):  
Miramgul E. Dyneva ◽  
Gulyumkhan E. Aminova ◽  
Oksana Kurbacheva ◽  
Natalya I. Il'ina
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Human Monoclonal Antibody ◽  
High Rate ◽  
Cytokine Signaling ◽  
Main Task ◽  
Receptor Complexes ◽  
Target Individual ◽  
Type 2 Inflammation

Airway inflammation plays a key role in asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). The inflammatory process can vary in intensity thus affecting the clinical picture of the disease and, most importantly, the effectiveness of therapy. Today, there is still a high rate of growth in the incidence of asthma and CRSwNP and dissatisfaction with the effectiveness of existing therapy for severe forms of asthma, especially when asthma is associated with CRSwNP, so the main task is to find new approaches to diagnosis and therapy. The development of biologics is a promising step forward in achieving control of severe and poorly controlled asthma and recurrent CRSwNP that target individual and specific components of inflammation. One of the latest monoclonal antibodies is Dupilumab that has shown significant success in the treatment of asthma and CRSwNP. Dupilumab is a fully human monoclonal antibody directed against the -subunit of the Il-4 interleukin receptor (IL-4R), common to both IL-4 and IL-4/IL-13 receptor complexes. This contributes to the suppression of type 2 cytokine signaling (IL-4 and IL-13), since the IL-4/IL-13/STAT6 signaling pathway plays a crucial role in type 2-inflammation. Currently, Dupilumab is approved for the treatment of severe asthma and CRSwNP, so this article summarizes the main information about Dupilumab and its effectiveness in these diseases, as well as presents the results of clinical observation.

scholarly journals Pathophysiological and Clinical Aspects of Chronic Rhinosinusitis: Current Concepts

2021 ◽  
Vol 2 ◽  
Author(s):  
Stephan Vlaminck ◽  
Frederic Acke ◽  
Glenis K. Scadding ◽  
Bart N. Lambrecht ◽  
Philippe Gevaert
Keyword(s):  
Chronic Rhinosinusitis ◽  
Inflammatory Responses ◽  
Adaptive Immune System ◽  
Current Approach ◽  
Clinical Aspects ◽  
Adaptive Immune ◽  
Clinical Observations ◽  
Localized Disease ◽  
Primary Focus

Adult chronic rhinosinusitis (CRS) is a chronic inflammation of the mucosa of the nose and paranasal sinuses. According to the latest EPOS guidelines CRS should be regarded as primary or secondary with distinction between diffuse and localized disease. Further pathophysiologic research identified different inflammatory patterns leading to the term “endotyping of CRS.” The primary focus of endotyping is to define a dominant inflammatory type allowing for better orientation of therapy. The current approach proposes the differentiation between type 2 (eosinophilic) and non-type 2 inflammatory responses. In this review pathophysiological concepts of CRS will be discussed, focusing on the different inflammatory endotypes of T cells with special attention to the eosinophilic type 2 inflammatory response. The contribution of innate and adaptive immune system responses is presented. The possibility of endotyping based on sinonasal secretions sampling is brought to attention because it is indicative of corticosteroid responsiveness and available to most ENT surgeons. Furthermore, the clinical aspects of the three distinct phenotypes are analyzed in view of their characteristics, the related endoscopic findings, typical radiological imaging, histopathology findings, their relation toward allergy and obvious therapeutical implications. This overview will enable clinicians to relate pathophysiological patterns with clinical observations by explaining the different inflammatory mechanisms, hence providing a better understanding of therapy.

scholarly journals Therapeutic Options for Chronic Rhinosinusitis in N-ERD Patients

2021 ◽  
Vol 2 ◽  
Author(s):  
Rik J. L. van der Lans ◽  
Wytske J. Fokkens ◽  
Sietze Reitsma
Keyword(s):  
Chronic Rhinosinusitis ◽  
Treatment Options ◽  
Additional Treatment ◽  
Aspirin Therapy ◽  
Sinus Surgery ◽  
Shared Decision ◽  
Diffuse Type ◽  
Treatment Resistant ◽  
The Right

Patients with non-steroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (N-ERD) often suffer from chronic rhinosinusitis (CRS) with nasal polyps, a form of primary diffuse Type 2 CRS. Although this disease is also seen in NSAID-tolerant patients, CRS in N-ERD often is more severe and more treatment resistant; local nasal therapy (nasal corticosteroids) and endoscopic sinus surgery are employed like in NSAID-tolerant patients, but with limited and/or short-lived effects. This mini-review gives an overview of the current additional treatment options for CRS in N-ERD. As such diets, aspirin therapy after desensitization, antileukotriene therapy and biologicals are discussed based on the current body of literature. Selecting the right treatment strategy depends on shared-decision making, local availability and cooperation between ENT-surgeons, allergists, and pulmonologists.

Type 1/type 2 inflammatory cytokines correlate with olfactory function in patients with chronic rhinosinusitis

2020 ◽  
Vol 41 (5) ◽  
pp. 102587
Author(s):  
Xingyu Han ◽  
Dawei Wu ◽  
Zhifu Sun ◽  
Haili Sun ◽  
Qianwen Lv ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Inflammatory Cytokines ◽  
Olfactory Function
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